BEHAVIORAL CHANGES IN CHILDREN WITH URTI MANAGED WITH OR WITHOUT ANTIHISTAMINES: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Upper respiratory tract infections (URTIs) are common in children and frequently lead to behavioural disturbances such as irritability, hyperactivity, and reduced attention. Although antihistamines are widely used for symptomatic relief, their behavioural effects during URTI episodes have not been systematically evaluated.

Objective: To compare short-term behavioural outcomes in children with URTI managed with second-generation antihistamines versus those managed without antihistamines.

Methods: This single-blind, randomized controlled trial included 100 children aged 2–12 years with clinically diagnosed URTI. Participants were randomized into two groups: one received age-appropriate doses of cetirizine or loratadine for five days, and the other received symptomatic treatment without antihistamines. Behavioural changes were assessed using the Achenbach Child Behaviour Checklist (CBCL) and Conners’ Parent Rating Scale (CPRS) at baseline, Day 3, and Day 7. Adverse effects and symptom duration were also recorded.

Results: Baseline demographic and behavioural scores were comparable between groups. By Day 3, children in the antihistamine group showed significant reductions in irritability and hyperactivity (p = 0.03 and 0.04, respectively). By Day 7, the antihistamine group demonstrated significant improvements in all behavioural domains, including attention deficit (p = 0.03) and social interaction (p = 0.05). However, adverse effects such as drowsiness (20%) and dry mouth (12%) were reported exclusively in the antihistamine group (p < 0.05).

Conclusion:Short-term use of second-generation antihistamines in children with URTI was associated with significant behavioural improvement, particularly in irritability, hyperactivity, and attention. However, these benefits were accompanied by mild but notable side effects. Judicious use of antihistamines is recommended, especially in cases with mild behavioural symptoms. Further large-scale trials are needed to confirm these findings and assess long-term outcomes.