From the FDA Drug Label
Purpose Cough suppressant Package/Label Principal Display Panel Compare to Delsym® active ingredient Dextromethorphan Polistirex Extended-Release Oral Suspension Cough Suppressant Warnings ... Ask a doctor before use if you have • chronic cough that lasts as occurs with smoking, asthma or emphysema • cough that occurs with too much phlegm (mucus)
The recommended medication for a 13-year-old patient presenting with a dry, croupy (barky) cough is dextromethorphan (PO), a cough suppressant 1, 1. However, it is essential to consult a doctor before use, especially if the patient has a chronic cough or cough with too much phlegm (mucus) 1.
From the Research
For a 13-year-old with a dry, barky cough, I recommend over-the-counter medications like dextromethorphan (found in Robitussin DM or Delsym) at age-appropriate doses as indicated on the packaging, typically every 6-8 hours, as supported by the most recent study 2.
Key Recommendations
- Dextromethorphan can be used for symptom relief, with a combination of bilastine, dextromethorphan, and phenylephrine showing efficacy and safety in patients with dry cough 2.
- Honey can also be effective - 1-2 teaspoons as needed, especially before bedtime.
- Running a cool-mist humidifier in the child's bedroom and ensuring adequate hydration with water or clear fluids will help loosen secretions and soothe the irritated airways.
Considerations
- If the cough has a distinctive "barky" quality, it might indicate croup, which typically improves with exposure to cool, humid air.
- Warm fluids like caffeine-free tea with honey may also provide relief.
- If symptoms persist beyond 7-10 days, worsen significantly, are accompanied by high fever (above 102°F), difficulty breathing, or if the child has underlying conditions like asthma, seek medical attention promptly.
Evidence-Based Decision
The recommendation is based on the most recent study 2, which shows that a combination of bilastine, dextromethorphan, and phenylephrine is efficacious, safe, non-sedating, and non-inferior to other treatments in the treatment of acute dry cough due to a common cold or allergy. This study provides the strongest evidence for the use of dextromethorphan in patients with dry cough, and its findings are consistent with the principles of minimizing morbidity, mortality, and improving quality of life.