Common cold

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Common cold
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BackgroundHeikkinen T and Järvinen A. Lancet
20033615159.

• Viral cause rhinoviruses 3050, coronaviruses
  1015, influenza viruses 5 15, RSV 5,
  parainfluenza viruses 5
• Youngest children 6 8 colds per year, adults 2
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• Seasonality
• Infection transmission
• Dose-dependant viral innoculation load - hand
  contact, direct hit large particle aerosols,
  lingering small particle aerosols
• Rhinovirus incubation period 1012h, influenza
  17 days

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http//www.idinchildren.com Source Gwaltney JM.
JAMA. 1967202494-498
.
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To treat a cold? Cochrane reviews (Arroll B,
Kenealy T. Issue 3 2005) and Clinical Evidence
(Arrol B. Search date May 2005)

• Antibiotics No evidence of benefit, at expense
  of evidence of side effects
• Decongestants Single dose relieves symptoms in
  adults, no evidence that repeated use helps. Not
  recommended in children
• Antihistamines Inconclusive
• Vitamin C No evidence that it prevents cold,
  some evidence, in high dose that it relieves
  duration by about 0.5 day.
• Zinc Inconclusive (harm?)
• Heat, humidified air Inconclusive some risks
• Echinacea - Poor quality studies. 3 recent better
  RCTs all negative

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Paracetamol or ibuprofen for children?Arch
Pediatr Adolesc Med 2004 158 521 526.

• Meta analysis 17 RCTs in total
• Pain relief (3 RCTs, 186 children) no difference
• Fever reduction favoured ibuprofen (9 RCTs, 1078
  children) at 2, 4 and 6 hours
• Safety data showed no difference

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Common cold - Summary

• The common cold is viral in origin and,
  therefore, antibiotics are of little benefit at
  the expense of known side effects
• Symptoms of the cold can last 2 weeks or more.
  Explanation of this and patient reassurance are
  important in patient management
• Paracetamol or ibuprofen may be useful to relieve
  symptoms of pain