General

Do you prescribe mucolytics/expectorants?

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5 Jul 2016 - General
 

It has been common practice for medical practitioners to prescribe symptom-relief medications, such as mucolytics and expectorants for productive cough. However, there is little amount of evidence to support this tradition. In fact, I cannot find an evidence-based guideline that recommends this form of treatment for productive/wet cough. (Except for COPD) In my own medical practice, I try my best to avoid prescribing these medications, unless patients request for it. If I have to, I usually prescribe N-acetylcysteine or Carbocysteine, but I emphasize that these medications may or may not work. A lot of them would still prefer to take something than nothing. As for expectorants, I only prescribe Guiafenesin and saline nebulization for selected pediatric patients. What is your local practice?

Hi Theekshana, thank you for the information. I was not aware that it's not popular practice in Sri Lanka. Despite the lack of substantial evidence, a lot of doctors in the Philippines, still opt to prescribe these medications. Personally, I think that there's probably a social pressure for doctors to prescribe something when patients consult. I remember one issue that went viral in social media about a doctor, who advised rest and hydration for systemic viral illness. Apparently, the pa...
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Prescription of mucolytics and expectorants are not commonly practiced in my country, Sri Lanka, either. As Marinelle said, there's little evidence to support that the use of mucolytics/expectorants reduce the duration of illness in uncomplicated lower respiratory tract infections. Generally an oral bronchodilator like theophylline and a histamine receptor blocker along with an antibiotic (Yes, antibiotics are prescribed most of the time in Sri Lanka for all respiratory tract infections thou...
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