Background
Mechanisms of action
Author | Cell type | BHC dosage | Outcomes |
---|---|---|---|
Merker 1966 [8] | Rats, bronchial secretory cells | 4-20 mg/kg/24 h parenteral | Quantitative and qualitative effect on mucus production |
Janatuinen 1969 [10] | Guinea pigs, bronchial goblet cells | 5-10 mg/kg/24 h parenteral | Reduction in goblet cells, increased secretory material in airways |
Gil 1971 [11] | Rats, type II alveolar cells | 200 mg/kg/24 h enteral | Increased secretion of phospholipids in alveolar space |
Harada 1977 [12] | Dogs, tracheal mucosa | 4 mg intravenous | Increase in the output of secretion; goblet cells and submucosal mucus glands emptying |
Von Wichert 1977 [14] | Rabbits, lung and liver tissues | 10 mg/kg intravenous | Rapid stimulation of phospholipid synthesis |
Martin 1993 [27] | Pigs, rheological characteristics of tracheal mucus | 0,5 mg/kg | Increased concentration of oxytetracycline within the secreted mucus and reversed mucospastic activity of oxytetracycline in vivo |
Effects of BHC on the production of mucosubstances
Effect of BHC on sputum
Effect on ciliary clearance
Effect of BHC on antibiotic penetration
Cough
Efficacy and safety of bromhexine in adults
Author | Study design | Subjects | BHC dosage | Outcome | Adverse events (n) |
---|---|---|---|---|---|
Gieseking 1968 [9] | Observational | Biopsy from 9 adult patients with cavitated tubercolosis or carcinoma | 4 mg 3 times/24 h | Increased secretion activity in the seromucus glands of the bronchial mucosa | - |
Lorenz 1974 [13] | Observational | 36 pregnant women | 1 mg/kg/24 h | Increase > 50% in total phospholipid concentration in fetal surfactant | - |
Crimi 1986 [15] | Observational | 13 adult patients with chronic bronchitis | 48 mg/24 h | Increase concentration of total phospholipids in bronchoalveolar fluid | - |
Flavell Matts 1973 [18] | Observational | 53 adult patients with asthmatic bronchitis and acute or chronic bronchitis | 8-32 mg/3 times/24 h | Reduced mucopolysaccharide fiber systems in sputum | - |
Bürgi 1974 [19] | Single-blind crossover | 22 adult patients with chronic bronchitis | 8 mg/3 times/24 h | Reduction in sputum glycoprotein fiber content and decreased viscosity | - |
Shimura 1983 [20] | Observational | 40 adults with chronic pulmonary diseases (excluding asthma) | 24 mg/24 h | BHC does not influence the molecular structure of the mucus | - |
Langlands 1970 [21] | Double blind randomized controlled trial | 27 adult patients with exacerbations of chronic bronchitis | 8 mg/3 times/24 h | No significant difference in respiratory function or mucus properties | Nausea (n = 1) |
Stark 1973 [22] | Randomized controlled trial | 42 adult patients with chronic bronchitis | 48 mg/24 h | No significant difference in mucus characteristics | - |
Götz 1970 [23] | Observational | 20 adult patients with allergic asthma | 16-24 mg/24 h | Increased gamma globulins in sputum | - |
Kado 1976 [24] | Observational | 13 adult patients with chronic bronchial infections | - | Increased concentrations of IgA and IgG in bronchial washings | - |
Thomson 1974 [25] | Observational | 9 adult subjects with chronic bronchitis | 48 mg/24 h | Increased mucociliary clearence | - |
Pavia 1979 [26] | Observational | 43 adult patients with chronic bronchitis | - | Increased mucociliary clearence | - |
Bergogne-Berezin 1979 [28] | Double blind placebo controlled stud | 22 adult patients undergone bronchoscopy and received erythromycin | 4-12 mg/24 h | Increased erythromycin concentration in bronchial fluid | - |
Roa 1995 [29] | Double blind multicenter randomized controlled trial | 392 adult patients hospitalized for uncomplicated bacterial lower respiratory tract infections receiving amoxicillin | 32 mg/24 h | Better overall resolution of symptoms and cough; increased expectoration | Undefined (n = 6) |
Lal 1975 [30] | Randomized crossover placebo-controlled trial | 41 adult patients with stable chronic obstructive bronchitis receiving oxytetracycline | 48 mg/24 h | Better subjective evaluation of sputum stickiness and physician assessment of outcome | Headache (n = 2) Stomacache (n = 2) |
Nesswetha 1967 [32] | Double blind randomized controlled trial | 242 adult patients with mixed respiratory conditions | 15 mg/24 h | Reduced cough | No adverse events reported |
Gent 1969 [33] | Cross sectional, double blind, placebo controlled study | 48 adult patients with chronic bronchitis, asthma, emphysema or diffuse parenchymal lung disease | 24 mg/24 h | Overall clinical and functional improvement | Diarrhea (n = 1) Headache (n = 1) |
Hamilton 1970 [34] | Double blind randomized controlled trial | 22 adult patients recovering from an exacerbation of chronic obstructive bronchitis | 48 mg/24 h | increased sputum production and reduced sputum viscosity | No adverse events reported |
Christensen 1970 [35] | Double blind randomized controlled trial | 61 adult patients with chronic bronchitis | 24 mg/24 h | Better overall clinical improvement and increased FEV1 | - |
Condie 1971 [36] | Single blind randomized controlled trial | 31 adult patients with chronic bronchitis | 24 mg/24 h | Reduced symptoms, increased sputum volume and PEFR | Nausea and abdominal distension (n = 3) |
Matts 1974 [37] | Double blind randomized controlled trial | 102 hospitalized adult patients with lower respiratory tract infections treated with oxytetracycline | 32 mg/24 h | Higher rate of favorable response to treatment, faster recovery and shorter hospitalization stay | Nausea and anorexia (n = 22) |
Armstrong 1975 [38] | Randomized crossover placebo-controlled trial | 12 adult patients with chronic bronchitis | 72 mg/24 h | Increased expectoration, improved auscultatory findings and PEFR | Headache and nausea (n = 1) Dizziness (n = 1) |
Valenti 1989 [39] | Double blind multicenter randomized controlled trial | 237 adult patients with chronic obstructive lung disease | 60 mg/24 h | decrease in cough, dyspnea and sputum volume; easier expectoration; improved auscultatory findings and improved FEV1 and PEFR; higher rates of treatment efficacy | Vomiting and gastralgia (n = 1) |
Bienvenido 1990 [40] | Randomized controlled trial | 28 adult patients with acute bronchitis or exacerbation of chronic bronchitis receiving amoxycillin | 24 mg/24 h | Reduced symptom severity and higher bacterial elimination | - |
Olivieri 1991 [41] | Double blind multicenter randomized controlled trial | 88 adult patients with exacerbation of bronchiectasis | 90 mg/24 h | Improved cough, auscultatory findings, expectoration difficulty and FEV1 | - |
Aylward 1973 [42] | Double blind multicenter randomized controlled trial | 38 adult patients with chronic obstructive bronchitis | 48 mg/24 h | Reduced sputum viscosity and increased expectoration volume | Gastrointestinal (n = 1) |
Barth 2015 [43] | Randomized double blind controlled parallel trial | 177 adult patients with cough due to uncomplicated upper respiratory tract infections | 24 mg/24 h | Better cough relief | Mixed (pruritus, diarrhea, abdominal pain, skin rash) (n = 6) |
Tarantino 1988 [44] | Double blind randomized controlled trial | 30 children with acute sinus inflammation receiving amoxycillin | 48 mg/24 h | Reduced nasal secretions, improvement in rhinitis; less school days lost | No adverse events reported |
Molina 1970 [45] | Observational | 48 infants with pharyngo-bronchitis, bronchopneumonia, bronchopneumonia with tubercolosis and asthmatic bronchitis | 4-24 mg/24 h | Better overall clinical improvement | - |
Fernandes 1973 [46] | Observational | 30 children with clinical symptom of mucus retention (asthma, common cold and bronchiolitis) | 0.5 mg/kg | Overall clinical improvement in patients with asthma and common cold | No adverse events reported |
Brezina 1973 [47] | Observational | 45 children with bronchitis | - | Overall clinical improvement | No adverse events reported |
Okamoto 1981 [48] | Observational | 37 children with bronchitis, common cold, asthmatic bronchitis, asthma and bronchiectasis | 0.4-0.6 mg/kg | Overall clinical improvement | No adverse events reported |
Koga 1981 [49] | Observational | 32 children with upper respiratory tract inflammation, acute bronchitis, bronchopneumonia and asthma | 0.4 mg/kg/3 times/24 h | Improved expectoration | No adverse events reported |
Camurri 1990 [50] | Open randomized comparative study | 32 children hospitalized for acute bronchitis | 24 mg/24 h | Improved expectoration and clinical outcom | No adverse events reported |
Azzolini 1984 [51] | Open randomized comparative study | 40 children with hypersecretory bronchopulmonary diseases (acute, asthmatic or recurrent bronchitis) | 6-12 mg/24 h | Improved general clinical conditions, dyspnea and sputum viscosity | Nausea and regurgitation (n = 2) Diarrhea (n = 1) |
Boner 1984 [52] | Observational | 100 children with respiratory tract infections | 0.6-0-8 mg/kg/24 h | Overall clinical improvement and better resolution in patients with acute episodes | Gastric intolerance (n = 3) |