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PubMed1997

Zinc lozenges reduce the duration of common cold symptoms.

A randomized, double-blind, placebo-controlled clinical trial has shown that treatment of the common cold with zinc gluconate lozenges resulted in a significant reduction in duration of symptoms of the cold. Patients received zinc-containing lozenges or placebo lozenges every 2 hours for the duration of cold symptoms. The median time to complete resolution of cold symptoms was 4.4 days in the zinc group compared with 7.6 days in the placebo group. The mechanism of action of zinc in treating the common cold remains unknown.

Administration, Oral↗
PubMedDate not supplied

Frequency of common colds and serum levels of sICAM-1 (CD54), sLFA-3 (CD58) and sIL-2R (CD25).

Epidemiologic case-control studies have suggested an inverse relationship between past medical history of frequency of common colds and subsequent cancer risk for various sites. One hypothetical explanation for this finding may be that there are unknown differences in immune responsiveness between patients developing cancer and healthy individuals. The present study examines the relationship between the frequency of common colds and a) plasma levels of sICAM-1/CD54, sLFA-3/CD58 and sIL-2R/CD25 which are believed to modulate activation of immune responses, and b) cell-mediated immunity in vivo as determined by Multitest Mérieux. The investigation was conducted as a correlation study amongst a healthy group of individuals from the general population in Germany. We found a statistically significant inverse relationship between frequency of common colds and levels of sCD58 and, partially, sCD54. No association was found between levels of sCD25 and results of Multitest Mérieux.

Aged↗
PubMed1986

Intranasal interferon (rIFN-alpha A, Ro 22-8181) for contact prophylaxis against common cold: a randomized, double-blind and placebo-controlled field study.

The prophylactic efficacy of low-dose intranasal recombinant leucocyte interferon alpha (rIFN-alpha A, Ro 22-8181) was investigated under field conditions in 147 families (n = 587 participants), randomized to receive placebo or rIFN-alpha A intranasally in daily doses of 1.5 or 0.3 X 10(6) IU. Treatment was started within 2 days after the appearance of an index case in the household and was continued for 5 days. Clinical data of the index case and of all members of the household were recorded for 10 days. In index cases and all ill contact persons nasal washes were collected for rhinovirus isolation and immunochemical detection of other respiratory viruses. The local tolerance of the intranasal rIFN-alpha A was excellent. Both doses of rIFN-alpha A failed to exert therapeutic effects on established common cold or to prevent the spread of common cold within families. Prophylactic treatment with 1.5 X 10(6) IU did however shorten the duration of the cold (median of 2 days vs. 4 in the placebo group, P = 0.01) and reduced the severity of any ensuing common cold (median total score of 10.5 vs. 30, P less than 0.001). No correlation was found between viral etiology (55% rhinoviruses vs. 13% other respiratory viruses, n = 122 nasal washes) and prophylactic efficacy or clinical severity.

Administration, Intranasal↗
PubMed1991

Evaluation of oral terfenadine for treatment of the common cold.

This study was a single center trial comparing the effects of the nonsedating antihistamine terfenadine, at a dose of 120 mg twice a day, with placebo in the treatment of rhinitis symptoms associated with the common cold. Forty-nine subjects were treated with terfenadine, 120 mg twice each day, and 48 subjects were treated with placebo twice each day for four or five days. Evaluations by both subjects and physicians suggest that terfenadine at 120 mg given twice daily marginally improved sneezing and total symptom scores at day 4. When comparing terfenadine to placebo, neither the symptoms nor signs of the common cold improved in a clinically or statistically significant manner. Terfenadine was well tolerated and had a low incidence of side effects. Terfenadine was found to be ineffective in the treatment of the signs and symptoms of the common cold.

Administration, Oral↗
PubMed2003

Current and future therapeutic approaches to the common cold.

For decades, investigators have strived to elucidate the pathogenesis, and hence a treatment, for the common cold. Therapy has been tried with a variety of agents, ranging from anecdotal folk remedies, to well-designed medications. Measures primarily directed to relieve the symptoms of the common cold, rather than specific antimicrobial agents, are the current main stay of therapy. Millions of patients would benefit from an easy-to-perform diagnostic test and specific therapy that works quickly, shortening the duration of illness and preventing further spread of infection.

Anti-Bacterial Agents↗
PubMed1999

Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study.

The objective of our study was to measure the effectiveness of Andrographis paniculata SHA-10 extract in reducing the prevalence and intensity of symptoms and signs of common cold as compared with a placebo. A group of 158 adult patients of both sexes completed the randomized double blind study in Valdivia, Chile. The patients were divided in two equal size groups, one of which received Andrographis paniculata dried extract (1200 mg/day) and the other a placebo during a period of 5 days. Evaluations for efficacy were performed by the patient at day 0, 2, and 4 of the treatment; each completed a self-evaluation (VAS) sheet with the following parameters: headache, tiredness, earache, sleeplessness, sore throat, nasal secretion, phlegm, frequency and intensity of cough. In order to quantify the magnitude of the reduction in the prevalence and intensity of the signs and symptoms of common cold, the risk (Odds Ratio = OR) was calculated using a logistic regression model. At day 2 of treatment a significant decrease in the intensity of the symptoms of tiredness (OR = 1.28; 95% CI 1.07-1.53), sleeplessness (OR = 1.71; 95% CI 1.38-2.11), sore throat (OR = 2.3; 95% CI 1.69-3.14) and nasal secretion (OR = 2.51; 95% CI 1.82-3.46) was observed in the Andrographis SHA-10 group as compared with the placebo group. At day 4, a significant decrease in the intensity of all symptoms was observed for the Andrographis paniculata group. The higher OR values were for the following parameters: sore throat (OR = 3.59; 95% CI 2.04-5.35), nasal secretion (OR = 3.27; 95% CI 2.31-4.62) and earache (OR = 3.11; 95% CI 2.01-4.80) for Andrographis paniculata treatment over placebo, respectively. It is concluded that Andrographis paniculata had a high degree of effectiveness in reducing the prevalence and intensity of the symptoms in uncomplicated common cold beginning at day two of treatment. No adverse effects were observed or reported.

Adult↗
PubMed1984

Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study.

As a possible treatment for common colds, we tested zinc gluconate lozenges in a double-blind, placebo-controlled, clinical trial. One 23-mg zinc lozenge or matched placebo was dissolved in the mouth every 2 wakeful h after an initial double dose. After 7 days, 86% of 37 zinc-treated subjects were asymptomatic, compared with only 46% of 28 placebo-treated subjects (P = 0.0005). Side effects or complaints were usually minor and consisted mainly of objectionable taste and mouth irritation. Zinc lozenges shortened the average duration of common colds by about 7 days.

Administration, Oral↗
PubMed1981

[A controlled clinical trial for testing the efficacy of the homeopathic drug eupatorium perfoliatum D2 inthe treatment of common cold (author's transl)].

53 outpatients suffering from common cold (flu) were randomly assigned to either a therapy with acetylsalicylic acid (ASA) or the homeopathic drug Eupatorium perfoliatum D2 in a controlled clinical trial. The efficacy of the drugs was assessed on day 1, 4 and 10 of the infection by symptom check lists and physical examinations. Neither subjective complaints nor body temperature or laboratory findings showed any significant differences between groups which was taken as evidence that both drugs were equally effective.

Aspirin↗
PubMedDate not supplied

Light and scanning electron microscopy of nasal biopsy material from patients with naturally acquired common colds.

As our knowledge of the histopathology of common colds is very limited, we have undertaken a blind quantitative examination by scanning electron microscopy and light microscopy of 56 nasal biopsies, taken from 29 volunteers with naturally acquired colds. In agreement with earlier reports we found evidence of sloughing of epithelial cells, but in contrast to in vitro experiments, this did not result in a destruction of the epithelial lining, which by and large remained continuous, with structurally normal cell borders. There was a significant increase in the number of neutrophils, both in epithelium and in lamina propria, already on the 2nd day of the disease, and the hypothesis is advanced that the virus infection itself is the cause of the local neutrophilia. The only other abnormality demonstrated was an increased number of extracellular erythrocytes in the acute stage. The histological picture was not suggestive of an involvement of epithelial mast cells in the inflammation.

Adult↗
PubMed2000

Echinacea for preventing and treating the common cold.

BACKGROUND: Extracts of the plant Echinacea (family Compositae) are widely used in some European countries and the USA for upper respiratory tract infections. OBJECTIVES: The objective of this review was to assess the effects of preparations containing extracts of Echinacea in the prevention and treatment of the common cold. SEARCH STRATEGY: We searched the Cochrane Acute Respiratory Infections Group and Complementary Medicine Field's trials registers, MEDLINE, EMBASE, Phytodok and reference lists of articles. We also contacted researchers and manufacturers. Date of last search: Spring 1998. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing preparations containing an extract of Echinacea compared with a placebo, no treatment, or another treatment for common colds. DATA COLLECTION AND ANALYSIS: At least two independent reviewers assessed trial quality and extracted data. MAIN RESULTS: Sixteen trials (eight prevention trials, and eight trials on treatment of upper respiratory tract infections) with a total of 3396 participants were included. Variation in preparations investigated and methodological quality of trials precluded quantitative meta-analysis. Overall, the results suggested that some Echinacea preparations may be better than placebo. REVIEWER'S CONCLUSIONS: The majority of the available studies report positive results. However there is not enough evidence to recommend a specific Echinacea product, or Echinacea preparations for the treatment or prevention of common colds.

Common Cold↗
PubMed1993

Association of the common cold in the first trimester of pregnancy with birth defects.

OBJECTIVE: To examine the association between the common cold with or without fever in the first 3 months of pregnancy and birth defects in offspring. DESIGN: A case-control study. SETTING: Data are from the Shanghai Birth Defects Monitoring Program, conducted in 29 hospitals in Shanghai, China from October 1, 1986 to September 30, 1987. SUBJECTS: A total of 986 birth defects cases, 990 frequency-matched live birth controls, and 159 stillbirth controls. RESULTS: Modestly elevated risk of birth defects was identified among women who reported having a cold with or without fever in the first trimester of pregnancy. Notably increased relative risks were observed for anencephalus (odds ratio [OR] = 3.9, 95% confidence interval [CI] = 2.0 to 7.7), spina bifida (OR = 4.1, 95% CI = 1.7 to 9.7), hydrocephalus (OR = 2.3, 95% CI = 1.1 to 5.1), cleft lip (OR = 2.2, 95% CI = 1.4 to 3.4), and undescended testicle (OR = 1.8, 95% CI = 1.0 to 3.0). Our study further found that the overall relative risks were consistent by using two different control groups, suggesting that this association was unlikely to be due to recall or report bias. CONCLUSION: Common cold in the first trimester of pregnancy may be associated with an increased risk of birth defects in offspring. However, these findings should be interpreted cautiously.

Adult↗
PubMed1983

Effects of oral norephedrine on common cold symptoms.

The aim of the trial was to examine the effectiveness of an oral decongestant in common cold. Thirty subjects with naturally acquired colds got a 100 mg sustained release tablet containing norephedrine on one day and a placebo tablet on another day in double blind design. Changes in nasal patency were assessed by rhinomanometry, measurement of nasal expiratory peak flow, and a self-assessment test, and the number of sneezes and of nose blowings were recorded in a 10 hours period after medication. Rhinomanometry, but not peak flow measurements showed a significant difference (p less than 0.02) two hours after medication, and the self-assessment of nasal blockage showed that the effect lasted for the entire 10 hours observation period (p less than 0.01). Nasal respiration was reestablished in half of the blocked noses. There was no effect on number of sneezes and nose blowings. In conclusion, oral norephedrine has a moderate decongestant effect, which may justify its use in adults with common colds. This symptom amelioration must be balanced against cost of therapy and risk of side effects. A prevention of otitis media and of sinusitis has not been documented in the literature.

Administration, Oral↗
PubMed2000

[Use of antimicrobial drug prescriptions in children with a common cold or diarrhea].

There are justified reasons to assume that antibicrobial drugs are too frequently prescribed in routine pediatric practice. The main aim of the study was to prove the frequency of antimicrobial administration to children. A total of 209 children of either sex and under 18 years of age with common colds and 95 children with diarrhea who were examined at the Primary Health Care Department of Hospital Konjic, Bosnia and Herzegovina for the period of Jan 1999-Apr 2000 were investigated for antimicrobial therapy. Antimicrobials were prescribed to 175 (83.73 per cent) patients with common cold and 78 (82.11 per cent) patients with diarrhea. Taking into consideration that the aetiology of these conditions was predominantly viral, the outcome of this study provides the evidence of irrational administration of antimicrobials and states the possible ones: diagnostic difficulties in routine pediatric practice, low educational level of physicians, lack of consulting skills, overworked primary health care physicians, influence of inpatient parents about prescribing antibiotics and influence of pharmaceutical industry. It is widely known that the negative effects of such superflous administration could leave numerous consequences to the patients health condition. Besides that, irrational use of the above mentioned drugs financially charges health system funds. It is therefore necessary to enhance consulting skills, to improve research and evidence based guidelines and monitoring strategies as well in order to support rational antimicrobial administration to children. The observation that irrational use of antibiotics was detected frequently with both common cold and diarrea suggests the need for continous monitoring and analyses of antibiotic administration to children from our region.

Acute Disease↗
PubMed2005

Antibiotics for the common cold and acute purulent rhinitis.

BACKGROUND: It has long been believed that antibiotics have no role in treating common colds yet they are often prescribed in the belief that they may prevent secondary bacterial infections. Given the increasing concerns about antibiotic resistance it is important to examine the evidence for the benefit of antibiotics for the common cold. OBJECTIVES: To determine:(1) the efficacy of antibiotics, in comparison with placebo, for reducing general symptoms and specific nasopharyngeal symptoms of acute upper respiratory tract infections; (2) if antibiotics have any influence on acute purulent rhinitis; (3) whether antibiotics cause significant adverse outcomes in patients with acute upper respiratory tract infections. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2005); MEDLINE (January 1966 to March, Week 1, 2005); EMBASE (1980 to December 2004), the Family Medicine Database (1908, volume 1 to 1993, volume 13; this database was discontinued in 1993), and reference lists of articles, and we contacted principal investigators. SELECTION CRITERIA: Randomised trials comparing any antibiotic therapy against placebo in people with acute upper respiratory tract infections and with less than seven days of symptoms, or acute purulent rhinitis less than ten days in duration. DATA COLLECTION AND ANALYSIS: Both authors independently assessed trial quality and extracted data. MAIN RESULTS: All analyses used the fixed-effect model unless otherwise stated. The overall quality of the included trials was variable. People receiving antibiotics did no better in terms of lack of cure or persistence of symptoms than those on placebo (relative risk (RR) 0.89, 95% confidence interval (CI) 0.77 to 1.04), based on a pooled analysis of six trials with a total of 1147 patients. Overall, the relative risk of adverse effects in the antibiotic group was RR 1.8 (95% CI 1.01 to 3.21), using a random-effects model. Adult patients had a significantly greater risk of adverse effects with antibiotics than with placebo (RR 2.62, 95% CI 1.32 to 5.18) (random-effects model) while there was no greater risk in children (RR 0.91, 95% CI 0.51 to 1.63). The pooled relative risk for persisting acute purulent rhinitis with antibiotics compared to placebo was 0.57 (95% CI 0.37 to 0.87) (random-effects model), based on 6 studies with 772 participants. AUTHORS' CONCLUSIONS: There is insufficient evidence of benefit to warrant the use of antibiotics for upper respiratory tract infections in children or adults. Antibiotics cause significant adverse effects in adults. The evidence on acute purulent rhinitis and acute clear rhinitis suggests a benefit for antibiotics for these conditions but their routine use is not recommended.

Acute Disease↗
PubMed2001

Role of nasopharyngeal culture in antibiotic prescription for patients with common cold or acute sinusitis.

The aim of the present study was to assess the hypothesis that, when present in nasopharyngeal secretions, Streptococcus pneumoniae. Haemophilus influenzae, and Moraxella catarrhalis play a pathogenic role early in the course of an upper respiratory tract infection. Adults with a clinical diagnosis of acute sinusitis or common cold were enrolled. Participants were randomly assigned in a double-blind manner to receive azithromycin 500 mg daily or placebo for 3 days. The effect of treatment on symptom evolution in the predefined subset of patients with Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis in their nasopharyngeal secretions was assessed. Of 265 patients enrolled, 132 received placebo and 133 azithromycin. Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis was identified in nasopharyngeal secretions of 77 patients (29%). In this predefined subgroup of patients with Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, resolution of symptoms by day 7 occurred in 73% of those treated with azithromycin compared with 47% of those who received placebo (P=0.007). The median time before resolution of symptoms was 5 days in the azithromycin group compared to 7 days in the placebo group. Respiratory complications requiring antibiotic treatment occurred in 19% of patients in the placebo group and in 3% of the azithromycin group (P=0.025). In the remaining 188 patients without Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, resolution of symptoms by day 7 was similar in both groups (69% in the placebo group vs. 64% in the azithromycin group [P=0.75]). Antibiotic treatment is of clinical benefit for patients with acute sinusitis or common cold when Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis is present in nasopharyngeal secretions. This observation provides new insights into the pathogenic role of these bacteria in the early stage of the common cold.

Acute Disease↗
PubMed1999

Efficacy and safety of a fixed combination phytomedicine in the treatment of the common cold (acute viral respiratory tract infection): results of a randomised, double blind, placebo controlled, multicentre study.

OBJECTIVE: The common cold (acute viral respiratory tract infection) is one of the most frequent diseases in man, world-wide. Clinically relevant efficacy should include early improvement of all symptoms. Results of a clinical trial of a commercially available fixed combination herbal remedy (Radix echinaceae, Radix baptisiae, Herba thujae) are reported here. The aim of this study was to verify clinical efficacy shown in recent studies under (i) good clinical practice (GCP) quality assurance and (ii) common situations at family doctors. METHODS: Patients attending one of 15 study centres (practitioners) as a result of an acute common cold were randomised to the double-blind placebo-controlled study. Three tablets of study medication were applied t.i.d. for 7 to 9 days. Patients daily documented the intensity of 18 cold symptoms, as well as the cold overall, using a 10-point scale and estimated their general well-being using the Welzel-Kohnen colour scales. Additionally, the severity of illness was assessed by the physician on days 4 and 8 (CGI-1). The main and confirmatory outcome measure was expressed as a total efficacy value. This was gauged from the z-standardised AUC values of the primary endpoints (rhinitis score, bronchitis score, CGI-1 and general well-being). Adverse events, overall tolerability, vital signs and laboratory parameters were documented. RESULTS: 263 patients were included. For safety analysis, all patients were used. 259 patients were evaluable for primary efficacy analysis (ITT). Results were confirmed analysing only the 238 valid cases (VCs). The primary efficacy parameters showed the superiority of the herbal remedy over placebo (p < 0.05). Effect size was 20.6% of the standard deviation (90% CI: 0.04-41.1%; ITT) and 23.1% (1.7-44.5%; VC). In relation to the general well-being, the effect size was 33.9% of the standard deviation (12.5-55.3%; VC). Patients who suffered from at least moderate symptom intensity at baseline showed response rates (at least 50% improvement of the global score, day 5) of 55.3% in the herbal remedy group and 27.3% in the placebo group (p = 0.017; NNT = 3.5). In the subgroup of patients who started therapy at an early phase of their cold, the efficacy of the herbal remedy was most prominent (p = 0.014 for the primary efficacy parameter). The therapeutic benefit of the herbal remedy had already occurred on day 2 and reached significance (p < 0.05) on day 4, and continued until the end of the treatment in the totdl score of symptoms, bronchitis score and rhinitis score, as well as in the patients' overall rating of the cold intensity. At that time, equal levels of improvement were reached three days earlier in the verum group than in the placebo group. In 26 patients receiving the herbal remedy and 23 patients receiving placebo, adverse events were reported. Adverse drug reactions were suspected in two patients in the verum group and in four patients in the placebo group. Serious adverse events did not occur. CONCLUSIONS: This study shows that the herbal remedy is effective and safe. The therapeutic benefit consists of a rapid onset of improvement of cold symptoms. If patients with colds are able to start the application of the herbal remedy as soon as practical after the occurrence of the initial symptoms, the benefit would be expected to increase (e.g. self-medication).

Adult↗
PubMed2006

The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children.

AIM: To determine the efficacy of prophylactic administration of zinc sulphate in reducing the occurrence of the common cold in children, and to evaluate the efficacy of zinc sulphate in reducing the duration and severity of cold symptoms. METHODS: A total of 200 healthy children were randomly assigned to receive oral zinc sulphate (zinc group, n=100) or placebo (placebo group, n=100). Zinc sulphate (15 mg of zinc) or placebo syrup were administered for prophylaxis once daily during a 7-mo study period. The dose was increased to two times per day (30 mg of zinc) at the onset of cold, until symptoms resolved. RESULTS: The mean number of colds in the zinc group was significantly less than in the placebo group (1.2 vs 1.7 colds per child; p=0.003). The mean cold-related school absence was 0.9 d per child in the zinc group versus 1.3 d in the placebo group (p=0.04). Compared to the placebo group, the zinc group had shorter mean duration of cold symptoms and decreased total severity scores for cold symptoms (p<0.0001). Adverse effects were mild and similar in both groups. CONCLUSION: Zinc sulphate appears to be an easily administered, safe and well-tolerated alternative for the prevention and treatment of the common cold in children.

Antiviral Agents↗
PubMed2005

Antibiotic prescribing for children with nasopharyngitis (common colds), upper respiratory infections, and bronchitis who have health-professional parents.

OBJECTIVE: Antibiotic resistance might be reduced if patients could be better informed regarding the lack of benefits of antibiotics for children with viral infections and avoid antibiotic prescriptions in these circumstances. This study investigated whether children having health professionals as parents, a group whose parents are expected to have more medical knowledge and expertise, are less likely than other children to receive antibiotics for nasopharyngitis (common colds), upper respiratory tract infections (URIs), and acute bronchitis. METHODS: Retrospective analyses were conducted by using National Health Insurance data for children of physicians, nurses, pharmacists, and non-health personnel, who had visited hospital outpatient departments or physician clinics for common colds, URIs, and acute bronchitis in Taiwan in 2000. A total of 53733 episodes of care for common colds, URIs, and acute bronchitis in a nationally representative sample of children (aged < or =18 years) living in nonremote areas were analyzed. RESULTS: The study found that, after adjusting for characteristics of the children (demographic, socioeconomic, and health status) and the treating physicians (demographic, practice style, and setting), children with a physician (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.36-0.68) or a pharmacist (OR: 0.69; 95% CI: 0.52-0.91) as a parent were significantly less likely than other children to receive antibiotic prescriptions. The likelihood of receiving an antibiotic for the children of nurses (OR: 0.91; 95% CI: 0.77-1.09) was similar to that for children in the comparison group. CONCLUSIONS: This finding supports our hypothesis that better parental education does help to reduce the frequency of injudicious antibiotic prescribing. Medical knowledge alone, however, may not fully reduce the overuse of antibiotics. Physician-parents, the expected medically savvy parents, can serve as a benchmark for the improvement potentially achievable in Taiwan through a combination of educational, regulatory, communication, and policy efforts targeted at more appropriate antibiotic prescribing in ambulatory settings.

Anti-Bacterial Agents↗