Pasteurized agave nectar and placebo were both perceived to be better by parents for the treatment of nighttime cough and also the resulting sleep difficulty in toddlers and infants than doing nothing at all, based on a study published in JAMA Pediatrics.
Cough is really a frequent overuse injury in children and one from the major causes they visit a health care professional. Little evidence props up utilization 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 much like honey but is not related to botulism.
Researchers Ian M. Paul, M.D., M.Sc., of the Penn State College of drugs, Hershey, Penn., and colleagues compared treatment with agave nectar, placebo or no treatment whatsoever on nighttime cough and also the accompanying sleep disturbance inside a number of 119 children who have been 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 led to perceived symptom improvement by parents in contrast to no treatment, but agave nectar didn’t outperform placebo when a comparison was made between the two.
“Both physicians and fogeys want symptomatic relief for children with one of these common and annoying illnesses. The significant placebo effect found warrants consideration as health care providers and fogeys determine how better to manage the disruptive symptoms that exist in the setting of upper respiratory system infections among young kids. Placebo could offer some perceived benefit, although in a financial cost, while reducing inappropriate antibiotic prescribing,” the study concludes.
In an associated editorial, James A. Taylor, M.D., and Douglas J. Opel, M.D., M.P.H., of the University of Washington, Seattle, write: “Even though the study intervention provided no more relief from cough symptoms than placebo, both treatments were statistically better than no treatment. The investigators contend these findings are suggestive of a placebo effect.”
“Rather, exactly what the investigators are observing within this study is really a placebo effect in the parents who assessed outcomes in study children using a cough symptom questionnaire,” they continue.
“As investigators such as Paul and colleagues continue to evaluate pharmacologic treatments, perhaps we should also conduct research made to identify other components of care (e.g., communication techniques and nonspecific treatments) that improve outcomes after appointments with clinicians by kids with cold symptoms, even if the improvement is simply caused by a placebo effect, as broadly characterized,” the authors conclude.