![]() Systematic reviews and a clinical practice guideline from the American College of Chest Physicians 46, 47Ĭonsistent findings of no benefit and increased adverse effects in systematic reviews of 11 RCTsĬodeine and other antitussives have not been proven effective for cough in adults. Systematic reviews of RCTs of varying qualityĪntibiotics are ineffective for treatment of the common cold in adults and children and should not be prescribed. Treatments with established effectiveness for cold symptoms in adults are limited to over-the-counter analgesics and decongestants with or without antihistamines (but not antihistamine monotherapy). Systematic review of cluster RCTs and observational studies with variable risk of bias The use of hand sanitizer or hand washing is the most effective way to prevent the common cold. Lack of benefit in 10 RCTs in children and observational studies of adverse effects Over-the-counter cold medications should not be used in children younger than four years because of potential harms and lack of benefit. 5, 6 Informing patients about the natural course of the common cold can help manage expectations, limit antibiotic use, 7 and avoid unnecessary over-the-counter purchases ( Table 2). Over-the-counter cold medications should not be used to treat children younger than four years because of lack of benefit and low but significant mortality rates associated with their use in this population. The primary goals of treatment are reduction of symptom duration and severity. 3 The common cold should be distinguished from allergic rhinitis, isolated pharyngitis, acute bronchitis (which generally has a longer duration, with a mean of 18 days in adults and 12 days in children 2, 4), influenza, bacterial sinusitis, and pertussis ( Table 1). ![]() 2 Viruses such as rhinovirus are the predominant cause of acute URI transmission occurs through contact with the nasal secretions and saliva of infected people. In children, the median duration is eight days in those who receive medical care, and 90% of cases resolve within 23 days. Symptoms are self-limited, often lasting up to 10 days. 1 Patients typically present with nasal congestion, rhinorrhea, sore throat, cough, general malaise, and/or low-grade fever. Counseling patients about the importance of good hand hygiene is the best way to prevent transmission of cold viruses.Īcute upper respiratory tract infection (URI), also called the common cold, is the most common acute illness in the United States and the industrialized world. Over-the-counter cold medications should not be used in children younger than four years. The only established safe and effective treatments for children are acetylcysteine, honey (for children one year and older), nasal saline irrigation, intranasal ipratropium, and topical application of ointment containing camphor, menthol, and eucalyptus oils. Lower-quality evidence suggests that Lactobacillus casei may be beneficial in older adults. Treatments with proven effectiveness for cold symptoms in adults include over-the-counter analgesics, zinc, nasal decongestants with or without antihistamines, and ipratropium for cough. Informing patients about the self-limited nature of the common cold can help manage expectations, limit antibiotic use, and avoid over-the-counter purchases that may not help. Patients typically present with nasal congestion, rhinorrhea, sore throat, cough, general malaise, and/or low-grade fever. Acute upper respiratory tract infections are extremely common in adults and children, but only a few safe and effective treatments are available.
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