Natural antitussive products for children and adolescents: darkness and shadow

Acute viral respiratory infections, usually the common cold, precede the acute post-viral cough (APVC): a common complaint in childhood and adolescence. The use of cough relievers is, therefore, relevant, as documented by the market data. Several medical devices for treating APVC contain natural components. The present article reviewed the most commonly sold products in Italy. The natural agents may include polyphenols, flavonoids, saponins, glucosides, and alkaloids, contained in different botanical varieties, including Althea officinalis, Grindelia robusta, Helichrysum italicum, Plantago lanceolata, and Thymus vulgaris, and honey. Also, the European Medicine Agency (EMA) has recognized the value of some plant extracts and other natural substances to relieve APVC. These natural components are present in some products available in Italy. The Task Force on nutraceuticals and medical devices of the Italian Society of Pediatric Allergy and Immunology (SIAIP) analyzed and discussed the data concerning these products, also including honey. A few clinical studies investigated the role of non-pharmacologic remedies for APVC. Also, the evidence generally is scarce and of poor quality. Doctors should prescribe APVC natural relievers knowing their precise composition, available literature, posology, and safety. On the other hand, peripheral antitussive agents are effective and safe.