From the Guidelines
The treatment for Upper Respiratory Tract Infections (URTIs) is primarily supportive care since most cases are viral and self-limiting. Rest, adequate hydration, and over-the-counter medications for symptom relief are the mainstays of treatment. For pain and fever, acetaminophen (500-1000mg every 6 hours, maximum 4g daily) or ibuprofen (400-600mg every 6-8 hours with food, maximum 2400mg daily) can be used 1. Nasal congestion may be relieved with saline nasal sprays or decongestants like pseudoephedrine (30-60mg every 4-6 hours, maximum 240mg daily) for up to 3-5 days to avoid rebound congestion. Cough suppressants containing dextromethorphan may help with troublesome cough, typically 10-30mg every 4-8 hours. Throat lozenges or warm salt water gargles can soothe sore throats.
Key Considerations
- Antibiotics are generally not recommended for URTIs as they are ineffective against viral infections and contribute to antibiotic resistance 1.
- If a bacterial infection is suspected (persistent symptoms beyond 10-14 days, high fever, or purulent discharge), antibiotics like amoxicillin (500mg three times daily for 5-7 days) may be prescribed 1.
- Patients should seek medical attention if symptoms worsen, persist beyond 10 days, or if they experience difficulty breathing, severe headache, persistent high fever, or neck stiffness.
Management Strategies
- The American College of Physicians and the Centers for Disease Control and Prevention recommend watchful waiting (without antibiotic therapy) as initial management for all patients with uncomplicated ABRS, regardless of severity 1.
- Adjunctive therapy, such as intranasal saline irrigation or intranasal corticosteroids, has been shown to alleviate symptoms and potentially decrease antibiotic use 1.
From the FDA Drug Label
Uses • temporarily relieves sinus congestion and pressure • temporarily relieves nasal congestion due to the common cold, hay fever or other upper respiratory allergies Uses temporarily relieves • cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants • the impulse to cough to help you get to sleep
The treatment for Upper Respiratory Tract Infections (URTI) may include:
- Pseudoephedrine (PO) to relieve sinus congestion and pressure, and nasal congestion due to the common cold or other upper respiratory allergies 2
- Dextromethorphan (PO) to relieve cough due to minor throat and bronchial irritation as may occur with the common cold 3
From the Research
URTI Treatment Overview
- Upper Respiratory Tract Infections (URTI) are typically caused by viruses, but some cases are caused by bacteria 4.
- Treatment for URTI usually focuses on alleviating symptoms, as antibiotics are ineffective against viral infections 4, 5.
Symptomatic Treatment
- Medications such as acetaminophen, ibuprofen, or naproxen can be used to treat pain and fever 4.
- Antihistamines and decongestants can help relieve congestion and runny nose 4.
- Combination treatments, such as paracetamol and pseudoephedrine, have shown promise in reducing nasal congestion and pain-related symptoms 6, 7.
Early Intervention
- Early intervention, administered prior to the peaking of viral shedding, can reduce the chances of developing a full-blown acute URTI, decrease symptom severity, and reduce viral transmission 8.
- Mucoadhesive gel nasal sprays have shown potential in early intervention, creating a barrier that can trap virus particles and prevent invasion of the mucosa 8.
Antibiotic Treatment
- Inhaled antibiotic therapy may be effective in treating certain cases of URTI, such as chronic rhinosinusitis (RS) in adults 5.
- However, there is a lack of strong evidence for the use of nebulized antibiotics to treat URTI in non-cystic fibrosis patients, and further studies are needed to determine the effectiveness of this treatment modality 5.