Respiratory tract diseases have a significant impact on the life of large number of people worldwide. In developed countries, they account for 7% of hospital admissions and are associated with approximately 12% of all-cause deaths. Hence, these are the common conditions for which medical advice is sought, and their management is largely dependent on the use of prescription and over-the-counter (OTC) medicines. Mucoactive drugs are frequently used as a therapeutic option for mucus alterations that involves hypersecretion. Their potential for mucus-thinning (mucolytics), cough-inducing (expectorants), and cough transport facilitating (mucokinetics) can be clinically used to ease airway clearance in several indications such as bronchiectasis, chronic obstructive pulmonary disease (COPD), acute, and chronic bronchitis or resolution of symptoms of acute cough caused by RTI. Several mucoactive agents have been regarded the status of OTC or prescription drugs, among which ambroxol is successfully used in upper respiratory infections.

The current study evaluated the evidence-based efficacy and safety of these mucoactive agents such as ambroxol in the management of upper respiratory airways infections. The authors reviewed MEDLINE and other databases for clinical trials conducted on the efficacy and safety of these agents such as ambroxol.

The results indicated that these mucolytics agents including ambroxol are potent drugs in the resolution of cough symptoms by easing the elimination of mucus.

Thus, it can be inferred that mucolytics such as ambroxol exhibit a good safety profile with certain precautions. Additionally, the evidences from randomised, controlled, and observational trials, along with pragmatic, real-life experience, demonstrate that these agents are efficacious in the management of upper respiratory airways infections, including bronchitis, sinusitis, and rhinosinusitis. These drugs are potent to alter the volume of secretions or their composition and thus, can successfully ease symptoms of respiratory tract diseases such as productive cough which is attributed to their mucolytic, anti-inflammatory, and antioxidant properties.

Source: Scaglione F, Petrini O. Mucoactive Agents in the Therapy of Upper Respiratory Airways Infections: Fair to Describe Them Just as Mucoactive?. Clin Med Insights Ear Nose Throat. 2019;12:1179550618821930. Published 2019 Jan 9.