What is the treatment for a 2-day history of upper respiratory infection (URI) and sinus pressure?

From the Guidelines

For a 2-day history of upper respiratory infection (URI) and sinus pressure, the most appropriate treatment is supportive care and symptom management, without the use of antibiotics, as most URIs are viral and resolve within 7-10 days without antibiotic therapy 1. The treatment should focus on relieving symptoms, such as pain, fever, and congestion. Over-the-counter medications like acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Advil, Motrin) 400mg every 6-8 hours can be used to reduce pain and fever.

• Nasal saline sprays or rinses can help clear congestion
• Decongestants such as pseudoephedrine (Sudafed) 30-60mg every 4-6 hours (not exceeding 240mg daily) can temporarily relieve sinus pressure
• Antihistamines like loratadine (Claritin) 10mg daily may help if allergies are contributing It is essential to stay well-hydrated with 8-10 glasses of water daily, use a humidifier to moisten air, and get plenty of rest. However, if symptoms worsen after 7-10 days, include high fever (over 101.5°F), severe facial pain, or thick, discolored nasal discharge, seek medical attention as bacterial sinusitis may have developed, potentially requiring antibiotics, as suggested by the guidelines for acute rhinosinusitis management 1. These measures work by reducing inflammation, thinning mucus, and supporting your immune system's natural ability to fight the infection. The American College of Physicians and the Centers for Disease Control and Prevention recommend reserving antibiotic treatment for patients with persistent symptoms for more than 7-10 days or those with severe illness, such as high fever or severe facial pain 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 Principal Display Panel Compare to Sudafed® Congestion active ingredient Pseudoephedrine Hydrochloride, 30 mg Nasal Decongestant MAXIMUM STRENGTH • SINUS PRESSURE • SINUS CONGESTION 24 TABLETS actual size NON-DROWSY Padagis™

The treatment for a 2-day history of upper respiratory infection (URI) and sinus pressure is pseudoephedrine (PO), which can temporarily relieve sinus congestion and pressure and nasal congestion due to the common cold or other upper respiratory allergies 2 2.

• Key benefits: temporarily relieves sinus congestion and pressure, non-drowsy
• Active ingredient: Pseudoephedrine Hydrochloride, 30 mg
• Dosage form: Nasal Decongestant, 24 TABLETS

From the Research

Treatment for Upper Respiratory Infection (URI) and Sinus Pressure

• The treatment for a 2-day history of upper respiratory infection (URI) and sinus pressure typically involves symptom management with over-the-counter drugs 3.
• Pseudoephedrine is a widely used oral decongestant that can be taken every 4-6 hours to treat nasal congestion associated with common cold and allergy 4.
• A study found that a single dose of 60 mg pseudoephedrine was superior to placebo in reducing nasal airway resistance and subjective scores of congestion 4.
• Another study compared the efficacy of a paracetamol-pseudoephedrine combination with paracetamol or pseudoephedrine alone and placebo for the treatment of symptomatic URTI, and found that the combination was superior to paracetamol and placebo for decongestion and pain relief 5.
• For viral URIs, antibiotics are not recommended unless symptoms worsen or do not improve after an additional 7 days 3.
• Recommended therapy for the common cold involves symptom management with over-the-counter drugs, such as acetaminophen, ibuprofen, or naproxen for pain or fever, and antihistamines and/or decongestants to treat congestion and runny nose 6.

Management of Symptoms

• Symptomatic treatment for URIs typically includes rest, hydration, and over-the-counter medications to relieve symptoms such as pain, fever, and congestion 7.
• It is essential to recognize the symptoms consistent with bacterial pharyngitis, infectious mononucleosis, and sinusitis to provide appropriate diagnostic testing, treatment, and return-to-play recommendations 7.
• The Food and Drug Administration advises against the use of over-the-counter drugs in children younger than 6 years 3.