Optimization of cough control in children with acute upper respiratory infections: results of an observational study
https://doi.org/10.22627/2072-8107-2025-24-3-34-43
Abstract
It is important to individualize therapy goals, including control of the cough reflex and inflammation suppression when treating cough in children with acute respiratory viral infections (ARVI).
Aim. To evaluate the efficacy and safety of the drug Rengalin in children over 3 years old with ARVI in clinical practice, focusing on cough management capabilities, an observational non-interventional program was conducted.
Methods. The study included 90 children with ARVI and cough, divided into three groups: monotherapy with Rengalin (Group 1, n = 31), combined treatment Rengalin and a Mucolytic (Group 2, n = 29), and monotherapy with a Mucolytic (Group 3, n = 30). Patients were monitored in a day hospital with follow-up visits on days 1.4 (±1), and 8 (±1). ARVI symptoms, cough severity was assessed using the specialized scales, therapy effectiveness was evaluated based on physicians' and parents' opinions, and adverse events were recorded.
Results. At visit 2 by day 3 of therapy, a significant reduction in cough severity was observed in Groups 1 and 2 (p < 0.0001), whereas Group 3 showed no statistically significant difference (p = 0.53). By day 7, at visit 3, the total cough score was significantly lower in patients receiving Rengalin: Group 1 — 0.6 ± 0.9, Group 2 — 1.2 ± 1.0, Group 3 — 2.8 ± 1.5; p1—3, 2—3 < 0.0001, and the proportion with a cough severity scale score of ≤1 point was significantly higher (93.5%, 75.9% and 23.3% in groups 1, 2 and 3, respectively (p1—3, 2—3 < 0.0001). No adverse events were reported.
Conclusions. Rengalin therapy, whether as monotherapy or combined with a mucolytic agent, provides better control of cough compared to mucolytic monotherapy and is well tolerated in children.
About the Authors
E. G. KondiurinaRussian Federation
Novosibirsk
L. A. Shpagina
Russian Federation
Novosibirsk
N. G. Timinskaia
Russian Federation
Novosibirsk
Y. A. Tatarenko
Russian Federation
Novosibirsk
V. V. Zelenskaia
Russian Federation
Novosibirsk
References
1. Geppe NA, Kozlova LV, Gorelov AV, Kondyurina EG, Malahov AB. Ostrye infekcii dyhatel'nyh putej u detej: diagnostika, lechenie, profilaktika: klinicheskoe rukovodstvo. M.: MedKom-Pro. 2018:200. (In Russ.)
2. Andrani F, Aiello M, Bertorelli G at al. Cough, a vital reflex. mechanisms, determinants and measurements. Acta Biomed. 2019 Jan 15; 89(4):477—480.
3. Marseglia GL, Manti S, Chiappini E at al. Acute cough in children and adolescents: A systematic review and a practical algorithm by the Italian Society of Pediatric Allergy and Immunology. Allergol Immunopathol (Madr). 2021 Mar 1; 49(2):155—169.
4. Rouadi PW, Idriss SA, Bousquet J at al. WAO — ARIA consensus on chronic cough: Executive summary. World Allergy Organ J. 2025 Feb 24; 18(3):101034.
5. Acute respiratory infection (ARVI). Clinical guidelines. 2022. URL: https://cr.minzdrav.gov.ru/preview-cr/25_2 . (In Russ.)
6. Mameli C, Picca M, Buzzetti R at al. Italian Society of Paediatrics Lombardy Section. Incidence of acute respiratory infections in preschool children in an outpatient setting before and during Covid-19 pandemic in Lombardy Region, Italy. Ital J Pediatr. 2022 Feb 3; 48(1):18.
7. Pappas DE. The Common Cold. Principles and Practice of Pediatric Infectious Diseases. 2018:199—202.e1.
8. Monto AS, Foster-Tucker JE, Callear AP at al. Respiratory Viral Infections From 2015 to 2022 in the HIVE Cohort of American Households: Incidence, Illness Characteristics, and Seasonality. J Infect Dis. 2025 Mar 17; 231(3):795—804.
9. Garzon Mora N, Jaramillo AP, Briones Andriuoli R at al. An Overview of the Effectiveness of Corticoids in Croup: A Systematic Literature Review. Cureus. 2023 Oct 1; 15(10):e46317.
10. Cao AM, Choy JP, Mohanakrishnan LN at al. Chest radiographs for acute lower respiratory tract infections. Cochrane Database Syst Rev. 2013 Dec 26; 2013(12):CD009119.
11. Marseglia GL, Pagella F, Klersy C at al. The 10-day mark is a good way to diagnose not only acute rhinosinusitis but also adenoiditis, as confirmed by endoscopy. Int J Pediatr Otorhinolaryngol. 2007 Apr; 71(4):581—3.
12. Gilchrist FJ. An approach to the child with a wet cough. Paediatr Respir Rev. 2019 Aug; 31:75—81.
13. Martin J, Townshend J, Brodlie M. Diagnosis and management of asthma in children. BMJ Paediatr Open. 2022 Apr; 6(1):e001277.
14. Costantino S, Torre A, Foti Randazzese S at al. Association between Second-Hand Exposure to E-Cigarettes at Home and Exacerbations in Children with Asthma. Children (Basel). 2024 Mar 18; 11(3):356.
15. Thompson M, Vodicka TA, Blair PS at al. TARGET Programme Team. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ. 2013 Dec 11; 347:f7027.
16. Morice AH, Millqvist E, Bieksiene K at al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J. 2020 Jan 2; 55(1):1901136. doi: 10.1183/13993003.01136-2019.
17. Bergmann M, Haasenritter J, Beidatsch D at al. Coughing children in family practice and primary care: a systematic review of prevalence, aetiology and prognosis. BMC Pediatr. 2021 Jun 4; 21(1):260.
18. Cheng ZR, Chua YX, How CH, Tan YH. Approach to chronic cough in children. Singapore Med J. 2021 Oct; 62(10):513—519.
19. Weinberger M. Chronic Cough and Causes in Children. J Clin Med. 2023 Jun 9; 12(12):3947.
20. Jin HJ, Kim CW. Understanding the Impact of Chronic Cough on the Quality of Life in the General Population. Allergy Asthma Immunol Res. 2020 Nov; 12(6):906—909.
21. McGovern AE, Short KR, Kywe Moe AA, Mazzone SB. Translational review: Neuroimmune mechanisms in cough and emerging therapeutic targets. J Allergy Clin Immunol. 2018 Nov; 142(5):1392—1402.
22. Naqvi KF, Mazzone SB, Shiloh MU. Infectious and Inflammatory Pathways to Cough. Annu Rev Physiol. 2023 Feb 10; 85:71—91.
23. Song WJ, Chang YS, Morice AH. Changing the paradigm for cough: does 'cough hypersensitivity' aid our understanding? Asia Pac Allergy. 2014 Jan; 4(1):3—13.
24. KarpovaE.P. Novoe reshenie problemy vybora preparata dlya patogeneticheski obosnovannoj terapii kashlya u detej. Voprosy Рrakticheskoj Рediatrii, 2015; 10(6):61—67. (In Russ.)
25. Kotova O.O. Sovremennye predstavleniya o roli kanalov s tranzitornym receptornym potencialom vanilloidnogo podsemejstva (TRPV) v razvitii osmoticheskoj giperreaktivnosti dyhatel'nyh putej u bol'nyh bronhial'noj astmoj (obzor literatury). Byulleten' fiziologii i patologii dyhaniya. 2021; (81):115—125. (In Russ.)
26. Zhang, M., Ma, Y., Ye, X. et al. TRP (transient receptor potential) ion channel family: structures, biological functions and therapeutic interventions for diseases. Sig Transduct Target The.; 2023; 8:261.
27. Zygmunt PM, Högestätt ED. TRPA1. Handb Exp Pharmacol. 2014; 222:583—630.
28. Zholos AV. TRP Channels in Respiratory Pathophysiology: the Role of Oxidative, Chemical Irritant and Temperature Stimuli. Curr Neuropharmacol. 2015; 13(2):279—91
29. Canning BJ. Afferent nerves regulating the cough reflex: mechanisms and mediators of cough in disease. Otolaryngol Clin North Am. 2010 Feb; 43(1):15—25.
30. Mazzone SB. Neurobiology of Coughing in Children. J Clin Med. 2023 Nov 24; 12(23):7285.
31. Grace MS, Baxter M, Dubuis E at al.. Transient receptor potential (TRP) channels in the airway: role in airway disease. Br J Pharmacol. 2014 May; 171(10):2593—607.
32. Kompleksalgoritmov lekarstvennoj terapii zabolevanij dyhatel'nyh putej «Traektoriya kashlya». Metodicheskoe posobie dlya vrachej. Pod red. Geppe N.A. 3 iss. Moscow: Tinkomarketing, 2023:116. (In Russ.)
33. Foti Randazzese S, Toscano F, Gambadauro A at al. Neuromodulators in Acute and Chronic Cough in Children: An Update from the Literature. Int J Mol Sci. 2024 Oct 18; 25(20):11229.
34. Kashel'. A.G. CHuchalin, V.N. Abrosimov. 4 iss. Moscow: GEOTAR-Media, 2017:150. (In Russ.)
35. Rengalin. Summary of Product Characteristics (SPCs). Unified Register of Registered medicines of the Eurasian Economic Union. https://eec.eaeunion.org.
36. Obshchaya farmakopejnaya stat'ya Gosudarstvennoj farmakopei Rossijskoj Federacii XV izdaniya, OFS.1.7.0001 Biologicheskie lekarstvennye preparaty, poluchennye na osnove gradual'noj tekhnologii. https://pharmacopoeia.regmed.ru/pharmacopoeia/izdanie-15/1/1-9/biologicheskielekarstvennye-preparaty-poluchennye-na-osnove-gradualnoy-tekhnologii/ date of access: 25.05.2025 (In Russ.)
37. Akopov A.L., Aleksandrova E.B., Il'kovich M.M. et al. Rengalin, a New Efficacious and Safe Antitussive Agent. Results of a Randomized, Comparative, Multicenter Clinical Trial in Patients with Acute Respiratory Tract Infections. Antibiotiki i Himioterapiya. 2015; 60:19—26. (In Russ.)
38. Blokhin B. M. An Actual Approach to the Problem of Cough in Acute Respiratory Infections in Children. Voprosy Sovremennoi Рediatrii. 2016; 15(1):100—104. doi: 10.15690/vsp.v15i1.1506 (In Russ.)
39. Klyachkina I.L. Modern approach to solve problems with cough in acute respiratory infections in adults. Farmateka. 2016; 4:35—40. (In Russ.)
40. Geppe N.A., Spasskii A.A. The results of the All-Russian Observational Program for the Study of Rengalin in Outpatient Management of Cough (REAL). Therapy. 2018; 3(21):134—143 (In Russ.)
41. Zaitsev AA, Vizel AA, Shakirova GR, Kulagina ITs, Ternovskaya NA. Clinical efficacy of Rengalin coughsuppressant therapy in patients with new coronavirus infection (COVID-19). The Bulletin of Contemporary Clinical Medicine. 2022; 15(4):33—43. DOI: 10.20969/VSKM.2022.15(4).33-43 (In Russ.)
Review
For citations:
Kondiurina E.G., Shpagina L.A., Timinskaia N.G., Tatarenko Y.A., Zelenskaia V.V. Optimization of cough control in children with acute upper respiratory infections: results of an observational study. CHILDREN INFECTIONS. 2025;24(3):34-43. (In Russ.) https://doi.org/10.22627/2072-8107-2025-24-3-34-43