Common Cold

Common Cold

More than 200 million cases of acute upper respiratory infection (URI) occur each year in the United States. In preschool children, they generally have 3 to 9 colds per year, or approximately one every 6 weeks. Children are affected more frequently during the winter months.

The common cold is a self-limited disease of viral origin. The virus families that cause the common cold include the rhinovirus, coronavirus, parainfluenza and respiratory syncytial virus. Symptoms consist of rhinorrhea, nasal congestion, cough and low grade fever defined as a temperature >= 39C.

Treatment of the common cold

Most infants and children require no pharmacologic treatment for the common cold. In fact, the America Academy of Pediatrics does not recommend cough and common cold medications for children less than 7 years of age. The FDA recommends no pharmacologic treatment in children less than 5 years of age. Using a cool vaporized mist, sleeping with the head elevated, and using saline nasal drops with a bulb syringe in infants prior to feeding may help reduce symptoms. Anedoctal evidence suggests that adding 1/4 teaspoon of salt to 8 oz of water for nasal saline drops may be helpful. Cold medications should be avoided during the first 6 to 9 months of life.

Antihistamines for the common cold

The common cold is most commonly caused by a rhinovirus. It is self-limiting disease but can cause major concern for the caregiver. In a recent Cochrane Database review, Sutter_CochranceDatabase_2015_Antihistamine for the Common cold, the effect in adults is self limited to the first two days of the common cold. The effect wears off after two days with significant effectiveness of OTC medications as compared to placebo. There is no evidence of effectiveness of antihistamines in children.

Corticosteroids

In Hayward_CochraneDatabaseSystRev_2015 Corticosteroids for the common cold, a meta-analysis looked at the effects of oral and nasal corticosteroids as compared to placebo. The trial concluded that there is currently no evidence that support the use of corticosteroid for the common cold. Two trials reported secondary bacterial infections (sinusitis and acute otitis media) associated with the corticosteroid usage.

Saline Nasal Irrigation

In King_CochraneDatabaseSystRev_2015_Saline nasal irrigation for acute upper respiratory infections, the meta-analysis looked at the common usage of saline nasal irrigation for acute upper respiratory tract infections. The meta-analysis looked at children and adults with most trial results being small and difficult to interpret. However, nasal saline irrigation can have beneficial effects of relieving the symptoms of acute upper respiratory tract infections.

Antibiotics

It has long been believed that antibiotics have no role in treating common colds as the majority of cases are caused by viruses. However, antibiotic are often prescribed in the belief that they may prevent secondary bacterial infections. In a meta-analysis by Kenealy_CochraneDatabaseSystRev_2013_antibiotics for the common cold and acute purulent rhinitis, there is no evidence that antibiotics help cure the common cold.