***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Codeine is generally accepted as the st and ard antitussive against which new antitussive medications are compared . This presents a problem because the support for codeine 's antitussive activity comes from studies on cough in animals , and chronic and induced cough models in man , whereas antitussives are almost exclusively used for the treatment of cough associated with acute upper respiratory tract infection ( URTI ) . The aims of this study were twofold . Firstly , to study the antitussive efficacy of codeine in cough associated with URTI and , secondly , to vali date a sound meter as tool for quantifying cough . The efficacy of codeine was assessed in a double-blind , stratified , placebo-controlled , parallel-group , clinical trial using three different measures of cough : cough sound-pressure levels ( CSPLs ) measured on a sound meter ; subjective scores of cough severity ; and cough frequency recorded by means of a microphone  connected to an ink-pen recorder .  A group of 82 subjects ( 51 females and 31 males ; mean age 23.5 years , range 18 - 46 years ) with cough owing to acute URTI were included in the study . The study took place on two separate study days . On study day 1 cough measurements were made before and 90 min after treatment with a single dose of either 50 mg codeine or matched placebo in capsule form . The same three measures of cough were repeated 2 - 5 days later ( study day 2 ) . On study day 1 a highly significant ( P < 0.0001 ) decrease in all three measures of cough was found after treatment with both placebo and codeine yet there was no significant difference between the treatment groups . A highly significant ( P < 0.0001 ) decrease in the three measures of cough was also found between days 1 and 2 . The results demonstrate that codeine is no more effective than placebo in reducing cough associated with acute URTI , as measured by CSPLs , cough frequency or subjective symptom scores . This result might be explained on the basis of two central pathways for cough ; a reflex pathway via the brain-stem which is sensitive to codeine and a voluntary pathway via the cortex which is unaffected by codeine . The results also demonstrate that the sound-level meter appears to be a potentially useful investigative tool for the assessment of cough and antitussive efficacy OBJECTIVES To compare the effects of a single nocturnal dose of buckwheat honey or honey-flavored dextromethorphan ( DM ) with no treatment on  nocturnal cough and sleep difficulty associated with childhood upper respiratory tract infections . DESIGN A survey was administered to parents on 2 consecutive days , first on the day of presentation when no medication had been given the prior evening and then the next day when honey , honey-flavored DM , or no treatment had been given prior to bedtime according to a partially double-blinded r and omization scheme . SETTING A single , outpatient , general pediatric practice . PARTICIPANTS One hundred five children aged 2 to 18 years with upper respiratory tract infections , nocturnal symptoms , and illness duration of 7 days or less . INTERVENTION A single dose of buckwheat honey , honey-flavored DM , or no treatment administered 30 minutes prior to bedtime . MAIN OUTCOME MEASURES Cough frequency , cough severity , bothersome nature of cough , and child and parent sleep quality . RESULTS Significant differences in symptom improvement were detected between treatment groups , with honey consistently scoring the best and no treatment scoring the worst . In paired comparisons , honey was significantly superior to no treatment for cough frequency and the combined score , but DM was not better than no treatment for any outcome . Comparison of honey with DM revealed no significant differences . CONCLUSIONS In a comparison of honey , DM , and no treatment , parents rated honey most favorably for symptomatic relief of their child 's nocturnal cough and sleep difficulty due to upper respiratory tract infection . Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00127686 OBJECTIVES : To compare the effects of a single nocturnal dose of 3 honey products ( eucalyptus honey , citrus honey , or labiatae honey ) to placebo ( silan date extract ) on  nocturnal cough and difficulty sleeping associated with childhood upper respiratory tract infections ( URIs ) . METHODS : A survey was administered to parents on 2 consecutive days , first on the day of presentation , when no medication had been given the previous evening , and the following day , when the study preparation was given before bedtime , based on a double-blind r and omization plan . Participants included 300 children aged 1 to 5 years with URIs , nocturnal cough , and illness duration of ≤7 days from 6 general pediatric community clinics . Eligible children received a single dose of 10 g of eucalyptus honey , citrus honey , labiatae honey , or placebo administered 30 minutes before bedtime . Main outcome measures were cough frequency , cough severity , bothersome nature of cough , and child and parent sleep quality . RESULTS : In all 3 honey products and the placebo group , there was a significant improvement from the night before treatment to the night of treatment . However , the improvement was greater in the honey groups for all the main outcome measures . CONCLUSIONS : Parents rated the honey products higher than the silan date extract for symptomatic relief of their children ’s nocturnal cough and sleep difficulty due to URI . Honey may be a preferable treatment for cough and sleep difficulty associated with childhood URI To determine whether the cough of the common cold arises from upper respiratory stimuli and whether antihistamine-decongestant therapy is an effective treatment for this cough , we prospect ively evaluated volunteers with uncomplicated common colds in a r and omized , double-blind , placebo-controlled study . After completing a st and ardized question naire and undergoing a physical examination , throat-culturing , and pulmonary function testing , subjects took the active drug or identical-appearing placebo for 7 days while they kept a diary in which they ranked the severity of 17 symptoms for 14 days . Pulmonary function testing was repeated , on average , on Days 4 , 8 , and 14 . Forty-six percent of the variation in cough severity could be explained by throat-clearing and 47 % of the variation in throat-clearing severity by postnasal drip . FIF50 % , the only physiologic parameter that significantly correlated with cough , rose as cough severity fell . Antihistamine-decongestant therapy reduced postnasal drip and significantly decreased the severity of cough , nasal obstruction , nasal discharge , and throat-clearing during the first few days of the common cold . In addition , cough was 20 to 30 % less prevalent in the active drug group within 3 days of starting therapy . We conclude that the cough of the common cold arose from upper respiratory tract stimuli and that cough and other cardinal symptoms of the common cold were reduced with antihistamine-decongestant therapy when these symptoms were at their worst The efficacy of guaifenesin in reducing cough frequency in young adults with acute respiratory disease was evaluated by both an objective cough counting system and a question naire . A guaifenesin cough preparation and the syrup vehicle were administered in a double-blind manner . Coughs were recorded on tape over a 24-hour baseline evaluation period and a 36-hour treatment period for 42 patients . A pronounced diurnal variation in cough frequency was observed . The evaluation of efficacy was based upon comparisons between equivalent six-hour time periods of successive days . No antitussive effect of guaifenesin was demonstrated . The question naire was administered to 65 patients , including the 42 whose coughs were recorded . Of 26 patients with productive cough receiving guaifenesin  , 25 ( 96 percent ) reported a decrease in sputum thickness compared to 13 ( 54 percent ) of 24 patients receiving the vehicle ( p = 0.01 , Fisher exact test ) . Twenty-three of 26 ( 88 percent ) patients receiving guaifenesin also reported reduction in sputum quantity compared to 15 of 24 ( 62.5 percent ) receiving the vehicle ( p = 0.07 , Fisher exact test ) . The diurnal variation in cough frequency measured by the tape recording was not apparent from the subjective cough frequency estimates obtained by the question naire A double blind vs placebo study was carried out to study the effect of letosteine on the symptoms and clinical course of paediatric patients suffering from acute febrile bronchitis . Forty children were recruited for the research : 20 were treated with letosteine in a dose of 25 mg x 3 g/die and 20 with placebo ; treatment lasted 10 days . The following parameters were assessed during the trial : body temperature , cough , thoracic objectivity , respiratory function indices . The results of the study show that in the letosteine treated group there is a statistically significant decrease in fever , a favourable evolution of thoracic objectivity and an improvement in certain respiratory function parameters ( MEF 75 , PEF ) . It is concluded that treatment with letosteine leads to a significant increase in the rate of regression of thoracic symptomatology and a faster , more substantial reduction in fever in children suffering from acute bronchitis . This is probably the result of drug action on mucus viscosity , restoring optimal mucociliary clearance , and through action fostering the penetration of antibacterial substances into the mucus OBJECTIVE . Pediatric cough and cold medications are widely marketed in the United States , but the precise patterns of use among children are not known . Such information is especially important given recent reports suggesting that these medications are responsible for previously underappreciated serious adverse events and deaths among children . We sought to describe the prevalence and patterns of pediatric use of cough and cold medications , with particular attention to use among young children . METHODS . We analyzed data on the use of cough and cold medications , defined as any oral medication that contains ≥1 antitussive , decongestant , expectorant , and /or first-generation antihistamine active ingredients , among 4267 US children who were younger than 18 years and enrolled during 1999–2006 in the Slone Survey , a national r and om-digit-dial telephone survey of medication use by the US population . RESULTS . In a given week , a cough and cold medication was used by 10.1 % of US children . Exposure was highest to decongestants ( 6.3 % ; mostly pseudoephedrine ) and first-generation antihistamines ( 6.3 % ; most common were chlorpheniramine , diphenhydramine , and brompheniramine ) , followed by antitussives ( 4.1 % ; mostly dextromethorphan ) and expectorants ( 1.5 % ; almost exclusively guaifenesin ) . Multiple-ingredient products accounted for 64.2 % of all cough and cold medications used . Exposure to antitussives , decongestants , and first-generation antihistamines was highest among 2- to 5-year-olds ( 7.0 % , 9.9 % , and 10.1 % , respectively ) followed by children who were younger than 2 years ( 5.9 % , 9.4 % , and 7.6 % , respectively ) ; expectorant use was low in all age groups . The use of cough and cold medications declined from 1999 through 2006 . CONCLUSIONS . Approximately 1 in 10 US children uses a cough and cold medication in a given week . The especially high prevalence of use among children of young age is noteworthy , given concerns about potential adverse effects and the lack of data on the efficacy of cough and cold medications in this age group OBJECTIVES Coughing is a prevalent symptom of upper respiratory infections ( URIs ) that cause disturbance in the sleep of children and their parents . There is as yet no reliable treatment to control URIs and their related cough ; however , drugs such as dextromethorphan ( DM ) and diphenhydramine ( DPH ) are now mainly used in the world . The aim of this study is to compare the effect of honey , DM , and DPH on the nightly cough and sleep quality of children and their parents . DESIGN This was a clinical trial study in which 139 children aged 24 - 60 months suffering from coughing due to URIs were selected and assigned r and omly to 4 groups . The first group received honey ( HG ) , the second one DM ( DMG ) , the third DPH ( DPHG ) , but the fourth group or control group ( CG ) was assigned to a supportive treatment . OUTCOME MEASURES After approximately a 24-hour intervention , the 4 groups were reexamined and their cough frequency , cough severity , and sleep quality in children and their parents were recorded by using the question naire with Likert-type questions . RESULTS The mean of cough frequency score HG is 4.09 + /- 0.72 and 1.93 + /- 0.65 before and after the intervention , respectively , while these figures for the CG are 4.11 + /- 0.78 and 3.11 + /- 0.57 , respectively . After the intervention , the difference of the mean score of the variables in all groups became statistically significant . The mean score of all variables in HG has stood significantly higher than those in other groups . There is also a significant relationship between the DMG and CG groups , even though there is no statistically difference between DMG and DPHG groups . CONCLUSIONS The result of the study demonstrated that receiving a 2.5 
    Output:
    
There is no good evidence for or against the effectiveness of OTC medicines in acute cough .