Reassure patients about the self-limiting nature of the condition, and that symptoms usually clear within 7 to 10 days. The severity and duration of symptoms appear to be related to what the patient believes and feels about the treatment received, and empathetic treatment, as perceived by the patient, is associated with improvement in symptoms and biochemical markers.[28]Barrett B, Brown R, Rakel D, et al. Placebo effects and the common cold: a randomized controlled trial. Ann Fam Med. 2011 Jul-Aug;9(4):312-22.
http://www.annfammed.org/content/9/4/312.long
http://www.ncbi.nlm.nih.gov/pubmed/21747102?tool=bestpractice.com
[29]Rakel D, Barrett B, Zhang Z, et al. Perception of empathy in the therapeutic encounter: effects on the common cold. Patient Educ Couns. 2011 Dec;85(3):390-7.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107395/
http://www.ncbi.nlm.nih.gov/pubmed/21300514?tool=bestpractice.com
[30]Coxeter P, Del Mar CB, McGregor L, et al. Interventions to facilitate shared decision making to address antibiotic use for acute respiratory infections in primary care. Cochrane Database Syst Rev. 2015 Nov 12;(11):CD010907.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010907.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/26560888?tool=bestpractice.com
Advise patients about hygiene measures and limiting the spread to others, as well as the importance of rest and maintaining fluid intake to stay hydrated. The implications of increased fluid intake in acute respiratory infections have not been studied in any trials to date.[31]Guppy MP, Mickan SM, Del Mar CB, et al. Advising patients to increase fluid intake for treating acute respiratory infections. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD004419.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004419.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/21328268?tool=bestpractice.com
Symptomatic relief is the mainstay of treatment. Many over-the-counter medications claim to alleviate symptoms of the common cold; however, quality evidence to support the use of these medications is limited.[32]van Driel ML, Scheire S, Deckx L, et al. What treatments are effective for common cold in adults and children? BMJ. 2018 Oct 10;363:k3786.
https://www.bmj.com/content/363/bmj.k3786.long
http://www.ncbi.nlm.nih.gov/pubmed/30305295?tool=bestpractice.com
The BMJ: what treatments are effective for common cold in adults and children?
external link opens in a new window
Fever and pain
Acetaminophen is recommended for pain and/or fever. Evidence suggests that it may also help with nasal congestion and rhinorrhea, but not sore throat, malaise, sneezing, or cough.[33]Li S, Yue J, Dong BR, et al. Acetaminophen (paracetamol) for the common cold in adults. Cochrane Database Syst Rev. 2013 Jul 1;(7):CD008800.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008800.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/23818046?tool=bestpractice.com
Despite this, it is still one of the most widely used analgesic/antipyretic agents, and is a first choice for many clinicians for the management of pain and fever in both adults and children.[34]Eccles R. Efficacy and safety of over-the-counter analgesics in the treatment of common cold and flu. J Clin Pharm Ther. 2006 Aug;31(4):309-19.
http://www.ncbi.nlm.nih.gov/pubmed/16882099?tool=bestpractice.com
A review of nonsteroidal anti-inflammatory drugs (NSAIDs) found benefit for reducing discomfort, but found no benefit in terms of easing respiratory symptoms. Possible adverse effects need to be considered (e.g., gastrointestinal adverse effects, rash).[35]Kim SY, Chang YJ, Cho HM, et al. Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst Rev. 2015 Sep 21;(9):CD006362.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006362.pub4/full
http://www.ncbi.nlm.nih.gov/pubmed/26387658?tool=bestpractice.com
[
]
Is there randomized controlled trial evidence to support the use of non-steroidal anti-inflammatory drugs in people with the common cold?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.1126/fullShow me the answer Studies of aspirin have found it to be effective for pain and fever, without serious gastrointestinal adverse effects with short-term use,[36]McCarthy DM. Efficacy and gastrointestinal risk of aspirin used for the treatment of pain and cold. Best Pract Res Clin Gastroenterol. 2012 Apr;26(2):101-12.
http://www.ncbi.nlm.nih.gov/pubmed/22542149?tool=bestpractice.com
although a small increased risk of dyspepsia has been reported.[37]Lanas A, McCarthy D, Voelker M, et al. Short-term acetylsalicylic acid (aspirin) use for pain, fever, or colds - gastrointestinal adverse effects: a meta-analysis of randomized clinical trials. Drugs R D. 2011 Sep 1;11(3):277-88.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586117/
http://www.ncbi.nlm.nih.gov/pubmed/21902288?tool=bestpractice.com
Aspirin should be avoided in children and adolescents under 18 years of age because of the risk of Reye syndrome.
Analgesics are available as single-agent or combination (with decongestants and/or antihistamines) formulations.
Nasal symptoms
There are many different formulations of decongestants and/or antihistamines available over the counter for the treatment of nasal symptoms (i.e., congestion, rhinorrhea, sneezing), including single-agent and combination formulations.
In adults, decongestants and/or antihistamines are the best option for patients with bothersome nasal symptoms; however, the effect is considered small.[32]van Driel ML, Scheire S, Deckx L, et al. What treatments are effective for common cold in adults and children? BMJ. 2018 Oct 10;363:k3786.
https://www.bmj.com/content/363/bmj.k3786.long
http://www.ncbi.nlm.nih.gov/pubmed/30305295?tool=bestpractice.com
Decongestant monotherapy
Sympathomimetic decongestants are available in oral (e.g., pseudoephedrine) or intranasal (e.g., oxymetazoline) formulations. There is no evidence to support the use of one route of administration over another.[32]van Driel ML, Scheire S, Deckx L, et al. What treatments are effective for common cold in adults and children? BMJ. 2018 Oct 10;363:k3786.
https://www.bmj.com/content/363/bmj.k3786.long
http://www.ncbi.nlm.nih.gov/pubmed/30305295?tool=bestpractice.com
A Cochrane review found a small subjective decrease in nasal congestion from multiple doses of nasal decongestants (3 to 4 doses per day over 5 to 10 days), but it was unclear whether this was beneficial for patients.[38]Deckx L, De Sutter AI, Guo L, et al. Nasal decongestants in monotherapy for the common cold. Cochrane Database Syst Rev. 2016 Oct 17;(10):CD009612.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009612.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/27748955?tool=bestpractice.com
Oxymetazoline nasal spray has been shown to have an effect in reducing airway resistance, but there is limited evidence on patient-oriented benefits.[39]Eccles R, Martensson K, Chen SC. Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin. 2010 Apr;26(4):889-99.
http://www.ncbi.nlm.nih.gov/pubmed/20151787?tool=bestpractice.com
[40]Allan GM, Arroll B. Prevention and treatment of the common cold: making sense of the evidence. CMAJ. 2014 Feb 18;186(3):190-9.
http://www.ncbi.nlm.nih.gov/pubmed/24468694?tool=bestpractice.com
Intranasal decongestants should be used for a maximum of 3 to 7 days due to the risk of chronic/rebound nasal congestion (rhinitis medicamentosa).
Antihistamine monotherapy
A Cochrane review found that (older, first-generation) sedating antihistamines are associated with relief of sneezing and rhinorrhea, but not nasal congestion; sedation is commonly reported. Studies evaluating (newer, second-generation) nonsedating antihistamines show an unclear effect on nasal congestion, with no effect on sneezing or rhinorrhea.[41]De Sutter AI, Saraswat A, van Driel ML. Antihistamines for the common cold. Cochrane Database Syst Rev. 2015 Nov 29;(11):CD009345.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009345.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/26615034?tool=bestpractice.com
Combination formulations of decongestants and antihistamines
Antihistamines and decongestants are often formulated together, with or without an analgesic. Certain combinations of these agents may improve congestion, rhinorrhea, and sneezing; however, the quality of trial data for these formulations is weak. Adverse effects include headache, sedation, and insomnia.[42]De Sutter AI, van Driel ML, Kumar AA, et al. Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database Syst Rev. 2012 Feb 15;(2):CD004976.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004976.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/22336807?tool=bestpractice.com
[
]
What are the effects of combination tablets containing an antihistamine, a decongestant, and an analgesic in people with the common cold?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.69/fullShow me the answer
Ipratropium
A systematic review found low-quality evidence to suggest ipratropium nasal spray is effective for rhinorrhea compared with placebo, but not for nasal congestion. Adverse effects (e.g., dry mouth, nose bleeds, nasal dryness) were more frequent compared with placebo or no treatment.[43]AlBalawi ZH, Othman SS, AlFaleh K. Intranasal ipratropium bromide for the common cold. Cochrane Database Syst Rev. 2013 Jun 19;(6):CD008231.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008231.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/23784858?tool=bestpractice.com
In children, the evidence for these treatments is more limited. There is no evidence that decongestants alleviate nasal symptoms in children, and they are known to cause adverse effects (e.g., drowsiness, gastrointestinal upset, more serious harms such as convulsions and rapid heart rate, and death). Therefore, decongestants are not recommended in children <6 years of age, and caution is recommended in children ages 6 to 12 years.[32]van Driel ML, Scheire S, Deckx L, et al. What treatments are effective for common cold in adults and children? BMJ. 2018 Oct 10;363:k3786.
https://www.bmj.com/content/363/bmj.k3786.long
http://www.ncbi.nlm.nih.gov/pubmed/30305295?tool=bestpractice.com
The Food and Drug Administration does not recommend cold products that contain a decongestant and/or antihistamine in children under 4 years of age due to possible serious and life-threatening adverse effects.[44]US Food and Drug Administration. Use caution when giving cough and cold products to kids. February 2018 [internet publication].
https://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm263948.htm
The advice differs in other countries. For example, in the UK and Canada, over-the-counter cold treatments are not recommended at all in children under 6 years of age.
There is low-quality evidence that saline drops or sprays may be effective and safe in younger children. They improve nasal congestion in older children, and possibly reduce rhinorrhea severity.[45]King D, Mitchell B, Williams CP, et al. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015 Apr 20;(4):CD006821.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006821.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/25892369?tool=bestpractice.com
FDA: use caution when giving cough and cold products to kids
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Despite these warnings, data from the Pediatric Cough and Cold Safety Surveillance System indicate that the overall rate of adverse effects related to over-the-counter cough and cold medications in children <12 years of age is relatively low (1 adverse effect per 1.75 million dose units sold), with 67% of adverse effects being related to accidental unsupervised ingestion. Fatalities were extremely rare (0.6% of patients) and not associated with therapeutic doses.[46]Green JL, Wang GS, Reynolds KM, et al. Safety profile of cough and cold medication use in pediatrics. Pediatrics. 2017 Jun;139(6).
http://pediatrics.aappublications.org/content/139/6/e20163070.long
http://www.ncbi.nlm.nih.gov/pubmed/28562262?tool=bestpractice.com
Cough
Many different cough suppressants or expectorants are available, including single-agent and combination formulations (often combined with decongestants and/or antihistamines). There is no evidence to support or refute the use of over-the-counter antitussive agents, expectorants, or mucolytic agents to reduce the incidence of cough in adults or children, particularly young children.[47]Isbister GK, Prior F, Kilham HA. Restricting cough and cold medicines in children. J Paediatr Child Health. 2012 Feb;48(2):91-8.
http://www.ncbi.nlm.nih.gov/pubmed/20598066?tool=bestpractice.com
[48]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 Nov 24;(11):CD001831.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001831.pub5/full
http://www.ncbi.nlm.nih.gov/pubmed/25420096?tool=bestpractice.com
However, the American College of Chest Physicians recommends against the use of over-the-counter cough and cold medicines for the treatment of cough.[49]Malesker MA, Callahan-Lyon P, Ireland B, et al. Pharmacologic and nonpharmacologic treatment for acute cough associated with the common cold: CHEST expert panel report. Chest. 2017 Nov;152(5):1021-37.
http://journal.chestnet.org/article/S0012-3692(17)31408-3/fulltext#sec3.6
http://www.ncbi.nlm.nih.gov/pubmed/28837801?tool=bestpractice.com
[Evidence C]e0feef9b-1d79-4880-b295-8a829bba54b0guidelineCWhat are the effects of over-the-counter (OTC) medications compared with placebo in reducing the duration of cough associated with the common cold in children and adults in community settings?[49]Malesker MA, Callahan-Lyon P, Ireland B, et al. Pharmacologic and nonpharmacologic treatment for acute cough associated with the common cold: CHEST expert panel report. Chest. 2017 Nov;152(5):1021-37.
http://journal.chestnet.org/article/S0012-3692(17)31408-3/fulltext#sec3.6
http://www.ncbi.nlm.nih.gov/pubmed/28837801?tool=bestpractice.com
Cough and cold medications that include opioids, such as codeine or hydrocodone, should not be used in children aged 18 years or younger as the risks (slowed or difficult breathing, misuse, abuse, addiction, overdose, and death) outweigh the benefits when used for cough in these patients.[50]Food and Drug Administration. FDA drug safety communication: FDA requires labeling changes for prescription opioid cough and cold medicines to limit their use to adults 18 years and older. January 2018 [internet publication].
https://www.fda.gov/Drugs/DrugSafety/ucm590435.htm
Honey has been shown to offer more relief of cough symptoms compared to no treatment, placebo, and diphenhydramine in children aged 1 to 18 years, but is not better than dextromethorphan.[51]Oduwole O, Udoh EE, Oyo-Ita A, et al. Honey for acute cough in children. Cochrane Database Syst Rev. 2018 Apr 10;(4):CD007094.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007094.pub5/full
http://www.ncbi.nlm.nih.gov/pubmed/29633783?tool=bestpractice.com
[49]Malesker MA, Callahan-Lyon P, Ireland B, et al. Pharmacologic and nonpharmacologic treatment for acute cough associated with the common cold: CHEST expert panel report. Chest. 2017 Nov;152(5):1021-37.
http://journal.chestnet.org/article/S0012-3692(17)31408-3/fulltext#sec3.6
http://www.ncbi.nlm.nih.gov/pubmed/28837801?tool=bestpractice.com
[Evidence C]67a39237-eee8-422e-bd97-6e50795d9a9eguidelineCWhat are the effects of honey in reducing the duration of cough associated with the common cold in children?[49]Malesker MA, Callahan-Lyon P, Ireland B, et al. Pharmacologic and nonpharmacologic treatment for acute cough associated with the common cold: CHEST expert panel report. Chest. 2017 Nov;152(5):1021-37.
http://journal.chestnet.org/article/S0012-3692(17)31408-3/fulltext#sec3.6
http://www.ncbi.nlm.nih.gov/pubmed/28837801?tool=bestpractice.com
A review of inhaled corticosteroids for acute and subacute cough found insufficient evidence to recommend their routine use for acute respiratory tract infections in adults. However, some trials have shown benefits, suggesting the need for further high-quality, adequately powered trials.[52]El-Gohary M, Hay AD, Coventry P, et al. Corticosteroids for acute and subacute cough following respiratory tract infection: a systematic review. Fam Pract. 2013 Oct;30(5):492-500.
http://www.ncbi.nlm.nih.gov/pubmed/23836094?tool=bestpractice.com
Antibiotic therapy
Antibiotics are not effective for symptoms of the common cold and are known to cause adverse effects.[53]Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013 Jun 4;(6):CD000247.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000247.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/23733381?tool=bestpractice.com
The Centers for Disease Control and Prevention, and the American College of Physicians do not recommend antibiotic treatment.[1]Harris AM, Hicks LA, Qaseem A. 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 Mar 15;164(6):425-34.
http://annals.org/article.aspx?articleid=2481815
http://www.ncbi.nlm.nih.gov/pubmed/26785402?tool=bestpractice.com
[54]Centers for Disease Control and Prevention. Antibiotic prescribing and use in doctor’s offices: common cold. Feb 2020 [internet publication].
https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/colds.html
Regulatory bodies in other countries also support this recommendation.[55]National Institute for Health and Care Excellence. Respiratory tract infections (self-limiting): prescribing antibiotics. July 2008 [internet publication].
https://www.nice.org.uk/guidance/cg69
Antibiotics are often requested by patients at consultation, but there is increasing evidence that this encourages resistant strains of bacteria and causes unnecessary harm. There is limited evidence that purulent nasal discharge (interpreted by many clinicians and patients as suggestive of bacterial infection) will not respond to antibiotics.[53]Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013 Jun 4;(6):CD000247.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000247.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/23733381?tool=bestpractice.com
A delayed prescription for antibiotics, alongside advice on the natural history of the illness and symptomatic treatments, has been found to reduce the rate of antibiotic use (31%) compared with immediate antibiotics (93%) with similar rates of patient satisfaction.[56]Spurling GK, Del Mar CB, Dooley L, et al. Delayed antibiotic prescriptions for respiratory infections. Cochrane Database Syst Rev. 2017 Sep 7;(9):CD004417.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004417.pub5/abstract
http://www.ncbi.nlm.nih.gov/pubmed/28881007?tool=bestpractice.com
Providing written information about the use of antibiotics to parents of children with upper respiratory tract infections can also reduce the number of antibiotics used without affecting parental satisfaction.[57]O'Sullivan JW, Harvey RT, Glasziou PP, et al. Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care. Cochrane Database Syst Rev. 2016 Nov 25;(11):CD011360.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011360.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/27886368?tool=bestpractice.com
Other interventions that may have an effect on reducing antibiotic prescribing in acute respiratory tract infections in a primary care setting include C-reactive protein testing, procalcitonin-guided management of infections, and shared decision making between doctors and their patients; however, there is only moderate quality evidence for these interventions.[58]Tonkin-Crine SK, Tan PS, van Hecke O, et al. Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews. Cochrane Database Syst Rev. 2017 Sep 7;(9):CD012252.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012252.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/28881002?tool=bestpractice.com
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How do point‐of‐care diagnostic tests for acute respiratory infection affect antibiotic prescribing behavior in primary care?/cca.html?targetUrl=https://www.cochranelibrary.com/cca/doi/10.1002/cca.2434/fullShow me the answer
Other treatments with limited or no evidence of efficacy
No other treatments are supported by adequate evidence. Interventions such as oral and nasally inhaled zinc, echinacea, and humidified air have all been studied in placebo-controlled trials.[20]Karsch-Völk M, Barrett B, Kiefer D, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014 Feb 20;(2):CD000530.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000530.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/24554461?tool=bestpractice.com
[59]Nahas R, Balla A. Complementary and alternative medicine for prevention and treatment of the common cold. Can Fam Physician. 2011 Jan;57(1):31-6.
http://www.cfp.ca/content/57/1/31.long
http://www.ncbi.nlm.nih.gov/pubmed/21322286?tool=bestpractice.com
[60]Caruso TJ, Prober CG, Gwaltney JM Jr. Treatment of naturally acquired common colds with zinc: a structured review. Clin Infect Dis. 2007 Sep 1;45(5):569-74.
http://cid.oxfordjournals.org/content/45/5/569.full
http://www.ncbi.nlm.nih.gov/pubmed/17682990?tool=bestpractice.com
[61]Singh M, Singh M, Jaiswal N, et al. Heated, humidified air for the common cold. Cochrane Database Syst Rev. 2017 Aug 29;(8):CD001728.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001728.pub6/full
http://www.ncbi.nlm.nih.gov/pubmed/28849871?tool=bestpractice.com
[62]D'Cruze H, Arroll B, Kenealy T, et al. Is intranasal zinc effective and safe for the common cold? A systematic review and meta-analysis. J Prim Health Care. 2009;1:134-139.
http://www.ncbi.nlm.nih.gov/pubmed/20690364?tool=bestpractice.com
[63]Hemilä H, Haukka J, Alho M, et al. Zinc acetate lozenges for the treatment of the common cold: a randomised controlled trial. BMJ Open. 2020 Jan 23;10(1):e031662.
https://www.doi.org/10.1136/bmjopen-2019-031662
http://www.ncbi.nlm.nih.gov/pubmed/31980506?tool=bestpractice.com
Overall, they have shown minimal evidence of effectiveness.
Vitamin C supplementation has been found to have no benefit on the incidence of colds.[18]Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000980.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000980.pub4/full
http://www.ncbi.nlm.nih.gov/pubmed/23440782?tool=bestpractice.com
[19]Gómez E, Quidel S, Bravo-Soto G, et al. Does vitamin C prevent the common cold?. Medwave. 2018 Aug 6;18(4):e7235.
https://www.doi.org/10.5867/medwave.2018.04.7236
http://www.ncbi.nlm.nih.gov/pubmed/30113569?tool=bestpractice.com
While one study found that vitamin C may reduce the duration of colds, systematic reviews (that included seven randomized controlled trials) found that vitamin C had minimal or no impact on the duration of the common cold in terms of the number of days at home or out of work.[64]Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;(1):CD000980.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000980.pub4/full
http://www.ncbi.nlm.nih.gov/pubmed/23440782?tool=bestpractice.com
[65]Quidel S, Gómez E, Bravo-Soto G, et al. What are the effects of vitamin C on the duration and severity of the common cold?. Medwave. 2018 Oct 3;18(6):e7261.
https://www.doi.org/10.5867/medwave.2018.06.7260
http://www.ncbi.nlm.nih.gov/pubmed/30339136?tool=bestpractice.com
However, administration of extra therapeutic doses of vitamin C at the onset of a cold, in addition to routine supplementation, has been found to reduce the duration of colds, shorten the time of indoor confinement, and provides symptomatic relief of chest pain, fever, and chills.[66]Ran L, Zhao W, Wang J, et al. Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials. Biomed Res Int. 2018;2018:1837634.
https://www.doi.org/10.1155/2018/1837634
http://www.ncbi.nlm.nih.gov/pubmed/30069463?tool=bestpractice.com
Commercial inhalant products are popular, although evidence from clinical trial data to support efficacy is limited. Studies evaluating a combination of intranasal and inhaled cromolyn sodium found inconclusive evidence of effectiveness.[67]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 Sep;26(9):1045-50.
http://www.ncbi.nlm.nih.gov/pubmed/8889259?tool=bestpractice.com
[68]Butler CC, Robling MR, Prout H, et al. The management of suspected acute viral upper respiratory tract infection in children: a community-based randomised controlled trial of treatment with intranasal sodium cromoglycate. Lancet. 2002 Jun 22;359(9324):2153-8.
http://www.ncbi.nlm.nih.gov/pubmed/12090980?tool=bestpractice.com
There is some evidence for the effectiveness of vapor rubs in providing symptomatic relief.[69]Paul IM, Beiler JS, King TS. Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms. Pediatrics. 2010 Dec;126(6):1092-9.
http://pediatrics.aappublications.org/content/126/6/1092.long
http://www.ncbi.nlm.nih.gov/pubmed/21059712?tool=bestpractice.com
Based on current evidence, there is no role for intranasal corticosteroids in the treatment of common cold.[70]Hayward G, Thompson MJ, Perera R, et al. Corticosteroids for the common cold. Cochrane Database Syst Rev. 2015 Oct 13;(10):CD008116.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008116.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/26461493?tool=bestpractice.com
Treatments for which there is evidence of benefit from a single trial or from poor-quality trials include green tea, garlic, various Chinese herbal medicines, Huo Xiang Zhengqi dropping pill, African geranium, and Pelargonium sidoides (also known as umckaloabo).[71]Rowe CA, Nantz MP, Bukowski JF, et al. Specific formulation of Camellia sinensis prevents cold and flu symptoms and enhances gamma,delta T cell function: a randomized, double-blind, placebo-controlled study. J Am Coll Nutr. 2007 Oct;26(5):445-52.
http://www.ncbi.nlm.nih.gov/pubmed/17914132?tool=bestpractice.com
[72]Pittler MH, Ernst E. Clinical effectiveness of garlic (Allium sativum). Mol Nutr Food Res. 2007 Nov;51(11):1382-5.
http://www.ncbi.nlm.nih.gov/pubmed/17918163?tool=bestpractice.com
[73]Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev. 2014 Nov 11;(11):CD006206.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006206.pub4/full
http://www.ncbi.nlm.nih.gov/pubmed/25386977?tool=bestpractice.com
[74]Zhang X, Wu T, Zhang J, et al. Chinese medicinal herbs for the common cold. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004782.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004782.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/17253524?tool=bestpractice.com
[75]Byun JS, Yang SY, Jeong IC, et al. Effects of So-cheong-ryong-tang and Yeon-gyo-pae-dok-san on the common cold: randomized, double blind, placebo controlled trial. J Ethnopharmacol. 2011 Jan 27;133(2):642-6.
http://www.ncbi.nlm.nih.gov/pubmed/21040773?tool=bestpractice.com
[76]Timmer A, Günther J, Motschall E, et al. Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane Database Syst Rev. 2013 Oct 22;(10):CD006323.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006323.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/24146345?tool=bestpractice.com
[77]Fan T, Zhang Y, Jiang H, et al. Huo Xiang Zhengqi dropping pill in treating wind cold and dampness stagnation pattern of common cold: a randomized controlled trial [in Chinese]. Chin J Evid Based Med. 2012;3:283-288.[78]Ross SM. African geranium (EPs 7630), part I: a proprietary root extract of Pelargonium sidoides (EPs 7630) is found to be effective in resolving symptoms associated with the common cold in adults. Holist Nurs Pract. 2012;26:106-109.
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There is limited evidence that sea buckthorn has no effect.[79]Larmo P, Alin J, Salminen E, et al. Effects of sea buckthorn berries on infections and inflammation: a double-blind, randomized, placebo-controlled trial. Eur J Clin Nutr. 2008 Sep;62(9):1123-30.
http://www.ncbi.nlm.nih.gov/pubmed/17593932?tool=bestpractice.com
A systematic review found evidence to support the use of black elderberry (Sambucus nigra) to reduce upper respiratory symptoms.[80]Hawkins J, Baker C, Cherry L, et al. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019 Feb;42:361-5.
https://www.doi.org/10.1016/j.ctim.2018.12.004
http://www.ncbi.nlm.nih.gov/pubmed/30670267?tool=bestpractice.com
A Cochrane review found that homeopathic products did not show any benefit in terms of cure rates or prevention of acute respiratory infections in children compared to placebo.[81]Hawke K, van Driel ML, Buffington BJ, et al. Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children. Cochrane Database Syst Rev. 2018 Apr 9;4:CD005974.
https://www.doi.org/10.1002/14651858.CD005974.pub4
http://www.ncbi.nlm.nih.gov/pubmed/29630715?tool=bestpractice.com