An approach to the Common Cold

This is the season when people get sick with the common cold. It's our pleasure to share with you some advice about preventing and treating it for adolescents and adults!

What prevents the common cold?

  • The best evidence is for hand washing, exercise and daily zinc (however, zinc can cause nausea, so we don’t recommend it)
  • There maybe a possible benefit for probiotics, but it is not definitive (L. casei or L. rhamnosus)
  • There is no proven benefit to ginseng (Cold FX), echinacea, or vitamin D
  • Vitamin C may be beneficial in marathon runners and those in extreme climates

How should I treat my symptoms?

  • Remember that the symptoms of common cold will usually resolve without any treatment - Most over the counter treatments don’t actually give any benefit, so save your money!
  • If you really want to treat it, then treat the specific symptoms, including runny nose, nasal congestion, cough, aches, sore throat, or fever
  • Always ask the pharmacist for generic products when possible, rather than paying top dollar for brand name products on the shelf

Sore throat?

  • Most sore throats are caused by a virus, and antibiotics won’t help at all
  • Viral sore throats are best treated with acetaminophen or ibuprofen, salt water gargles, honey, and lozenges; patients with viral sore throats don’t need to see a doctor
  • Strep throat is caused by bacteria (should get antibiotic). Patients usually have some combination of: fever, tender neck lymph nodes, absence of cough, and pus on the tonsils

Runny nose or nasal congestion?

  • Unless it lasts more than a few weeks, or you have a specific concern, you don't need to see a doctor
  • A combination of an oral antihistamine and a decongestant can help, but we don't generally recommend avoiding them as the symptoms will usually resolve on their own! Oral antihistamines like chlorpheniramine can cause dry mouth and sedation and the the newer antihistamines (Claritin, Aerius, Allegra, Reactine) don’t work for cold symptoms, they only help with allergies
  • Decongestant: If you don't have a contraindication, you can use oral pseudoephedrine but personally we would strongly advise against using a decongestant
  • Don’t use the decongestant for more than 3 days
  • Don’t use the decongestant if you have heart disease, stroke or issues with blood pressure – It puts blood pressure up!
  • Consider nasal irrigation with a salt water solution like Neil Med

Cough?

(If you have any of fever, significant sputum, night sweats or shortness of breath, you should be evaluated for possible pneumonia. A cough that doesn't go away should also be seen.)

  • Humidified air can be beneficial
  • Honey taken at bed time is effective (not for children under 12 months of age)
  • No proven benefit to vitamin C, intranasal zinc, ginseng, Echinacea or codeine - Guaifenesin is an “expectorant”, but has not shown to provide benefit

Do you have a history of allergies?

  • The allergies may be contributing and using a nasal steroid may help

Do you think you may have a sinus infection?

  • Antibiotics are never prescribed earlier than 7 days unless you are having severe pain, high fever, vision changes, signs of meningitis, or visible facial swelling
  • In the first 7 days, we recommend treating with a sinus rinse, and acetaminophen (Tylenol) for pain/aches
  • After 7 days, first line treatment will likely be nasal steroids for 72 hours - If no improvement after 72 hours, we may consider using antibiotics 

Adapted from Dr Mario Ella