para>In 2007, the FDA issued a warning to limit the use of all cough and cold preparations for children age ≤2 years due to risk of overdose (10,11)[A]. ‚
COMPLEMENTARY & ALTERNATIVE MEDICINE
- Zinc prevents viral replication in vitro:
- Avoid intranasal preparations of zinc: risk of potential permanent loss of smell (12)[C]
- Has shown moderate benefit in reducing symptoms and duration, but proper dosing has not been determined
- Echinacea has not proven consistently effective for treatment of common cold symptoms (12)[C].
- Probiotics may decrease severity and duration of URIs and possibly reduce episodes (3,13)[B].
- Vitamin C (ascorbic acid) (14)[C]
- Regular supplementation trials have shown that vitamin C may reduce the duration of colds.
- Vitamin C prophylaxis not recommended for general use but may be beneficial in those exposed to severe physical exertion and cold environments.
Geriatric Considerations
Cold medications, especially decongestants and antihistamines, commonly produce adverse effects in older patients and should not be used routinely.
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Pregnancy Considerations
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ONGOING CARE
FOLLOW-UP RECOMMENDATIONS
Contact a physician 's office for prolonged fever, difficulty breathing, or concern for secondary complications. ‚
DIET
Encourage fluids and adequate hydration. ‚
PATIENT EDUCATION
- Discuss the difference between viral and bacterial infections; instruct about appropriate antibiotic use.
- Good hand hygiene
- Symptomatic treatment; no cure
- Reinfection is possible with reexposure.
- Patient information: www.niaid.nih.gov/factsheets/cold.htm
PROGNOSIS
- Excellent; expect full recovery. Usual duration 5 to 7 days but may last up to 2 weeks. For smokers, 3 to 4 additional days
- Cough may persist after other symptoms have resolved.
COMPLICATIONS
Small percentage may develop worsening symptoms leading to secondary otitis media, sinusitis, bronchitis, or pneumonia. ‚
REFERENCES
11 Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/community/materials-references/index.html.22 Jefferson ‚ T, Del Mar ‚ CB, Dooley ‚ L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2011;(7):CD006207.33 Hatakka ‚ K, Savilahti ‚ E, P ƒ ¶nk ƒ ¤ ‚ A, et al. Effect of long term consumption of probiotc milk on infections in children attending day care centres: double blind, randomised trial. BMJ. 2001;322(7298):1327.44 Kenealy ‚ T, Arroll ‚ B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013;(6):CD000247.55 Li ‚ S, Yue ‚ J, Dong ‚ BR, et al. Acetaminophen (paracetamol) for the common cold in adults. Cochrane Database Syst Rev. 2013;(7):CD008800.66 Kim ‚ SY, Chang ‚ YJ, Cho ‚ HM, et al. Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst Rev. 2013;(6):CD006362.77 Horak ‚ F, Zieglmayer ‚ P, Zieglmayer ‚ R, et al. A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. Ann Allergy Asthma Immunol. 2009;102(2):116 " “120.88 Pratter ‚ MR. Cough and the common cold: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1)(Suppl):72S " “74S.99 Sutter ‚ AI, Lemiengre ‚ M, Campbell ‚ H, et al. Antihistamines for the common cold. Cochrane Database Syst Rev. 2003;(3):CD001267.1010 Centers for Disease Control and Prevention. Infant deaths associated with cough and cold medications " ”two states, 2005. MMWR Morb Mortal Wkly Rep. 2007;56(1):1 " “4.1111 Singh ‚ M, Das ‚ RR. Zinc for the common cold. Cochrane Database Syst Rev. 2013;(6):CD001364.1212 Linde ‚ K, Barrett ‚ B, W ƒ ¶lkart ‚ K, et al. Echinacea for preventing and treating the common cold.. Cochrane Database Syst Rev. 2006;(1):CD000530.1313 Hao ‚ Q, Lu ‚ Z, Dong ‚ BR, et al. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 2011;(9):CD006895.1414 Hemil ƒ ¤ ‚ H, Chalker ‚ E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;(1):CD000980.
ADDITIONAL READING
Wald ‚ ER, Applegate ‚ KE, Bordley ‚ C, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. Pediatrics. 2013;132(1):e262 " “e280. ‚
SEE ALSO
Bronchitis, Acute; Pharyngitis; Rhinitis, Allergic ‚
CODES
ICD10
- J06.9 Acute upper respiratory infection, unspecified
- J11.1 Influenza due to unidentified influenza virus with other respiratory manifestations
- B97.4 Respiratory syncytial virus causing diseases classd elswhr
- B97.29 Oth coronavirus as the cause of diseases classd elswhr
ICD9
- 465.9 Acute upper respiratory infections of unspecified site
- 465.8 Acute upper respiratory infections of other multiple sites
- 487.1 Influenza with other respiratory manifestations
- 079.6 Respiratory syncytial virus (RSV)
- 079.3 Rhinovirus infection in conditions classified elsewhere and of unspecified site
SNOMED
- 54150009 upper respiratory infection (disorder)
- 43692000 Influenzal acute upper respiratory infection
- 281794004 Viral upper respiratory tract infection (disorder)
- 55735004 Respiratory syncytial virus infection (disorder)
- 186747009 Coronavirus infection (disorder)
- 41546002 Disease due to Rhinovirus (disorder)
CLINICAL PEARLS
- Supportive therapy is mainstay for most upper respiratory tract infections.
- Point of care testing can rule out group A Streptococcus infection in the appropriate clinical setting
- Limit unnecessary use of antibiotics.
- URI symptoms last 3 to 4 more days in smokers.