No one likes a cold but it’s generally viewed as
something to endure. However, for those with a chronic condition, it can create
serious problems.
In January, the Canadian Medical Association Journal recently issued a review
article on what works and what doesn’t as far as the “common” cold. Below is
their press release on this article.
Since colds and flu season seem to go hand in hand, be sure
to check out Don’t Have Time for the Flu. Take Time to Prevent it.
Preventing and treating the common cold: Nothing to sneeze at
Hand washing, zinc may be best prevention
How do you prevent and treat the common cold? Hand washing and zinc may be
best for prevention whereas acetaminophen, ibuprofen and perhaps
antihistamine–decongestant combinations are the recommended treatments,
according to a review in CMAJ (Canadian Medical Association Journal).
The common cold is well, common, affecting adults approximately 2-3 times a
year and children under age 2 approximately 6 times a year. Symptoms such as
sore throat, stuffy or runny nose, cough and malaise are usually worse in days
1-3 and can last 7-10 days, sometimes as long as 3 weeks.
"Although self-limiting, the common cold is highly prevalent and may
be debilitating. It causes declines in function and productivity at work and
may affect other activities such as driving," write Drs. Michael Allan,
Department of Family Medicine, University of Alberta, Edmonton, and Bruce
Arroll, Department of General Practice and Primary Health Care, University of
Auckland, New Zealand.
Colds are also costly. It is estimated that direct medical costs in the
United States, including physician visits, secondary infections and medications
for colds, were an estimated $17 billion a year in 1997. Indirect costs from
missed work for illness or to look after a sick child were an estimated $25
billion per year.
Most colds are caused by viruses, with only about 5% of clinically
diagnosed colds having a bacterial infection, yet antibiotics are sometimes
used inappropriately for viral infections.
The review, aimed at physicians and patients, looked at available evidence
for both traditional and nontraditional approaches for preventing and
alleviating colds.
What works?
Prevention
•
Clean hands: a review of 67 randomized controlled
trials (RCTs) indicated that hand washing, a traditional public health
approach, as well as alcohol disinfectants and gloves, is likely effective.
•
Zinc may work for children (and possibly adults) — at
least 2 RCTs indicated that children who took 10 or 15 mg of zinc sulfate daily
had lower rates of colds and fewer absences from school due to colds. The
authors suggest that zinc may also work for adults.
•
Probiotics: there is some evidence that probiotics may
help prevent colds, although the types and combinations of organisms varied in
the studies as did the formulations (pills, liquids, etc.), making comparison
difficult.
Treatment
•
Antihistamines combined with decongestants and/or pain
medications appear to be somewhat or moderately effective in treating colds in
older children — but not in children under age 5 — and adults.
•
Pain relievers: ibuprofen and acetaminophen help with
pain and fever. Ibuprofen appears better for fever in children.
•
Nasal sprays: ipratropium, a drug used to treat
allergies and chronic obstructive pulmonary disorder, may alleviate runny nose
when used in a nasal spray but has no effect on congestion.
Other approaches and treatments
According to the evidence, the benefits of frequently used remedies such as
ginseng, (found in ColdFX), gargling, vapor rubs and homeopathy are unclear.
Cough medicines show no benefit in children but may offer slight benefit in
adults. Honey has a slight effect in relieving cough symptoms in children over
age 1. Vitamin C and antibiotics show no benefit, and misused antibiotics can
have associated harms.
The authors note that the evidence for preventing and treating colds is
often of poor quality and has inconsistent results.
"Much more evidence now exists in this area, but many uncertainties
remain regarding interventions to prevent and treat the common cold," write
the authors. "We focused on RCTs and systematic reviews and meta-analyses
of RCTs for therapy, but few of the studies had a low risk of bias. However,
many of the results were inconsistent and had small effects (e.g., vitamin C),
which arouses suspicion that any noted benefit may represent bias rather than a
true effect."
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