Agave nectar, placebo both perceived better than doing nothing for cough in kids

Pasteurized agave nectar and placebo were both perceived to be better by parents for treating nighttime cough and the resulting sleep difficulty in infants and toddlers than doing nothing at all, according to a study published in JAMA Pediatrics.

Cough is a frequent symptom in children and one of the main reasons they visit a professional. Little evidence supports the use of over-the-counter medicine for acute cough. An alternative to treat cough is honey but children younger than 1 year are precluded from consuming honey because of concerns over infant botulism. Agave nectar has properties similar to honey but has not been associated with botulism.

Researchers Ian M. Paul, M.D., M.Sc., of the Penn State College of Medicine, Hershey, Penn., and colleagues compared treatment with agave nectar, or no treatment at all on nighttime cough and the accompanying sleep disturbance in a group of 119 children who were randomized to one of the three treatment groups. The one-night study included children 2 to 47 months old who had nonspecific acute cough for seven days or less.

Study results indicate that agave nectar and placebo resulted in perceived symptom improvement by parents compared with no treatment, but agave nectar did not outperform placebo when a comparison was made between the two.

"Both physicians and parents want symptomatic relief for children with these common and annoying illnesses. The significant found warrants consideration as and parents determine how best to manage the disruptive symptoms that occur in the setting of upper among young children. Placebo could offer some perceived benefit, although at a financial cost, while reducing inappropriate antibiotic prescribing," the study concludes.

In a related editorial, James A. Taylor, M.D., and Douglas J. Opel, M.D., M.P.H., of the University of Washington, Seattle, write: "Although the study intervention provided no more relief from cough symptoms than placebo, both treatments were statistically superior to no treatment. The investigators contend that these findings are indicative of a placebo effect."

"Rather, what the investigators are observing in this study is a placebo effect in the parents who assessed outcomes in study children using a symptom questionnaire," they continue.

"As investigators such as Paul and colleagues continue to evaluate pharmacologic treatments, perhaps we should also conduct research designed to identify other components of care (e.g., communication techniques and nonspecific treatments) that improve outcomes after visits to clinicians by with cold symptoms, even if the improvement is simply caused by a placebo effect, as broadly characterized," the authors conclude.

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Honey a sweet treatment for kids' night-time cough

More information: JAMA Pediatr. Published online October 27, 2014. DOI: 10.1001/jamapediatrics.2014.1609
JAMA Pediatr. Published online October 27, 2014. DOI: 10.1001/jamapediatrics.2014.2355
Journal information: JAMA Pediatrics

Citation: Agave nectar, placebo both perceived better than doing nothing for cough in kids (2014, October 27) retrieved 19 July 2019 from
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