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The common cold: a review of the literature.

Respiratory viral infections, also known as the common cold, are the most common infections in humans. Despite their benign nature, they are a major cause of morbidity and mortality on a worldwide basis. Several viruses have been associated with such illness, of which rhinovirus is the most common. Symptom production is a combination of viral cytopathic effect and the activation of inflammatory pathways. Therefore, antiviral treatment alone may not be able to prevent these events. The optimal use of such agents also requires earlier initiation; therefore, it is important to develop accurate and rapid diagnostic techniques for respiratory viruses. Before any reliable and effective treatment is available, symptomatic therapies may remain the only possible choice of management.

Journal Article↗

Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions.

BACKGROUND: Upper-respiratory-tract infection is one of the main causes of overuse of antibiotics. We have found previously that bacteria such as Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae can be isolated from the nasopharyngeal secretions of a substantial proportion of adults with upper-respiratory-tract infections. We have assessed the efficacy of co-amoxiclav in patients with common colds but no clinical signs of sinusitis or other indications for antibiotics. METHODS: Between January, 1992 and March, 1994, 314 patients who presented to our outpatient clinic with common colds were enrolled in the double-blind, placebo-controlled study. They were randomly assigned 5 days' treatment with co-amoxiclav (375 mg three times daily) or identical placebo. Clinical examinations were done at enrolment and on day 5-7 to assess outcome (cured, persistent symptoms, worse symptoms). Seven patients were excluded after randomisation, seven did not have nasopharyngeal aspiration, and 12 did not return for followup assessment. FINDINGS: Of 300 patients with nasopharyngeal aspirates, 72 had negative bacterial cultures, 167 had cultures positive only for bacteria unrelated to respiratory infections, and 61 had cultures positive for H influenzae, M catarrhalis, or S pneumoniae. At 5-day follow-up of these culture-positive patients, the distribution of outcome was significantly better among co-amoxiclav-treated (n=30) than placebo-treated (n=28) patients (cured 27 vs 4%; persistent symptoms 70 vs 60%; worse symptoms 3 vs 36%; p=0.001). Patients on co-amoxiclav also scored their symptoms significantly lower than patients on placebo (p=0.008). Among culture-negative patients (n=230), the outcome distribution did not differ between the treatment groups (p=0.392). INTERPRETATION: The majority of patients with upper-respiratory-tract infection do not benefit from antibiotics and side-effects are frequent. However, for the subgroup whose nasopharyngeal secretions contain H influenzae, M catarrhalis, or S pneumoniae, antibiotics are clinically beneficial.

Adult↗

The perception of the common cold, and other ailments and discomforts, as related to age.

Perception of the common cold and other discomforts was studied as a function fo age among 456 normals ranging in age from 18 to 82. Respondents completed a questionnaire which deal with the frequency and duration of their colds, their symptoms and treatments-and, finally, with the perceived severity of various discomforts. Though older Rs were found to suffer more than younger with body aches, the former had less difficulty with a variety of other physical and psychological symptoms-and also contracted relatively few colds. Older Rs treated their colds less often with Contac and Dristan, but more often by staying home and/or calling their doctor. As compared with younger Rs, older respondents perceived intestinal flu to be relatively less serious-but earache, sprained toe, indigestion, having a tooth filled, stiff neck, and hangover to be relatively more serious.

Adolescent↗

Common colds. Causes, potential cures, and treatment.

Colds are a common clinical condition, caused by a variety of pathogens. This article reviews the etiology of the cold, proposed cures, symptomatic relief, method of transmission, and advice for patients. Transmission through indirect contact, or self-inoculation, seems more common than was once thought. Experimental antiviral agents hold some promise; in the meantime, symptomatic relief is available.

Adolescent↗

[Efficacy of Derinox assessed with one PNIF (Peak Nasal Inspiratory Flow) in patients suffering from common cold].

OBJECTIVES: The aim of this study was to compare the efficacy and tolerance of Dérinox (D) to Rhinofluimucil (R) and placebo (P) in the treatment of common cold, using an objective measure of nasal obstruction, the Peak Nasal Inspiratory Flow (PNIF--Clement Clarke International, Harlow, Angleterre). PATIENTS AND METHODS: This randomized, double-blind, double-dummy, parallel group study enrolled 354 patients (34 P, 165 D et 155 R) included by 85 general practitioners. The treatment duration was 5 days at usual recommended dosage regimens. PNIF measures were done before drug administration (T0) as well as 15 min and 3 h after each intake. Moreover, nasal obstruction, rhinorrhea and global discomfort were subjectively assessed. RESULTS: The efficacy of D was superior to that of P and R when comparing PNIF from T0 to T3 h after the first intake. At T15 min, rhinorrhea was significantly improved with both active treatments and global discomfort was significantly improved with D only. Treatment tolerance was satisfactory and comparable between the 3 groups. CONCLUSION: Efficacy of Dérinox(R) was superior to that of P and R for the improvement of the nasal obstruction (PNIF) between T0 and T3h (main criteria) after the first intake in patients suffering from common cold.

Acetylcysteine↗

Intranasal recombinant alfa-2b interferon treatment of naturally occurring common colds.

In a double-blind, placebo-controlled study, patients with naturally occurring common colds of less than or equal to 48 h duration were randomly assigned to receive nasal sprays of recombinant alfa-2b interferon at 10 or 20 MU/day or placebo four times per day for 5 days. The 10-MU (n = 74), 20-MU (n = 74), and placebo (n = 72) groups had comparable frequencies of documented rhinovirus colds (50 to 65%) and mean durations of pretreatment symptoms (26 to 27 h). The median duration of colds tended to be longer in the 20-MU group (10 days) than the 10-MU group (8 days) or placebo group (8 days) (P = 0.06). In those with proven rhinovirus colds treated within 24 h, the median duration was significantly longer in the 20-MU group (9 days) than in the placebo group (6 days). No differences favoring interferon treatment were found in respiratory symptom scores or resolution of specific symptoms. On days 5 and 7, nasal washings from compliant subjects with proven rhinovirus colds yielded rhinoviruses more often in placebo (47 and 48%, respectively) than in interferon (15 and 16%, respectively) recipients (P less than 0.02), but no differences in new respiratory illness occurrence were observed in household contacts. Interferon recipients had significantly higher frequencies of blood in nasal mucus (16 to 18%) than did placebo recipients (4%) during treatment. Antibiotics for presumed secondary infections were given more often in the 20-MU group (11%) than in the placebo group (0%) (P less than 0.01). Nasal sprays of recombinant alfa-2b interferon were not an effective treatment for natural colds and were associated with toxicity.

Administration, Intranasal↗

After-effects of the common cold on mood and performance.

The present study examined whether volunteers who had recently had common colds showed impairments in mood and performance in the weeks following the illness. All volunteers (n = 24) were tested when healthy to provide baseline data for simple and choice reaction time tasks, attention and memory tasks and ratings of mood. When participants developed a cold (n = 13) they returned to the laboratory so that the illness could be verified. When they were symptom free they returned to the laboratory and repeated the procedure. They then completed the study with a final session 1 week later. Volunteers (n = 11) who remained healthy over 10 weeks were recalled as controls and also repeated the procedures. The results showed that those who had recently had colds showed few impairments in mental performance and mood. Taken together with the results of previous studies, this suggests that after-effects of viral infection are largely restricted to severe illnesses such as infectious mononucleosis and influenza. After-effects of colds may occur but these probably reflect poor learning at the time of the illness.

Adolescent↗

Increase in common cold symptoms and mouth ulcers following smoking cessation.

OBJECTIVE: To examine changes in reports of common cold symptoms and mouth ulcers following smoking cessation. It was hypothesised that reports of these symptoms would increase on stopping smoking. DESIGN: Smokers were assessed one week before stopping smoking (baseline), then after one, two, and six weeks of smoking abstinence. PARTICIPANTS: 174 smokers attending a seven week smoking cessation programme combining behavioural support with nicotine patches. MAIN OUTCOME MEASURES: Self reports of cold symptoms, mouth ulcers, and smoking abstinence (validated using expired carbon monoxide) were recorded on each measurement occasion. RESULTS: Following one, two, and six weeks of smoking abstinence 73.0% (127/174), 57.5% (100/174), and 44.8% (78/174) of the participants, respectively, maintained continuous abstinence and provided reports of cold symptoms and mouth ulcers. For those abstinent from smoking for six weeks, relative to baseline, a significant increase in reports of the number of cold symptoms was observed following one and two weeks of smoking abstinence (p = 0.009 and p = 0.038, respectively) and an increase in reports of mouth ulcers after one and two weeks of abstinence (p = 0.004 and p = 0.008, respectively). Following one week of abstinence significant increases in reports of sore throat, coughing, deafness, and sneezing were observed (p = 0.049, p < 0.001, p< 0.039, and p < 0.003, respectively). CONCLUSIONS: This is the first study to systematically document significant increases in cold symptoms and mouth ulcers following smoking cessation. Smokers should be informed that they have an increased chance of experiencing these symptoms on stopping smoking. Being psychologically prepared for these effects may reduce their impact on the attempt to stop smoking.

Adult↗

Cross-linked fibrin in the nasal fluid of patients with the common cold.

To determine whether adherent material found on the walls of the paranasal sinuses during common colds might be fibrin clot, we examined the nasal fluid (a surrogate for sinus secretion) of 11 young adults with experimentally induced rhinovirus colds and that of 4 control subjects for the presence of fibrin. The mean concentration (+/- the standard error) of insoluble fibrin (measured as D-dimer) in subjects with rhinovirus colds increased from a baseline level of 0.8+/-0.4 microgram/mL to a peak of 2.4+/-0.7 microgram/mL (P=.0008) on day 4 after inoculation of the virus, but the fibrin concentration remained at baseline levels in the 4 uninfected control subjects.

Adult↗

Survey of parenting books for advice on the common cold, diarrhea, and otitis media in infants and toddlers.

Parenting books often provide advice for common medical ailments of infants and toddlers. However, the accuracy of such advice has never been evaluated. The purpose of this study is to survey the informational content of a sample of parenting books. Fifty general parenting books were identified and reviewed for the informational content on the following topics: common colds, diarrhea, and otitis media. When covered by the book, accurate and consistent information was generally provided in the following topic areas: non-medicated nose drops for nasal congestion, upright positioning for children with colds, breastfeeding infants with diarrhea, electrolyte solutions for diarrhea, and feeding practices as they relate to otitis media. The following topic areas displayed significant inconsistency: the use of decongestants, antihistamines, expectorants, cough suppressants, and decongestant nose drops for colds; antidiarrheal medications; soft drinks and juice for diarrhea; home recipes for oral hydration solutions; and the usefulness of pressure equalization tubes for refractory otitis media. Practitioners should be aware that parents may be misinformed by some parenting books and take measures to educate parents.

Books↗