Guaifenesin/Pseudoephedrine May Reduce Antibiotic Rx for Acute URTI

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URTI symptoms were significantly reduced in the guaifenesin/pseudoephedrine group compared to the placebo group.
URTI symptoms were significantly reduced in the guaifenesin/pseudoephedrine group compared to the placebo group.

A ‘wait-and-see' approach, where a guaifenesin/pseudoephedrine combination product is used as a first-line strategy, may reduce the number of inappropriate antibiotic prescriptions for acute upper respiratory tract infections (URTIs). The findings come from a new study published in the journal Current Therapeutic Research.

Previous literature has shown that the 'wait-and-see' approach, where antibiotic prescribing is delayed, could be as effective as antibiotics in the treatment of childhood ear infections. For this study, researchers set out to determine whether treatment with a guaifenesin/pseudoephedrine HCl combination product (Mucinex D; Reckitt Benckiser) could reduce antibiotic use for URTIs, compared to placebo.

A total of 1189 patients with acute URTI symptoms from 45 study sites in the US were enrolled, with a final intent-to-treat population of 1179. Participants were randomized to either 1200mg guaifenesin/120mg pseudoephedrine hydrochloride extended-release or a matching placebo for 7 consecutive days. These patients were considered suitable for a wait-and-see approach.

Results found that at day 8 of the study, a significantly lower amount of patients receiving guaifenesin/pseudoephedrine desired antibiotics compared to placebo, 4.2% vs 8.0%, respectively. URTI symptoms – recorded each day by the patients – were significantly reduced in the guaifenesin/pseudoephedrine group compared to the placebo group, however at day 4 of the study the proportion of patients who experienced overall relief (primary endpoint) was not statistically different between both groups.

"Addressing patient concerns and recommending symptom-relieving products for URTIs early on can meet patient expectations for rapid relief and diminish [the patient's] desire for antibiotic prescriptions," the authors write.

Reference

Septimus EJ, Albrecht HH, Solomon G, Shea T, Guenin EP. Extended-release guaifenesin/pseudoephedrine hydrochloride for symptom relief in support of a wait-and-see approach for the treatment of acute upper respiratory tract infections: A randomized, double-blind, placebo-controlled study. Curr Ther Res Clin Exp. 2017;84:54-61.

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