These symptoms resolve within a few days and are followed by nasal congestion, rhinorrhea, and cough within 24 to 48 hours after onset of the first symptoms.The second set of symptoms are what prompt most patients to see a physician for relief.1 Symptoms usually peak around day 3 or 4 and begin to resolve by day 7.12 Nasal discharge, appearing at the peak of illness, can become thick and purulent and may be misdiagnosed as a bacterial sinus infection.13Because there are no effective antivirals to cure the common cold and few effective measures to prevent it, treatment should focus on symptom relief.Antihistamine/decongestant treatment has not been shown to benefit young children.6Two systematic reviews have examined the use of nasal decongestants.730 The reviews included four trials that studied the short-term benefits of a single-dose topical (intranasal) or oral decongestant and one trial that studied the effects of repeated dosing.The single-dose decongestant had a moderate short-term benefit for adolescents and adults with nasal congestion.Acute upper respiratory infection is the second most common diagnosis in physician offices1 and the most common discharge diagnosis in emergency departments.2 A survey revealed that almost one fourth of U. adults had taken a cough or cold medication with or without a sedating antihistamine in the preceding week.3 Prevention of colds and influenza and “immune boosting” were among the top 10 reasons participants took vitamins and herbal supplements.3 A survey conducted by the Centers for Disease Control and Prevention showed that, in 1991, two thirds of three-year-olds had taken cough or cold medicine in the preceding 30 days.4 Because colds are common presentations in physician offices, and cough and cold remedies are used almost universally, it is important that physicians know the evidence Codeine (Robitussin AC) and other narcotics, dextromethorphan (Delsym), antihistamines, and combination antihistamine/decongestants are not recommended to treat cough or other cold symptoms in children.
These treatments can be used alone or in combination.
Antihistamines and combination antihistamine/decongestant therapies can modestly improve symptoms in adults; however, the benefits must be weighed against potential side effects.
Newer nonsedating antihistamines are ineffective against cough.
Furthermore, the number of participants often is small, interventions vary from individual to combination medications, compliance often is not addressed, single or multiple symptom outcomes are used, and outcomes are subjectively reported in some studies and objectively reported in others.
Not surprisingly, there is great heterogeneity among the results.Hydrocodone commonly is prescribed for suppression of cold-related acute cough.