EXPLORING THE EFFECTIVENESS AND SAFETY OF COMPLEMENTARY AND HERBAL MEDICINES IN PEDIATRIC COUGH MANAGEMENT: A SYSTEMATIC REVIEW

Background: Cough is a prevalent problem that pediatricians and respiratory physicians frequently encounter. Various cultures have been using herbal remedies for a long time. However, there is a general lack of randomized controlled trial data to support their effectiveness. In order to provide a comprehensive overview of the existing literature, this systematic review aims to evaluate the efficacy and safety of herbal medicine in managing pediatric cough. Methods: A thorough search of major databases was conducted to find relevant studies on the impact of complementary and herbal interventions on pediatric cough. The inclusion criteria included randomized controlled trials if they involved pediatric patients with cough due to respiratory tract infections while non-RCTs were excluded. The primary outcomes measured were post-treatment cough severity and changes in symptoms scored on a Likert-type scale. The secondary outcomes included post-treatment cough frequency, duration of resolution of symptoms, and the incidence of adverse events during the trial period. The Cochrane RoB 2 risk of bias tool was used to evaluate the methodological quality of the studies. Results: The literature search identified 89 studies of which a final total of 8 randomized controlled trials are identified comprising 2109 patients. When used as an alternative therapy or as an add-on therapy, complementary and herbal medicine significantly improved the cough severity, and frequency as well as decreased the duration of cough symptoms, although variations in study designs and outcomes exist. However, some of these medicines were associated with significant and non-significant adverse events when for treating cough in the pediatric age group. The included studies had a high risk of bias, resulting in moderate to low certainty of herbal medicines’ effectiveness. Discussion: This systematic review likely encompasses a wide array of complementary and herbal remedies, ranging from traditional options like honey and ginger to more contemporary choices such as Zataria multiflora. Each herbal intervention’s impact on cough severity, frequency and duration in the pediatric population is scrutinized, providing a comprehensive overview of their potential therapeutic benefits. While these medicine shows promise in pediatric cough management, the varying quality of evidence and potential safety concerns necessitate cautious interpretation.