Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms

Abstract

Objective: To determine if a single application of a vapor rub (VR) or petrolatum is superior to no treatment for nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection.

Methods: Surveys were administered to parents on 2 consecutive days--on the day of presentation when no medication had been given the previous evening, and the next day when VR ointment, petrolatum ointment, or no treatment had been applied to their child's chest and neck before bedtime according to a partially double-blinded randomization scheme.

Results: There were 138 children aged 2 to 11 years who completed the trial. Within each study group, symptoms were improved on the second night. Between treatment groups, significant differences in improvement were detected for outcomes related to cough, congestion, and sleep difficulty; VR consistently scored the best, and no treatment scored the worst. Pairwise comparisons demonstrated the superiority of VR over no treatment for all outcomes except rhinorrhea and over petrolatum for cough severity, child and parent sleep difficulty, and combined symptom score. Petrolatum was not significantly better than no treatment for any outcome. Irritant adverse effects were more common among VR-treated participants.

Conclusions: In a comparison of VR, petrolatum, and no treatment, parents rated VR most favorably for symptomatic relief of their child's nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups.

Trial registration: ClinicalTrials.gov NCT00743990.

FIGURE 1

Survey questions to assess nocturnal URI symptoms.

FIGURE 2

Between-night treatment effects of VR, petrolatum, and no treatment on (A) cough frequency (P = .003, 3-way treatment comparison), (B) cough severity (P = .02), (C) severity of congestion (P = .04), (D) severity of rhinorrhea (P = not significant), (E) child’s ability to sleep (P < .001), (F) parent’s ability to sleep (P < .001), and (G) combined symptom score (P < .001). N/S indicates nonsignificant.