Effect of Caffeine on Coughing in Children Aged 3-36 Months: A Randomized Clinical Trial

Aims: Coughing is one of the most common clinical complaints in pediatric medicine. Since caffeine, as a central nervous system stimulant from methylxanthine, inhibits tumor necrosis factor-alpha (TNFα) and leukotriene synthesis and reduces inflammation and initiates the immune process, the aim of this study was to determine the effect of caffeine on coughing in children aged 3-36 months. Materials and Methods: In this randomized clinical trial study in 2015, among children referred to the Shahid Mofateh Pediatric Clinic of Yasuj, 120 children aged 3-36 months with coughing due to bronchiolitis, lower respiratory viral disease, increased airway sensitivity, or moderate persistent asthma were selected by convenience sampling method. They were assigned in intervention (reciving salbutamol and caffeine) and control (reciving salbutamol alone) groups by quadratic block randomization. In addition to completing demographic information at the beginning of the study, data on daily and nocturnal cough at the beginning of the study, 48 hours, 1 week, and 2 weeks after starting the drug were recorded. The data were analyzed by SPSS 21 software, using Mann-Whitney test, Chi-square or Fisher's exact test, generalized estimating equation, Friedman, and Wilcoxon statistical tests. Findings: Daily cough and nocturnal cough significantly decreased in the intervention group at 48 hours, 1 and 2 weeks after beginning the treatment (p<0.05). Conclusion: Prescription of caffeine with salbutamol is effective in accelerating improvement of cough in children.