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Acetylcysteine and carbocysteine for acute upper and lower respiratory tract infections in paediatric patients without chronic broncho-pulmonary disease

  1. Martin Chalumeau1,*,
  2. Yvonne CM Duijvestijn2

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 31 MAY 2013

Assessed as up-to-date: 6 MAR 2013

DOI: 10.1002/14651858.CD003124.pub4


How to Cite

Chalumeau M, Duijvestijn YCM. Acetylcysteine and carbocysteine for acute upper and lower respiratory tract infections in paediatric patients without chronic broncho-pulmonary disease. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD003124. DOI: 10.1002/14651858.CD003124.pub4.

Author Information

  1. 1

    Necker Hospital, AP-HP and Paris Descartes University, INSERM U953 and Department of Pediatrics, Paris, France

  2. 2

    Medical Centre Alkmaar, Department of Paediatrics (119), Alkmaar, Netherlands

*Martin Chalumeau, INSERM U953 and Department of Pediatrics, Necker Hospital, AP-HP and Paris Descartes University, Paris, France. martin.chalumeau@gmail.com. martin.chalumeau@nck.aphp.fr.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions), comment added to review
  2. Published Online: 31 MAY 2013

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Characteristics of included studies [ordered by study ID]
Bellomo 1972

MethodsRCT
All participants received thiamphenicol with or without acetylcysteine


Participants59 paediatric outpatients (22 < 1 year; 28 1 to 5 years; 9 > 5 years) seen for acute bronchitis or broncho-pulmonary infections


InterventionsOral acetylcysteine
13.8 mg/kg/day 2 to 4 times a day for 6 to 7 days average (maximum 14 days)


OutcomesClinical: duration of febrile state, dyspnoea, thoracic semeiologic alterations, cough


NotesItalian


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskOnly reported that allocation was done randomly

Allocation concealment (selection bias)Unclear riskNothing in the text deals with allocation concealment

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskOnly reported that treatment was randomly assigned

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNothing in the text deals with blinding of outcome assessment

Incomplete outcome data (attrition bias)
All outcomes
Unclear riskNothing in the results clearly mentioned the number of patients used in the analysis

Selective reporting (reporting bias)Low riskAll the judgement criteria were reported in the analysis

Biscatti 1972

MethodsRCT
All participants received some kind of antibiotic


Participants50 children (29 < 2 years; 21 > 2 years) hospitalised for acute respiratory infections


InterventionsOral acetylcysteine 100 mg/day under 2 years
200 mg/day between 2 and 4 years
300 mg/day above 4 years for 6 days


OutcomesClinical: cough, dyspnoea, thoracic semeiologic alteration, temperature reading
Biological: ESR and leucocyte count


NotesItalian
Possibly not a comparable treatment because various antibiotics were used


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskIt is only mentioned that treatments were assigned randomly

Allocation concealment (selection bias)Unclear riskNothing is mentioned about allocation concealment

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNothing is mentioned about blinding of participants and personnel

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNothing is mentioned about blinding of outcome assessment

Incomplete outcome data (attrition bias)
All outcomes
Low riskAll patients are mentioned in the analyses and the tables

Selective reporting (reporting bias)Low riskAll criteria mentioned in 'Methods' were mentioned in the analysis

Fiocchi 1989

MethodsRCT
All participants received antibiotics if necessary


Participants100 paediatric ambulatory participants (all > 2 years) seen in a paediatric department for acute lower respiratory infections


InterventionsOral acetylcysteine 20 mg/kg/day 3 times daily for 28 days


OutcomesClinical: cough, cough productivity and thoracic semeilogic alteration
PFT


NotesItalian
Side effects: 2 participants vomited in the acetylcysteine group, with 1 drop-out


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskIt is only mentioned that randomisation was based on a list

Allocation concealment (selection bias)Unclear riskNothing is mentioned about allocation concealment

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskNothing is mentioned about blinding of participants and personnel

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNothing is mentioned about blinding of outcome assessment

Incomplete outcome data (attrition bias)
All outcomes
Low riskAll patients are mentioned in the analyses and the tables

Selective reporting (reporting bias)Low riskAll the criteria mentioned in 'Methods' were mentioned in the analysis

Malka 1990

MethodsRCT
All participants received antibiotics if necessary


Participants106 paediatric ambulatory participants (2 to 12 years) seen in general practice for acute bronchitis


InterventionsOral carbocysteine for 7 days: 200 mg/day under 5 years. 300 mg/day above 5 years


OutcomesClinical: cough, expectoration, bronchial congestion, dyspnoea
PFT


NotesFrench
9 participants with side effects (in the carbocysteine group: 2 nausea, 3 diarrhoea, 1 stomach pain; in the placebo group: 1 nausea, 2 stomach pain)


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskQuote: "Randomised multicentre trial"

Allocation concealment (selection bias)High riskQuote: "The lack of respect in the order of the randomisation list..."

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskQuote: "Double blinding"

Blinding of outcome assessment (detection bias)
All outcomes
Unclear riskNothing in the text deals with blinding of outcome assessment

Incomplete outcome data (attrition bias)
All outcomes
Low riskQuote: "The patients included for wrong reasons or who did not respect the protocol were included in the analysis"

Selective reporting (reporting bias)Low riskAll the judgement criteria were reported in the analysis

Nakayama 1977

MethodsRCT
Participants received bronchodilators, antibiotics, antihistamine if previously treated


Participants152 paediatric outpatients (0 to 18 years) bronchial asthma or acute bronchitis


InterventionsOral carbocysteine 30 mg/kg/day (administered in 3 or 4 doses) for 7 days


OutcomesClinical: overall assessment, cough, stridor, expectoration
PFT


NotesFrench

Results tables were not available


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskQuote: "a table of random administration of products"

Allocation concealment (selection bias)Low riskQuote: "to ensure the impossibility of identifying the products, the random distribution, the secrecy of the key table..."

Blinding of participants and personnel (performance bias)
All outcomes
Low riskQuote: "aspect, characteristics, taste, flavour and packaging were verified by a independent person"

Blinding of outcome assessment (detection bias)
All outcomes
Low riskQuote: "The data statistics analyses were performed by a independent person"

Incomplete outcome data (attrition bias)
All outcomes
High riskIn the 'Results' section, it is mentioned that not all the patients were included in the statistical analyses

Selective reporting (reporting bias)Low riskAll the criteria mentioned in the 'Methods' section were mentioned in the 'Results' section

Zanini 1974

MethodsRCT
In treatment group: 15 children received antibiotics; 4 received inhaled acetylcysteine
In control group: 8 children received antibiotics


Participants30 children (18 < 1 year; 12 > 1 year) hospitalised for acute respiratory infections


InterventionsOral carbocysteine from 100 to 400 mg/day depending on age for 5 to 9 days


OutcomesClinical: cough, dyspnoea, temperature level, appetite, general condition


NotesItalian


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskQuote: "The patients were assigned randomly"

Allocation concealment (selection bias)Unclear riskThe text did not mention anything about allocation concealment

Blinding of participants and personnel (performance bias)
All outcomes
High riskQuote: "we had noticed the better efficacy of one of the produce in looking clinically at the therapeutic results"

Blinding of outcome assessment (detection bias)
All outcomes
High riskQuote: "we had noticed the better efficacy of one of the produce in looking clinically at the therapeutic results"

Incomplete outcome data (attrition bias)
All outcomes
Low riskAll the patients included were mentioned in the analysis

Selective reporting (reporting bias)Low riskAll the relevant criteria were mentioned in the analysis

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Amir 1985No control group; chronic disease

Anonymous 1987No control group

Baldini 1989Active control treatment

Banovcin 1990Non-randomised; active control treatment

Banovcin 1992Non-randomised; active control treatment

Bellomo 1967aNon-randomised

Bellomo 1967bNo control group

Bellomo 1973Active control treatment

Berger 1978No control group; chronic disease

Berni 1983Active control treatment

Boner 1984No control group

Camurri 1990Active control treatment

Caramia 1984No control group

Careddu 1989Active control treatment

Castello 1979No control group

Chalumeau 2002No control group

Dano 1971No control group

Egreteau 1992Chronic disease

Gaudier 1968No control group

Ginocchi 1978No control group

Gusberti 1985Active control treatment

Henocq 1985No placebo
Type of outcome measures

Hofmann 1980No placebo
Chronic disease

Jean 1982No placebo

Leupold 1970No placebo

Loscialpo Ramundo 1968No control group

Mayaud 1980No placebo

Michael 1986No placebo

Nigam 1981No placebo
Chronic disease

Nikolic 1980No placebo

Olivieri 1979Chronic diseases
No control group

Plietz 1976Chronic diseases
No control group

Poder 1982Chronic diseases
No control group

Ramenghi 1984No control group

Ribeiro 1980Chronic diseases
No control group

Rudnik 1980Chronic diseases
No control group

Samsygina 1995Chronic disease
No randomisation
Active control treatment

Santangelo 1985No control group

Szekely 1980Chronic diseases
No control group

Trastotenojo 1984No randomisation

Varricchio 2008Antibiotic treatment only in treatment group
Type of disease

Volkl 1992No control group

Zens 1967Chronic diseases
No control group

Zuppi 1984Chronic diseases

 
Comparison 1. Febrile state (AC or CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Febrile state after 6 days3139Risk Difference (M-H, Random, 95% CI)-0.05 [-0.12, 0.02]

 2 Febrile state after 6 days3139Risk Ratio (M-H, Random, 95% CI)0.21 [0.02, 1.77]

 
Comparison 2. Cough (AC or CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Cough after 6 to 7 days3139Risk Difference (M-H, Random, 95% CI)-0.10 [-0.19, -0.01]

 2 Cough after 6 to 7 days3139Risk Ratio (M-H, Random, 95% CI)0.37 [0.12, 1.20]

 3 Cough at the end of treatment (= 28 days)1100Risk Difference (M-H, Fixed, 95% CI)-0.03 [-0.13, 0.07]

    3.1 Subgroup = bronchitis
148Risk Difference (M-H, Fixed, 95% CI)-0.07 [-0.25, 0.11]

    3.2 Subgroup = tracheitis
152Risk Difference (M-H, Fixed, 95% CI)0.01 [-0.10, 0.12]

 4 Cough at the end of treatment (= 28 days)1100Risk Ratio (M-H, Fixed, 95% CI)0.67 [0.16, 2.76]

    4.1 Subgroup = bronchitis
148Risk Ratio (M-H, Fixed, 95% CI)0.52 [0.10, 2.83]

    4.2 Subgroup = tracheitis
152Risk Ratio (M-H, Fixed, 95% CI)1.26 [0.08, 19.09]

 
Comparison 3. Dyspnoea (AC or CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Dyspnoea after 6 to 7 days4245Risk Difference (M-H, Random, 95% CI)-0.03 [-0.09, 0.03]

 2 Dyspnoea after 6 to 7 days4245Risk Ratio (M-H, Random, 95% CI)0.66 [0.25, 1.74]

 
Comparison 4. Thoracic semeiologic alterations (AC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Thoracic semeiologic alterations after 5 days2109Risk Difference (M-H, Fixed, 95% CI)-0.06 [-0.13, 0.02]

 2 Thoracic semeiologic alterations after 5 days2109Risk Difference (M-H, Random, 95% CI)-0.05 [-0.20, 0.10]

 3 Thoracic semeiologic alterations after 5 days2109Risk Ratio (M-H, Fixed, 95% CI)0.14 [0.01, 2.63]

 4 Thoracic semeiologic alterations at the end of treatment (= 28 days)1100Risk Difference (M-H, Fixed, 95% CI)-0.14 [-0.25, -0.03]

    4.1 Subgroup = bronchitis
148Risk Difference (M-H, Fixed, 95% CI)-0.11 [-0.27, 0.06]

    4.2 Subgroup = tracheitis
152Risk Difference (M-H, Fixed, 95% CI)-0.17 [-0.32, -0.02]

 5 Thoracic semeiologic alterations at the end of treatment (= 28 days)1100Risk Ratio (M-H, Fixed, 95% CI)0.17 [0.03, 0.99]

    5.1 Subgroup = bronchitis
148Risk Ratio (M-H, Fixed, 95% CI)0.26 [0.03, 2.32]

    5.2 Subgroup = tracheitis
152Risk Ratio (M-H, Fixed, 95% CI)0.11 [0.01, 1.95]

 
Comparison 5. General condition (CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Bad general condition after 6 to 7 days2182Risk Difference (M-H, Random, 95% CI)-0.07 [-0.35, 0.20]

 2 Bad general condition after 6 to 7 days2182Risk Ratio (M-H, Random, 95% CI)0.78 [0.31, 1.95]

 
Comparison 6. Cough productivity (AC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Cough productivity at the end of treatment (= 28 days)1100Risk Difference (M-H, Fixed, 95% CI)-0.08 [-0.20, 0.03]

    1.1 Subgroup = bronchitis
148Risk Difference (M-H, Fixed, 95% CI)-0.07 [-0.25, 0.11]

    1.2 Subgroup = tracheitis
152Risk Difference (M-H, Fixed, 95% CI)-0.09 [-0.25, 0.06]

 2 Cough productivity at the end of treatment (= 28 days)1100Risk Ratio (M-H, Fixed, 95% CI)0.41 [0.11, 1.56]

    2.1 Subgroup = bronchitis
148Risk Ratio (M-H, Fixed, 95% CI)0.52 [0.10, 2.83]

    2.2 Subgroup = tracheitis
152Risk Ratio (M-H, Fixed, 95% CI)0.32 [0.04, 2.63]

 
Comparison 7. Appetite (CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Appetite trouble at the end of treatment (5 to 9 days)130Risk Difference (M-H, Fixed, 95% CI)-0.09 [-0.29, 0.11]

 
Comparison 8. Expectoration (CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Expectoration at the end of treatment (= 7 days)1106Risk Difference (M-H, Fixed, 95% CI)-0.15 [-0.31, 0.01]

 2 Expectoration at the end of treatment (= 7 days)1106Risk Ratio (M-H, Fixed, 95% CI)0.55 [0.27, 1.10]

 
Comparison 9. Pulmonary function tests (CC versus placebo)

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Alteration of the pulmonary function after 3 days1106Risk Difference (M-H, Fixed, 95% CI)0.05 [-0.14, 0.24]

 2 Alteration of the pulmonary function after 3 days1106Risk Ratio (M-H, Fixed, 95% CI)1.12 [0.75, 1.66]

 
Table 1. Characteristics of studies included to evaluate safety

StudyMethodsParticipantsInterventionOutcomesNotesAllocation concealment

Anonymous 1987Case report20 children (1 to 14 years)Oral carbocysteine
300 mg/day above 5 years
200 mg/day under 5 years
2 to 3 times daily for 6 days (except 1: 3 days)
Clinical: cough frequency and intensity, sputum quality and quantityFrenchNot used

Baldini 1989RCT
Active treatment (ambroxol);
participants received antibiotics if necessary
28 children older than 2 years oldOral acetylcysteine
300 mg/day above 5 years
200 mg/day under 5 years
For 10 days
Clinical: expectoration, sputum viscosity, dyspnoea, cough, difficulty of expectoration.
Biological: blood exam, monitoring of hepatic and renal function
ItalianUnclear

Banovcin 1990Controlled trial
Active treatment (Ipecac syrup);
antibiotics and vitamins for all participants
18 children (6 to 15 years)Oral carbocysteine
250 mg 3 times a day
PFTSlovakUnclear

Banovcin 1992RCT
Active treatment (Ipecac syrup);
antibiotics for all participants
51 children (6 to 24 months)Oral carbocysteine
50 to 62.5 mg 3 times a day
Clinical score: lung auscultation, fever, cough
Biological: blood exam
SlovakUnclear

Bellomo 1967aControlled trial
Control participants received no treatment
81 children (< 8 years)Intramuscular acetylcysteine
25 to 50 mg/kg/day
Clinical: cough, dyspnoea, thoracic semeilogic alteration, feverItalianUnclear

Bellomo 1967bUncontrolled trial
Thiamphenicol for all participants
39 children (16: < 2 years)Intramuscular acetylcysteine
10 to 18 mg/kg/day
Clinical: cough, dyspnoea, thoracic semeilogic alteration, fever
Biological: blood exam; X-ray
ItalianUnclear

Bellomo 1972RCT
All participants received thiamphenicol with or without acetylcysteine
59 children (22: < 1 year; 28: 1 to 5 years; 9: > 5 years)Oral acetylcysteine
13.8 mg/kg/day 2 to 4 times daily for 6 to 7 days average (maximum 14 days)
Clinical: duration of febrile state, dyspnoea, thoracic semeiologic alterations, coughItalianUnclear

Bellomo 1973RCT
Oral and intramuscular acetylcysteine;
thiamphenicol for all participants
50 children (35: < 2 years)Oral and intramuscular acetylcysteine
300 mg/day under 2 years
600 mg/day above
Clinical: cough, dyspnoea, thoracic semeilogic alteration, feverItalianUnclear

Berni 1983RCT
Antibiotics if necessary
30 children (2 to 8 years)Oral carbocysteine
200 to 300 mg
Clinical: cough, dyspnoea, expectorationItalianUnclear

Biscatti 1972RCT
All participants received some kind of antibiotic
50 children (29: < 2 years; 21: > 2 years)Oral acetylcysteine
100 mg/day under 2 years
200 mg/day between 2 and 4 years
300 mg/day above 4 years for 6 days
Clinical: cough, dyspnoea, thoracic semeilogic alteration, temperature level
Biological: ESR and leucocyte count
Italian
Possibly not comparable treatment because various antibiotics were used
Unclear

Boner 1984Uncontrolled trial
Cefuroxime for all participants
60 children (4 to 12 years)Intramuscular acetylcysteine
15 to 30 mg/kg/day
Clinical: temperature, cough, chest and abdomen pain, dyspnoea, wheezing
Bacteriological: respiratory secretion cultures
X-ray
EnglishUnclear

Camurri 1990RCT
Active treatment (bromhexine)
32 children (2 to 11 years)Oral acetylcysteine
300 mg/day
Clinical: cough, dyspnoea, expectoration (difficulty, quantity and quality)ItalianUnclear

Caramia 1984Uncontrolled trial
Cefuroxime for all participants
40 children (4 months to 13 years)Intramuscular acetylcysteine
20 to 30 mg/kg/day
Clinical: cough, temperature, sputum viscosity, intrinsic sputum characteristics
Bacteriological: respiratory secretion cultures
X-ray
EnglishUnclear

Careddu 1989RCT
Active treatment (nesosteine)
40 children (5 to12 years)Oral carbocysteine
900 mg/day
Clinical: cough, dyspnoea, expectoration
Biological: blood exam
ItalianUnclear

Castello 1979Controlled trial
Antibiotics if necessary
13 children (1 of 15 months + 12: 2 to 12 years)Oral carbocysteine;
3 spoons/day (2% under
4 years; 5% above
4 years)
Clinical: monitoring;
viscosimetry
ItalianUnclear

Chalumeau 2002Targeted pharmacovigilance study6 children (< 2 years)19.5 to 34.6 mg/kg/day

3 received oral carbocysteine
3 received oral acetylcysteine
Clinical: cough, sputum viscosityFrenchNot used

Dano 1971Uncontrolled trial37 children (5 to 17 years)Inhaled acetylcysteine
2 ml 10% + 2 ml 20%
Clinical: monitoring;
PFT
EnglishUnclear

Fiocchi 1989RCT
All participants received antibiotics if necessary
100 children (all > 2 years)Oral acetylcysteine
20 mg/kg/day 3 times a day for 28 days
Clinical: cough, cough productivity and thoracic semeilogic alteration
PFT
Italian
Side effects: 2 participants vomiting in acetylcysteine group, with 1 drop-out
Unclear

Gaudier 1968Uncontrolled trial50 children (< 15 years)Oral acetylcysteine;
2 spoons 2%/day
Clinical: monitoring (evolution of asthma)FrenchUnclear

Ginocchi 1978Uncontrolled trial
Antibiotics in 33 children
44 children (2 months to 13 years)Oral carbocysteine
2 spoons/day under 5 years; 3 spoons/day above
Clinical: cough, dyspnoea, expectoration, sputum viscosity
Biological: blood exam
ItalianUnclear

Gusberti 1985RCT
Active treatment (acetylsalicylate of acetylcysteine 4%, 5 ml x 3)
40 children (4 months to 13 years)Oral acetylcysteine
200 mg 3 times a day
Clinical: cough, dyspnoea, expectoration (difficulty, quantity and quality), temperature
Biological: blood exam
ItalianUnclear

Henocq 1985RCT
Control participants received no treatment
50 children (1 month to 4 years)Oral carbocysteine
5 ml 2% per 5 kg/day
IgA levelFrenchUnclear

Jean 1982Uncontrolled trial
Thiamphenicol for all participants
29 children (< 10 years)Inhaled acetylcysteine
200 mg/day under 3 months
400 mg/day above
Clinical: cough, dyspnoea, expectoration, sputum viscosity, temperature
Bacteriological
X-ray, PFT, bronchoscopy
FrenchUnclear

Leupold 1970Uncontrolled trial36 children (7 to 16 years)Inhaled acetylcysteine
15 min: 18 participants at 20% and 18 participants at 10%
Clinical: monitoring
PFT
GermanUnclear

Loscialpo Ramundo 1968Uncontrolled trial
Thiamphenicol for all participants
84 children (2 to 12 years)Inhaled acetylcysteine
1.5 ml 10% above 5 years
3 ml 10 % under (the first 5 days twice a day then once a day)
Clinical: cough, dyspnoea, fever
Biological: blood exam
X-ray
ItalianUnclear

Malka 1990RCT
All participants received antibiotics if necessary
106 children (all > 2 years); all participants received antibiotics if necessaryOral carbocysteine;
200 mg/day under 5 years
300 mg/day above for 7 days
Clinical: cough, expectoration, bronchial congestion, dyspnoea
PFT
French
9 participants with side effects (in the carbocysteine group: 2 nausea, 3 diarrhoea, 1 stomach pain; in the placebo group: 1 nausea, 2 stomach pain)
Unclear

Mayaud 1980Uncontrolled trial
Thiamphenicol for all participants
112 children (< 8 years; 33: < 1 year)Oral and intramuscular acetylcysteine
50 mg/kg/day
Clinical: fever, expectoration (quality);
Biological: blood exam
Bacteriological: quality of sputum
X-ray
FrenchUnclear

Michael 1986Uncontrolled trial374 children (mean: 5 years +/- 3)Oral carbocysteine;
500 mg/day under 4 years
750 mg/day above
Clinical: cough, sputum viscosity, expectoration, breathingGermanUnclear

Nakayama 1977RCT
Patients received bronchodilators, antibiotics, antihistamine if previously treated
152 children (0 to 18 years)Oral carbocysteine;
30 mg/kg/day (in 3 to 4 doses a day for 7 days)
Clinical: overall assessment, cough, stridor, expectoration
PFT
FrenchAdequate

Nikolic 1980Uncontrolled trial20 children (3 to 14 years)Oral acetylcysteine
100 to 200 mg 3 times a day
Clinical
PFT
EnglishUnclear

Ramenghi 1984Uncontrolled trial
Cefuroxim for all participants
20 children (10 months to 2 years)Intramuscular acetylcysteine
15 mg/kg/day
Clinical: cough, rale, vesicular murmur, irritability, hypo-alimentation
Biological: blood exam
Bacteriological: on pharyngotracheal aspirate
EnglishUnclear

Santangelo 1985Uncontrolled trial
Cefuroxim for all participants
103 children (2 months to 11 years)Intramuscular acetylcysteine; 20 to 30 mg/kg/dayClinical: monitoring
Bacteriological: secretion cultures; X-ray
EnglishUnclear

Trastotenojo 1984Controlled trial
Antibiotics and bronchodilator if necessary
60 children (2 months to 13 years)Oral acetylcysteine 100 mg 3 times a dayClinical: cough, dyspnoea, findings on auscultation;
Biological: blood exam
X-ray
EnglishUnclear

Zanini 1974RCT
In treatment group 15 children received antibiotics + 4 inhaled acetylcysteine; in control group 8 children received antibiotics
30 children (18 < 1 year; 12 > 1 year)Oral carbocysteine from 100 to 400 mg/day depending on age for 5 to 9 daysClinical: cough, dyspnoea, temperature level, appetite, general conditionItalianUnclear

 RCT: randomised controlled trial
PFT: pulmonary function tests
ESR: erythrocyte sedimentation rate