Cough medicines have been in use for over a century to treat the common and troublesome, but often helpful, symptoms of cough in children. They contain various combinations of “anti-tussive” drugs including opioids, antihistamines, herbal preparations, mucolytics, decongestants and expectorants. Whilst theoretically attractive for symptom relief when children are suffering, as time has passed these popular over the counter medicines have been shown to lack efficacy, delay more serious underlying diagnoses, and can cause complications and sometimes death. This has resulted in clinician concerns, a citizen petition to the American Food and Drug Association in 2007, some self-regulation from manufacturers and escalating restrictions on their use from regulatory agencies across the world over the last twenty years. This article will review the protective role of cough, juxtapose the conflicting treatment goals of suppressing a dry cough and promoting expectoration for a wet cough, consider the evidence basis for prescribing cough medicines in comparison to other more specific treatments such as for asthma [beta agonists] or infection [antibiotics], regulatory interventions, and conclude with the view that over counter cough medicines should not be used in children, especially young children.

咳嗽药已经使用了一个多世纪，用于治疗儿童咳嗽的常见和麻烦的症状，但通常是有帮助的。它们含有各种“止咳”药物的组合，包括阿片类药物、抗组胺药、草药制剂、粘液溶解剂、减充血剂和祛痰剂。虽然理论上对于缓解儿童遭受痛苦时的症状很有吸引力，但随着时间的推移，这些流行的非处方药已被证明缺乏疗效，会延迟更严重的潜在诊断，并可能导致并发症，有时甚至导致死亡。这引起了临床医生的担忧、2007 年向美国食品药品协会提交的一份公民请愿书、制造商的一些自我监管以及过去 20 年来世界各地监管机构对其使用的不断限制。本文将回顾咳嗽的保护作用，将抑制干咳和促进湿咳排痰这两个相互矛盾的治疗目标并列，考虑与其他更具体的治疗方法（例如哮喘[β受体激动剂]）相比开出止咳药物的证据基础] 或感染[抗生素]、监管干预措施，并得出结论认为，儿童，尤其是幼儿不应使用非处方止咳药。