An expert review has concluded that over-the-counter decongestant medications should not be used for the treatment of the common cold in children under 6 years of age, and should be used with caution in children aged 6 to 12 years.
The review found no evidence that decongestants (with or without an antihistamine) alleviate nasal symptoms such as congestion, rhinorrhoea, or sneezing in children. However, there is evidence that they may cause adverse effects such as drowsiness and gastrointestinal upset. More serious harms such as convulsions and rapid heart rate, as well as death, have also been linked to decongestant use in very young children.
Saline nasal drops or irrigations may be used safely, but do not always give effective relief. There is no adequate evidence for other treatments in children. Antibiotics are neither effective nor recommended.
The review also looked at the use of over-the-counter products in adults. Evidence supports the use of decongestants (with or without an antihistamine or analgesic) for 3 to 7 days if cold symptoms are bothersome; however, the effect is considered small.
Reassure the patient that the common cold is self-limiting and that symptoms usually clear in 7 to 10 days.
See Management: approach See Management: treatment algorithmProfessor
Department of General Practice and Primary Health Care
University of Auckland
Auckland
New Zealand
BA is an author of a number of references cited in this topic.
Associate Professor of Integrated Care
Department of General Practice and Primary Health Care
University of Auckland
Auckland
New Zealand
TK is an author of a number of references cited in this topic.
Senior Research Fellow
Division of Community Health Sciences
St. George's University of London
London
UK
CC declares that he has no competing interests.
Professor
Faculty of Health Sciences and Medicine
Bond University
Queensland
Australia
CDM declares that he has no competing interests.
Associate Professor
Department of General Practice and Primary Health Care
Ghent University
Belgium
ADS declares that she has no competing interests.
Mary Lowell Leary Endowed Professor
General Internal Medicine
Paediatrics
Mayo Clinic
Rochester
MN
GP has no competing interests in regards to the common cold. He does consult with a variety of manufacturers and performs research studies related to influenza, founded by vaccine manufacturers, none of which involves virus related to the common cold.
Professor of Clinical Medicine
Albert Einstein College of Medicine
Director
Intensive Care Unit
Weiler Division/Montefiore Medical Center
Bronx
NY
PD has served as a consultant to Reckitt Benckiser, Procter & Gamble, Wyeth Pharmaceuticals, Novartis, Glaxo SmithKline, and Boehringer Ingelheim.
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