What are the discharge (D/C) instructions for a mother with rhinovirus infection?

From the Guidelines

For a mother with rhinovirus, I strongly recommend focusing on symptom management and supportive care to improve quality of life, rather than seeking antibiotics, which are ineffective against viral infections. The management of viral rhinosinusitis (VRS) is primarily directed toward relief of symptoms, as antibiotics are not recommended for treating VRS since they are ineffective for viral illness and do not provide direct symptom relief 1.

Symptom Management

To alleviate symptoms, the following measures can be taken:

• Take acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Advil, Motrin) 400mg every 6 hours as needed for fever or pain
• Use saline nasal sprays or rinses to relieve congestion
• Consider an over-the-counter decongestant like pseudoephedrine if congestion is severe, but avoid if you have high blood pressure
• Honey mixed with warm tea can help soothe a sore throat (1-2 teaspoons as needed), and throat lozenges may provide additional relief
• Increase fluid intake to at least 8-10 glasses of water daily to thin mucus secretions
• Humidifying the air in your home can also ease breathing difficulties

Breastfeeding Considerations

For breastfeeding mothers, most maternal infections, including rhinovirus, are compatible with breastfeeding, and breast milk provides antibodies and protection to the infant 1. However, it is essential to practice good hygiene, such as hand washing and wearing a mask when breastfeeding, to minimize the risk of transmission to the infant.

Monitoring and Follow-up

Most rhinovirus infections resolve within 7-10 days without antibiotics. If symptoms worsen significantly, persist beyond 10 days, or if you develop high fever, severe headache, or difficulty breathing, seek medical attention promptly.

From the Research

Rhinovirus Infection Management

• Rhinoviruses are a common cause of infections in children, and treatment is limited to symptomatic therapy 2
• There is no clear evidence that treatment with zinc or echinacea has any role in rhinovirus infections 2
• Interruption of transmission by handwashing remains the only method for prevention of rhinovirus infections 2

Antihistamines for Rhinovirus Infections

• Antihistamines have a limited short-term beneficial effect on severity of overall symptoms, but not in the mid to long term 3
• There is no clinically significant effect on nasal obstruction, rhinorrhoea, or sneezing 3
• Antihistamines are not effective in children 3
• Sedating antihistamines may have some beneficial effect on individual symptoms, but this effect is clinically non-significant 3

Antiviral Therapeutic Approaches

• There is currently no licensed vaccine for rhinovirus, due to the large variety of rhinovirus serotypes 4
• Antiviral drugs and small molecule inhibitors of rhinovirus infection are being researched as potential therapeutic approaches 4
• Antiviral host defense peptides are also being explored as a potential therapeutic approach 4

Intranasally and Orally Administered Antihistamine Treatment

• Orally administered chlorpheniramine maleate and intranasally administered diphenhydramine hydrochloride had no significant effects on nasal symptoms or nasal mucus production in experimental rhinovirus colds 5
• Both treatments were well tolerated, but had no significant effects on the clinical outcome of the cold 5

Diagnosis and Treatment Challenges

• Diagnosis of rhinovirus infections is difficult due to unspecific clinical symptoms 6
• Laboratory detection is sophisticated, and distinction between clinically relevant infection and contamination is not always possible 6
• Specific therapeutic antiviral strategies against rhinovirus infection do not exist, and development of vaccines remains a challenge due to the large variety of subtypes 6