What is a good cough suppressant for pneumonia (PNA) cough?

From the Guidelines

For pneumonia (PNA) cough, dextromethorphan is a suggested cough suppressant, as it has shown some effect in patients with acute cough 1. When considering a cough suppressant for pneumonia, it's essential to weigh the benefits and drawbacks of suppressing a cough, as it is a physiological response to clear mucus from the bronchial tree. However, in cases where the cough is dry and frequent, and especially at night, suppression can be useful. Some key points to consider when managing pneumonia cough include:

• The quality of evidence for cough management in pneumonia is generally low, but guidelines suggest that cough suppressants like dextromethorphan can be useful in certain cases 1.
• It's crucial to diagnose pneumonia accurately, using a combination of clinical symptoms, signs, and diagnostic tests like C-reactive protein (CRP) measurement and chest radiography 1.
• The use of antibiotics and antiviral treatments should be guided by local and national guidelines, and microbiological testing should be considered if it may change therapy 1.
• Staying hydrated, using saline nasal sprays, and sleeping with your head elevated can provide additional relief for cough symptoms.
• If your cough persists beyond 2 weeks or is accompanied by fever, shortness of breath, or colored sputum, consult a healthcare provider as you may need prescription medications. In terms of specific cough suppressants, dextromethorphan has shown some effect in patients with acute cough, whereas codeine has not shown beneficial effects in the same patients 1. However, it's essential to follow the recommended dosage and consult a healthcare provider if symptoms persist or worsen.

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

Dextromethorphan (PO) is a cough suppressant that can be used for pneumonia (PNA) cough, as indicated by its purpose as a cough suppressant 2 and its packaging label describing it as a cough suppressant for 12 Hour Cough Relief 2.

• Key points:
  • Cough suppressant for relief of cough
  • Available in oral suspension and liquid forms
  • Dextromethorphan is the active ingredient

From the Research

Cough Suppressants for Pneumonia

• There is insufficient evidence to decide whether over-the-counter (OTC) medications for cough associated with acute pneumonia are beneficial 3, 4.
• Mucolytics may be beneficial, but there is insufficient evidence to recommend them as an adjunctive treatment for acute pneumonia 3, 4.
• Theoretical recommendations suggest that OTC medications containing codeine and antihistamines should not be used in young children 3, 4.

Alternative Treatments

• Azithromycin has been shown to be effective in the treatment of atypical pneumonia in adult patients, with equal efficacy when given for 3 or 5 days at the same total dose 5.
• Azithromycin has also been shown to be safe and effective in the treatment of community-acquired pneumonia in children, with fewer side effects compared to other antibiotics 6.
• New antibiotics such as ceftaroline, ceftobiprole, omadacycline, solithromycine, and delafloxacin have been developed, but their place in the management of community-acquired pneumonia needs to be clarified 7.

Key Findings

• The use of mucolytics may reduce the secondary outcome of 'not cured' in patients with pneumonia 3, 4.
• Azithromycin has been shown to have a satisfactory therapeutic outcome in the treatment of community-acquired pneumonia 6.
• New antibiotics may offer some advantages, such as reduced treatment duration and anti-toxin effects, but more research is needed to determine their efficacy and potential benefits 7.