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Cochrane Database of Systematic Reviews

Codeine versus placebo for chronic cough in children

Overview of attention for article published in Cochrane database of systematic reviews, July 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • Good Attention Score compared to outputs of the same age and source (71st percentile)

Mentioned by

1 news outlet
2 blogs
14 tweeters
2 Facebook pages
1 Wikipedia page


15 Dimensions

Readers on

147 Mendeley
Codeine versus placebo for chronic cough in children
Published in
Cochrane database of systematic reviews, July 2016
DOI 10.1002/14651858.cd011914.pub2
Pubmed ID

Samantha J Gardiner, Anne B Chang, Julie M Marchant, Helen L Petsky


Cough in children is a commonly experienced symptom that is associated with increased health service utilisation and burden to parents. The presence of chronic (equal to or more than four weeks) cough in children may indicate a serious underlying condition such as inhaled foreign body or bronchiectasis. Codeine (and derivative)-based medications are sometimes used to treat cough due to their antitussive properties. However, there are inherent risks associated with the use of these medications such as respiratory drive suppression, anaesthetic-induced anaphylaxis, and addiction. Metabolic response and dosage variability place children at increased risk of experiencing such side effects. A systematic review evaluating the quality of the available literature would be useful to inform management practices. To evaluate the safety and efficacy of codeine (and derivatives) in the treatment of chronic cough in children. We searched the Cochrane Airways Group Register of Trials, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1946 to 8 June 2016), EMBASE (1974 to 8 June 2016), the online trials registries of the World Health Organization and ClinicalTrials.gov, and the bibliographic references of publications. We imposed no language restrictions. We considered studies eligible for analysis when: the participant population included children aged less than 18 years with chronic cough (duration equal to or more than four weeks at the time of intervention); and the study design evaluated codeine or codeine-based derivatives against placebo through a randomised controlled trial. Two review authors independently screened the search results to determine eligibility against a standardised criteria, and we had a pre-planned method for analysis. We identified a total of 556 records, of which 486 records were excluded on the basis of title and abstract. We retrieved the remaining 70 references in full to determine eligibility. No studies fulfilled the inclusion criteria of this review, and thus we found no evidence to support or oppose the use of codeine or derivatives as antitussive agents for chronic cough in children.While chronic cough is not the same as acute cough, systematic reviews on the use of codeine efficacy for acute cough in children conclude an overall lack of evidence to support or oppose the use of over-the-counter cough and cold medications containing codeine (or derivatives) for treatment of acute cough in children. The lack of sufficient evidence to support the use of these medications has been consistently reaffirmed by medical experts in international chronic cough guidelines and by governing medical and pharmaceutical authorities in the USA, Europe, Canada, New Zealand, and Australia. Due to the lack of sufficient evidence to support efficacy, and the known risks associated with use - in particular the increased risks for children - these medications are now not recommended for children less than 12 years of age and children between 12 to 18 years with respiratory conditions. This review has highlighted the absence of any randomised controlled trials evaluating codeine-based medications in the treatment of childhood chronic cough. Given the potential adverse events of respiratory suppression and opioid toxicity, national therapeutic regulatory authorities recommend the contraindication of access to codeine in children less than 12 years of age. We suggest that clinical practice adhere to clinical practice guidelines and thus refrain from using codeine or its derivatives to treat cough in children. Aetiological-based management practices continue to be advocated for children with chronic cough.

Twitter Demographics

The data shown below were collected from the profiles of 14 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 147 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 147 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 36 24%
Student > Bachelor 24 16%
Researcher 11 7%
Other 8 5%
Student > Ph. D. Student 8 5%
Other 27 18%
Unknown 33 22%
Readers by discipline Count As %
Medicine and Dentistry 44 30%
Nursing and Health Professions 26 18%
Psychology 10 7%
Pharmacology, Toxicology and Pharmaceutical Science 4 3%
Social Sciences 4 3%
Other 21 14%
Unknown 38 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 27. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 February 2021.
All research outputs
of 18,708,811 outputs
Outputs from Cochrane database of systematic reviews
of 11,847 outputs
Outputs of similar age
of 267,119 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 134 outputs
Altmetric has tracked 18,708,811 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,847 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 26.3. This one has done well, scoring higher than 79% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,119 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 134 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.