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The common cold in adults: Treatment and prevention

Authors
Daniel J Sexton, MD
Micah T McClain, MD
Section Editors
Martin S Hirsch, MD
Mark D Aronson, MD
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

The common cold is a benign self-limited syndrome representing a group of diseases caused by members of several families of viruses. It is the most frequent acute illness in the United States and throughout the industrialized world [1]. The term "common cold" refers to a mild upper respiratory viral infection involving, to variable degrees, nasal congestion and discharge (rhinorrhea), sneezing, sore throat, cough, low-grade fever, headache, and malaise. The common cold is a separate and distinct entity, distinguishable from influenza, bacterial pharyngitis, acute bronchitis, acute bacterial sinusitis, allergic rhinitis, and pertussis.

Treatment and prevention for the common cold are reviewed here. The epidemiology and clinical manifestations of colds are discussed separately. (See "The common cold in adults: Diagnosis and clinical features".)

PROGNOSIS

For most people and most colds, symptoms are self-limited. The common cold is usually an uncomplicated illness; however, occasionally, patients may develop complications (eg, sinusitis, lower respiratory tract disease, asthma exacerbations, acute otitis media). (See "The common cold in adults: Diagnosis and clinical features", section on 'Incubation period and symptom duration' and "The common cold in adults: Diagnosis and clinical features", section on 'Complications'.)

MILD SYMPTOMS

Most patients with mild symptoms do not require any symptomatic therapies. Such patients should be advised to return for review if their condition worsens or exceeds the expected time for recovery [2,3]. (See "The common cold in adults: Diagnosis and clinical features", section on 'Incubation period and symptom duration'.)

MODERATE-TO-SEVERE SYMPTOMS

Symptomatic therapy remains the mainstay of common cold treatment. Patients with moderate-to-severe symptoms may use a variety of therapies to relieve symptoms.

                               

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Literature review current through: Nov 2016. | This topic last updated: Tue Apr 05 00:00:00 GMT+00:00 2016.
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References
Top
  1. Kirkpatrick GL. The common cold. Prim Care 1996; 23:657.
  2. Tan T, Little P, Stokes T, Guideline Development Group. Antibiotic prescribing for self limiting respiratory tract infections in primary care: summary of NICE guidance. BMJ 2008; 337:a437.
  3. National Institute for Health and Care Excellence. Prescribing of antibiotics for self limiting respiratory tract infections in adults and children in primary care. 2008. (Clinical guideline 69). www.nice.org.uk/guidance/index.jsp?action=download&o=41323 (Accessed on August 31, 2011).
  4. Little P, Moore M, Kelly J, et al. Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ 2013; 347:f6041.
  5. Bachert C, Chuchalin AG, Eisebitt R, et al. Aspirin compared with acetaminophen in the treatment of fever and other symptoms of upper respiratory tract infection in adults: a multicenter, randomized, double-blind, double-dummy, placebo-controlled, parallel-group, single-dose, 6-hour dose-ranging study. Clin Ther 2005; 27:993.
  6. Kim SY, Chang YJ, Cho HM, et al. Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst Rev 2015; :CD006362.
  7. De Sutter AI, van Driel ML, Kumar AA, et al. Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database Syst Rev 2012; :CD004976.
  8. Over-the-counter (OTC) cough remedies. Med Lett Drugs Ther 2001; 43:23.
  9. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev 2014; :CD001831.
  10. Pavesi L, Subburaj S, Porter-Shaw K. Application and validation of a computerized cough acquisition system for objective monitoring of acute cough: a meta-analysis. Chest 2001; 120:1121.
  11. Aberg N, Aberg B, Alestig K. The effect of inhaled and intranasal sodium cromoglycate on symptoms of upper respiratory tract infections. Clin Exp Allergy 1996; 26:1045.
  12. AlBalawi ZH, Othman SS, Alfaleh K. Intranasal ipratropium bromide for the common cold. Cochrane Database Syst Rev 2013; :CD008231.
  13. Taverner D, Latte J. Nasal decongestants for the common cold. Cochrane Database Syst Rev 2007; :CD001953.
  14. Hatton RC, Winterstein AG, McKelvey RP, et al. Efficacy and safety of oral phenylephrine: systematic review and meta-analysis. Ann Pharmacother 2007; 41:381.
  15. 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; 102:116.
  16. US Food and Drug Administration. Phenylpropanolamine (PPA) information page. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm150738.htm (Accessed on March 28, 2007).
  17. King D, Mitchell B, Williams CP, Spurling GK. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev 2015; :CD006821.
  18. Turner RB. Epidemiology, pathogenesis, and treatment of the common cold. Ann Allergy Asthma Immunol 1997; 78:531.
  19. Lizogub VG, Riley DS, Heger M. Efficacy of a pelargonium sidoides preparation in patients with the common cold: a randomized, double blind, placebo-controlled clinical trial. Explore (NY) 2007; 3:573.
  20. Matthys H, Heger M. Treatment of acute bronchitis with a liquid herbal drug preparation from Pelargonium sidoides (EPs 7630): a randomised, double-blind, placebo-controlled, multicentre study. Curr Med Res Opin 2007; 23:323.
  21. Hemilä H. Zinc lozenges may shorten the duration of colds: a systematic review. Open Respir Med J 2011; 5:51.
  22. Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2012; 184:E551.
  23. Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev 2013; :CD001364.
  24. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm166931.htm (Accessed on April 04, 2011).
  25. Davidson TM, Smith WM. The Bradford Hill criteria and zinc-induced anosmia: a causality analysis. Arch Otolaryngol Head Neck Surg 2010; 136:673.
  26. Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev 2011; :CD001364.
  27. Harris AM, Hicks LA, Qaseem A, High Value Care Task Force of the American College of Physicians and for the Centers for Disease Control and Prevention. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med 2016; 164:425.
  28. Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev 2013; :CD000247.
  29. De Sutter AI, Saraswat A, van Driel ML. Antihistamines for the common cold. Cochrane Database Syst Rev 2015; :CD009345.
  30. Chubak J, McTiernan A, Sorensen B, et al. Moderate-intensity exercise reduces the incidence of colds among postmenopausal women. Am J Med 2006; 119:937.
  31. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2013; :CD000980.
  32. Mygind N, Andersson M. Topical glucocorticosteroids in rhinitis: clinical aspects. Acta Otolaryngol 2006; 126:1022.
  33. Hayward G, Thompson MJ, Perera R, et al. Corticosteroids for the common cold. Cochrane Database Syst Rev 2015; :CD008116.
  34. Singh M, Singh M. Heated, humidified air for the common cold. Cochrane Database Syst Rev 2013; :CD001728.
  35. Jefferson T, Del Mar C, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev 2010; :CD006207.
  36. Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev 2015; :CD006895.
  37. Grande AJ, Keogh J, Hoffmann TC, et al. Exercise versus no exercise for the occurrence, severity and duration of acute respiratory infections. Cochrane Database Syst Rev 2015; :CD010596.
  38. Barrett B, Hayney MS, Muller D, et al. Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Ann Fam Med 2012; 10:337.
  39. Prather AA, Janicki-Deverts D, Hall MH, Cohen S. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep 2015; 38:1353.
  40. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2009; 169:384.
  41. Murdoch DR, Slow S, Chambers ST, et al. Effect of vitamin D3 supplementation on upper respiratory tract infections in healthy adults: the VIDARIS randomized controlled trial. JAMA 2012; 308:1333.
  42. Rees JR, Hendricks K, Barry EL, et al. Vitamin D3 supplementation and upper respiratory tract infections in a randomized, controlled trial. Clin Infect Dis 2013; 57:1384.
  43. Meydani SN, Leka LS, Fine BC, et al. Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial. JAMA 2004; 292:828.
  44. Miller ER 3rd, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005; 142:37.
  45. Jacobs JL, Ohde S, Takahashi O, et al. Use of surgical face masks to reduce the incidence of the common cold among health care workers in Japan: a randomized controlled trial. Am J Infect Control 2009; 37:417.
  46. Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev 2014; :CD006206.
  47. Seida JK, Durec T, Kuhle S. North American (Panax quinquefolius) and Asian Ginseng (Panax ginseng) Preparations for Prevention of the Common Cold in Healthy Adults: A Systematic Review. Evid Based Complement Alternat Med 2011; 2011:282151.
  48. Satomura K, Kitamura T, Kawamura T, et al. Prevention of upper respiratory tract infections by gargling: a randomized trial. Am J Prev Med 2005; 29:302.
  49. Bisgaard H, Zielen S, Garcia-Garcia ML, et al. Montelukast reduces asthma exacerbations in 2- to 5-year-old children with intermittent asthma. Am J Respir Crit Care Med 2005; 171:315.
  50. Horiguchi T, Ohira D, Kobayashi K, et al. Clinical evaluation of leukotriene receptor antagonists in preventing common cold-like symptoms in bronchial asthma patients. Allergol Int 2007; 56:263.