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Clinical trials, randomised controlled observational studies, case reports and meta-analyses of randomised controlled trials showed that there was a low level of evidence that an antispasmodic is better than a placebo for primary hypoventilation and chronic cough. In addition no studies have assessed whether any antispasmodic is more effective for chronic cough than
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The effect of main antibacterial and antispasmodic medications in acute cough, asthma, upper respiratory tract infection, infection recurrent pneumonia and acute bronchitis could not be analysed due to their being inadequately characterised.
There is inadequate evidence to make any statements about the potential effect of various non-pharmacological treatments which are often used in primary care to reduce the severity of disease. In particular, there is insufficient evidence to determine the effect of any these treatments in combination with each other or a new combination for acute cough due to non-specific or unknown etiologies. In fact the effect of all but one these interventions, the antitussive drug amitriptyline, was not identified in any of the trials and no meta-analyses of combined therapy for cough.
The quality of evidence for most interventions was low to moderate. Trials were usually of poor design which resulted in high baseline differences, thus making it difficult to differentiate them from randomised controlled trials, and of low quality which resulted in power to observe clinical differences.
Although there is
cialis 20mg ireland low quality evidence that both placebo and no treatment, treatment with either drug, combination and placebo are not significantly superior to placebo or no treatment, combination, there is low quality evidence that they are significantly superior to other antispasmodic agents in acute cough. This was assessed by meta-analysis and not clinical trials of individual treatments. There was no evidence that some antispastic agents are superior to others or a treatment another that is similar except in the specific situation of acute bronchitic spasm.
There is insufficient evidence to assess which specific antispasmodic treatment is more effective in particular coughs because most of the studies included were small, short term and of variable quality evidence. The effect of an antispasmodic was examined in combination with placebo and no treatment. In some studies the effect of one and combination the two interventions was compared to no treatment, however, it was not possible to draw any conclusions because the trials did not measure severity of disease, and therefore not the severity of symptoms. There also was insufficient evidence to assess whether any combination of antispasmodics was more effective than placebo or no treatment in acute cough, but several studies and meta-analyses of individual treatments suggest that all antispasmodics are more effective than placebo. In some cases it is unclear whether any combination more effective than placebo or no treatment.
There is insufficient evidence to assess the effect of any different therapies on the duration of coughing. This was assessed by measuring average or mean cough duration and either of coughing frequency or duration cough onset. Many studies showed no effect of the antispasmodic therapies on duration of cough, however two studies showed an adverse pharmacy online 365 effect, whereas another showed no effect. Meta-analyses of individual therapies indicated they were no better than placebo or treatment, although some
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