{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:08:57Z","timestamp":1788952137171,"version":"build-2803163510"},"reference-count":89,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Ear Nose Throat"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Upper and lower respiratory tract infections are common conditions for which medical advice is sought, and their management relies on the use of prescription and over-the-counter (OTC) medicines. Ambroxol, bromhexine, carbocysteine, erdosteine, N-acetyl cysteine (NAC), and sobrerol are mucoactive agents for which clinical trials have been conducted, have been awarded well-established status by regulatory authorities, and are available as OTC or prescription products. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p> To briefly review the evidence-based efficacy and safety of these substances in the therapy of upper respiratory airways infections. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> We conducted searches in MEDLINE and other databases for clinical trials and reviews done on the efficacy and safety of ambroxol, bromhexine, carbocysteine, erdosteine, NAC, and sobrerol. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Clinical trials have shown that these mucolytics have an important place in the relief of cough symptoms by easing the elimination of mucus. All drugs have shown comparable efficacy in the symptomatic treatment of productive cough, with some shared characteristics and some specific features. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and relevance:<\/jats:title><jats:p> All mucolytics reviewed have a good safety profile, although some precautions should be taken when using ambroxol and bromhexine, and the use of NAC and carbocysteine should be monitored in special patient groups. Overall, however, the available evidence from randomised, controlled, and observational trials, as well as pragmatic, real-life experience, suggests that these products are useful in the therapy of upper respiratory airways infections, including bronchitis, sinusitis, and rhinosinusitis. <\/jats:p><\/jats:sec>","DOI":"10.1177\/1179550618821930","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T19:52:25Z","timestamp":1547063545000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":32,"title":["Mucoactive Agents in the Therapy of Upper Respiratory Airways Infections: Fair to Describe Them Just as Mucoactive?"],"prefix":"10.1177","volume":"12","author":[{"given":"Francesco","family":"Scaglione","sequence":"first","affiliation":[{"name":"Department of Oncology and Onco-Hematology, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1234-7832","authenticated-orcid":false,"given":"Orlando","family":"Petrini","sequence":"additional","affiliation":[{"name":"Pole Pharma Consulting, Breganzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,9]]},"reference":[{"key":"bibr1-1179550618821930","unstructured":"The burden of lung disease. https:\/\/www.erswhitebook.org\/chapters\/the-economic-burden-of-lung-disease\/. Accessed September 10, 2018."},{"key":"bibr2-1179550618821930","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X677130"},{"key":"bibr3-1179550618821930","unstructured":"The economic burden of lung disease. https:\/\/www.erswhitebook.org\/chapters\/the-economic-burden-of-lung-disease\/. Accessed September 10, 2018."},{"key":"bibr4-1179550618821930","first-page":"1176","volume":"52","author":"Rogers DF.","year":"2007","journal-title":"Respir Care"},{"key":"bibr5-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S140603"},{"key":"bibr6-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00711-2017"},{"key":"bibr7-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1016\/j.pupt.2016.09.007"},{"key":"bibr8-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S87091"},{"key":"bibr9-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1016\/j.pupt.2015.06.004"},{"key":"bibr10-1179550618821930","first-page":"351","volume":"11","author":"Shen Y","year":"2014","journal-title":"COPD"},{"key":"bibr11-1179550618821930","volume":"7","author":"Poole P","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr12-1179550618821930","volume":"7","author":"Welsh EJ","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr13-1179550618821930","volume":"11","author":"Smith SM","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr14-1179550618821930","volume":"3","author":"Chang CC","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr15-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.4.8.1119"},{"key":"bibr16-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-006-0099-2"},{"key":"bibr17-1179550618821930","first-page":"967","volume":"37","author":"Gene R","year":"1987","journal-title":"Arzneimittelforschung"},{"key":"bibr18-1179550618821930","first-page":"369","volume":"6","author":"Principi N","year":"1986","journal-title":"Int J Clin Pharmacol Res"},{"key":"bibr19-1179550618821930","first-page":"965","volume":"37","author":"Spatola J","year":"1987","journal-title":"Arzneimittelforschung"},{"key":"bibr20-1179550618821930","first-page":"974","volume":"31","author":"Wiemeyer JC.","year":"1981","journal-title":"Arzneimittelforschung"},{"key":"bibr21-1179550618821930","unstructured":"European Medicines Agency (EMA). Revised assessment report\u2014procedure under article 31 of directive 2001\/83\/EC resulting from pharmacovigilance data. Ambroxol and bromhexine containing medicinal products. https:\/\/www.ema.europa.eu\/documents\/referral\/ambroxol-bromhexine-article-31-referral-prac-assessment-report_en.pdf.EMA\/PRAC\/800767\/2015. Published September 10, 2015."},{"key":"bibr22-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0000000000000031"},{"key":"bibr23-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1186\/s40248-017-0088-1"},{"key":"bibr24-1179550618821930","first-page":"705","volume":"34","author":"Bergogne-Berezin E","year":"1979","journal-title":"Therapie"},{"key":"bibr25-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-7158.1993.tb03696.x"},{"key":"bibr26-1179550618821930","first-page":"267","volume":"45","author":"Roa CC","year":"1995","journal-title":"Arzneimittelforschung"},{"key":"bibr27-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200124070-00003"},{"key":"bibr28-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1177\/030006057900700518"},{"key":"bibr29-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2011.11.004"},{"key":"bibr30-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00053805"},{"key":"bibr31-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2174\/138945006777435254"},{"key":"bibr32-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2012.01.015"},{"key":"bibr33-1179550618821930","volume":"8","author":"Poole P","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr34-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7297.1271"},{"key":"bibr35-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01373.x"},{"key":"bibr36-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.00592_9.x"},{"key":"bibr37-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1999.tb01265.x"},{"key":"bibr38-1179550618821930","volume":"5","author":"Chalumeau M","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr39-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022792"},{"key":"bibr40-1179550618821930","first-page":"609","volume":"45","author":"Koreeda Y","year":"2007","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"bibr41-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.52.7882"},{"key":"bibr42-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1517\/17425250902814790"},{"key":"bibr43-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2174\/1389450111314020007"},{"key":"bibr44-1179550618821930","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199652060-00009"},{"key":"bibr45-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1016\/j.pupt.2009.10.002"},{"key":"bibr46-1179550618821930","doi-asserted-by":"publisher","DOI":"10.5414\/CPP45016"},{"key":"bibr47-1179550618821930","doi-asserted-by":"publisher","DOI":"10.5414\/CPP38402"},{"key":"bibr48-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2009.01646.x"},{"key":"bibr49-1179550618821930","first-page":"381","volume":"7","author":"Braga PC","year":"1987","journal-title":"Int J Clin Pharmacol Res"},{"key":"bibr50-1179550618821930","first-page":"761","volume":"109","author":"Dalla Valle V","year":"1970","journal-title":"Boll Chim Farm"},{"key":"bibr51-1179550618821930","first-page":"263","volume":"63","author":"Braga PC","year":"2009","journal-title":"Giorn It Mal Tor"},{"key":"bibr52-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003124.pub3"},{"key":"bibr53-1179550618821930","doi-asserted-by":"publisher","DOI":"10.3889\/seejim.2017.20011"},{"key":"bibr54-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2008.09.0024"},{"key":"bibr55-1179550618821930","volume":"186","author":"Dal Negro RW","year":"2008","journal-title":"Lung"},{"key":"bibr56-1179550618821930","first-page":"191","volume":"38","author":"Seidita F","year":"1984","journal-title":"G Ital Mal Torace"},{"key":"bibr57-1179550618821930","first-page":"105","volume":"135","author":"Marchioni CF","year":"1990","journal-title":"Clin Ter"},{"key":"bibr58-1179550618821930","first-page":"1353","volume":"72","author":"Finiguerra M","year":"1981","journal-title":"Minerva Med"},{"key":"bibr59-1179550618821930","first-page":"477","volume":"21","author":"Medici TC","year":"1985","journal-title":"Bull Eur Physiopathol Respir"},{"key":"bibr60-1179550618821930","first-page":"936","volume":"37","author":"Meyer-Shang H","year":"1983","journal-title":"Prax Klin Pneumol"},{"key":"bibr61-1179550618821930","first-page":"1846","volume":"112","author":"Shang H","year":"1982","journal-title":"Schweiz Med Wochenschr"},{"key":"bibr62-1179550618821930","first-page":"258","volume":"33","author":"Puler\u00e0 N","year":"1989","journal-title":"J Nucl Med Allied Sci"},{"key":"bibr63-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1159\/000194928"},{"key":"bibr64-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1177\/030006059001800602"},{"key":"bibr65-1179550618821930","first-page":"31","volume":"8","author":"Distefano SM","year":"1988","journal-title":"Int J Clin Pharmacol Res"},{"key":"bibr66-1179550618821930","first-page":"243","volume":"7","author":"Milvio C","year":"1981","journal-title":"Acta Ther"},{"key":"bibr67-1179550618821930","first-page":"1199","volume":"36","author":"Miraglia del Giudice M","year":"1984","journal-title":"Minerva Pediatr"},{"key":"bibr68-1179550618821930","first-page":"241","volume":"27","author":"Azzollini E","year":"1990","journal-title":"Clin Trials J"},{"key":"bibr69-1179550618821930","first-page":"1995","volume":"64","author":"Balzano E","year":"1973","journal-title":"Minerva Med"},{"key":"bibr70-1179550618821930","first-page":"562","volume":"43","author":"Monzali G","year":"1970","journal-title":"Riv Pat Clin Tuberc"},{"key":"bibr71-1179550618821930","first-page":"135","volume":"60","author":"Marchioni CF","year":"1972","journal-title":"Clin Ter"},{"key":"bibr72-1179550618821930","first-page":"82","volume":"78","author":"Dotta F","year":"1971","journal-title":"Policlin Med"},{"key":"bibr73-1179550618821930","first-page":"163","volume":"26","author":"Morandini G","year":"1989","journal-title":"Clin Trials J"},{"key":"bibr74-1179550618821930","first-page":"127","volume":"25","author":"Morandini GC","year":"1986","journal-title":"Min Pneum"},{"key":"bibr75-1179550618821930","first-page":"83","volume":"11","author":"Catena E","year":"1989","journal-title":"Med Toracica"},{"key":"bibr76-1179550618821930","first-page":"791","volume":"44","author":"Gramiccioni E","year":"1989","journal-title":"Arch Monaldi Mal Torace"},{"key":"bibr77-1179550618821930","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2049-6958-7-1","volume":"7","author":"Zanasi A","year":"2012","journal-title":"Multidiscip Respir Med"},{"key":"bibr78-1179550618821930","first-page":"239","volume":"106","author":"Zanasi A","year":"2015","journal-title":"Minerva Med"},{"key":"bibr79-1179550618821930","first-page":"269","volume":"92","author":"Fadda G.","year":"2001","journal-title":"Minerva Med"},{"key":"bibr80-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1177\/030006058901700311"},{"key":"bibr81-1179550618821930","first-page":"151","volume":"132","author":"Gramolini C","year":"1990","journal-title":"Clin Ter"},{"key":"bibr82-1179550618821930","first-page":"391","volume":"7","author":"Milder H","year":"1981","journal-title":"Acta Ther"},{"key":"bibr83-1179550618821930","first-page":"247","volume":"139","author":"Crosca V","year":"1982","journal-title":"Arch Sci Med (Torino)"},{"key":"bibr84-1179550618821930","first-page":"859","volume":"52","author":"Rubin BK.","year":"2007","journal-title":"Respir Care"},{"key":"bibr85-1179550618821930","volume":"129","author":"Braman SS.","year":"2006","journal-title":"Chest"},{"key":"bibr86-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.1_suppl.95S"},{"key":"bibr87-1179550618821930","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255526"},{"key":"bibr88-1179550618821930","volume":"5","author":"Wilkinson M","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr89-1179550618821930","volume-title":"Farmaci mucoattivi nebulizzati: differenze nelle caratteristiche dell\u2019aerosol ed effetto della combinazione con broncodilatatori e cortisonici","author":"Zanasi A","year":"2014"}],"container-title":["Clinical Medicine Insights: Ear, Nose and Throat"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179550618821930","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1179550618821930","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179550618821930","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T02:57:10Z","timestamp":1727665030000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1179550618821930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":89,"alternative-id":["10.1177\/1179550618821930"],"URL":"https:\/\/doi.org\/10.1177\/1179550618821930","relation":{},"ISSN":["1179-5506","1179-5506"],"issn-type":[{"value":"1179-5506","type":"print"},{"value":"1179-5506","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]},"article-number":"1179550618821930"}}