What is the diagnosis and treatment for coryza (common cold)?

From the Guidelines

Coryza, or the common cold, is a viral infection that should be managed with supportive care, as antibiotics are ineffective and can cause harm, and the most effective treatment approach is to provide symptom relief with over-the-counter medications and lifestyle modifications. The diagnosis of coryza is primarily clinical, based on symptoms such as nasal congestion, runny nose, sneezing, sore throat, and mild cough. According to the european position paper on rhinosinusitis and nasal polyps 2020 1, there is no evidence to support the use of antibiotics for the common cold, and they may cause significant adverse effects.

For symptom relief, the following options can be considered:

• Over-the-counter medications like acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours to reduce fever and pain
• Decongestants such as pseudoephedrine (Sudafed) 30-60mg every 4-6 hours to help with nasal congestion
• Antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours to reduce runny nose and sneezing
• Staying hydrated, getting adequate rest, and using saline nasal sprays or humidifiers to provide additional comfort
• Vitamin C may be useful for people exposed to brief periods of severe physical exercise, and zinc lozenges at a dose of >=75 mg/day may reduce the duration of the common cold, but the benefits must be weighed against the risk of adverse effects 1.

It is essential to note that most cases of coryza resolve within 7-10 days without complications, and the condition spreads through respiratory droplets, so frequent handwashing and avoiding close contact with infected individuals can help prevent transmission. If symptoms worsen significantly or persist beyond two weeks, medical evaluation is recommended to rule out secondary infections or other conditions. The use of probiotics, nasal saline irrigation, and some herbal medicines like Andrographis paniculata SHA-10 extract may also have some benefits in reducing the duration and severity of the common cold, but more research is needed to confirm their effectiveness 1.

From the Research

Diagnosis of Coryza (Common Cold)

• The common cold is a major and recurrent cause of morbidity, affecting children and adults two or more times each year 2
• Nasal congestion is the commonest symptom of the common cold 2

Treatment of Coryza (Common Cold)

• Nasal decongestants, such as pseudoephedrine, can provide short-term relief of congestion in adults 2, 3, 4
• A single oral dose of pseudoephedrine can produce a moderate decrease in nasal airway resistance and a small but statistically significant decrease in subjective symptoms 3, 4
• Repeated doses of pseudoephedrine can produce a small statistical benefit over three to five days 2, 4
• Topical xylometazoline has been shown to have a clearer and longer-lasting decongestive effect than oral pseudoephedrine 5
• Other treatments that may be effective in reducing the severity and duration of symptoms in adults include:
  • Zinc (acetate or gluconate) 6
  • Nonsteroidal anti-inflammatory drugs 6
  • Some herbal preparations, including Echinacea purpurea 6
• In children, treatments that may be effective in reducing the severity and duration of symptoms include:
  • Vapor rub 6
  • Zinc sulfate 6
  • Pelargonium sidoides (geranium) extract 6
  • Buckwheat honey 6
• Prophylactic measures that may help reduce the incidence of colds include:
  • Hand hygiene 6
  • Prophylactic probiotics 6
  • Zinc sulfate 6
  • Nasal saline irrigation 6
  • Garlic 6
  • Vitamin C 6