What are the treatments for Upper Respiratory Infection (URI) or common cold?

From the Guidelines

The most effective treatment for Upper Respiratory Infection (URI) or common cold focuses on symptom relief, as it is a viral infection that resolves on its own within 7-10 days, and antibiotics are ineffective against colds since they're caused by viruses, not bacteria. The mainstays of treatment include rest, adequate hydration, and over-the-counter medications. For congestion, decongestants like pseudoephedrine (Sudafed) 30-60mg every 4-6 hours or phenylephrine can help, though they should be limited to 3-5 days to avoid rebound congestion, as suggested by 1. Nasal saline sprays can be used as needed for moisture. For pain and fever, acetaminophen (Tylenol) 325-650mg every 4-6 hours (maximum 3000mg daily) or ibuprofen (Advil, Motrin) 200-400mg every 4-6 hours with food can provide relief, as indicated by 1. Some key points to consider in the treatment of URI or common cold include:

• Antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours may help with runny nose and sneezing but cause drowsiness.
• Cough suppressants containing dextromethorphan (DM) can help with persistent coughs, while guaifenesin helps thin mucus.
• Throat lozenges, warm salt water gargles, and honey (for adults and children over 1 year) can soothe sore throats.
• Humidifiers add moisture to the air, helping ease congestion.
• Zinc administered as zinc acetate or zinc gluconate lozenges at a dose of >=75 mg/day and taken within 24 hours of onset of symptoms significantly reduces the duration of common cold, as shown by 1. If symptoms worsen after 7-10 days or include high fever, severe headache, or difficulty breathing, medical attention should be sought as these may indicate complications or secondary infections, as advised by 1 and 1. It's also important to note that some treatments have been shown to be ineffective, such as antibiotics for the common cold, as stated by 1 and 1. Overall, the goal of treatment is to provide symptom relief and support the body's natural recovery process, rather than trying to cure the infection with antibiotics, which are ineffective against viral infections, as emphasized by 1, 1, and 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 treatments for Upper Respiratory Infection (URI) or common cold include:

• Pseudoephedrine (PO) to relieve sinus congestion and pressure, and nasal congestion due to the common cold 2
• Dextromethorphan (PO) to relieve cough due to minor throat and bronchial irritation as may occur with the common cold 3

From the Research

Treatments for Upper Respiratory Infection (URI) or Common Cold

• The common cold is a viral illness that affects persons of all ages, prompting frequent use of over-the-counter and prescription medications and alternative remedies 4.
• Treatment focuses on relieving symptoms such as cough, nasal congestion, and rhinorrhea 4.
• The following treatments have proven effectiveness for cold symptoms in adults:
  • Over-the-counter analgesics
  • Zinc
  • Nasal decongestants with or without antihistamines
  • Ipratropium for cough 5
• For children, the only established safe and effective treatments are:
  • Acetylcysteine
  • Honey (for children one year and older)
  • Nasal saline irrigation
  • Intranasal ipratropium
  • Topical application of ointment containing camphor, menthol, and eucalyptus oils 5
• Nasal decongestants may have a small positive effect on subjective measures of nasal congestion in adults with the common cold, but the clinical relevance of this small effect is unknown 6.
• Saline nasal irrigation possibly has benefits for relieving the symptoms of acute URTIs, but the included trials were generally too small and had a high risk of bias 7.
• Over-the-counter medicines used for treatment of common cold and flu can be used to relieve symptoms of COVID-19, as the innate immune response responsible for the mechanisms of the symptoms of URTI is the same for all respiratory viruses, including SARS-CoV-2 8.

Non-Recommended Treatments

• Antibiotics have not been shown to improve symptoms or shorten illness duration 4.
• Complementary and alternative therapies (i.e., Echinacea, vitamin C, and zinc) are not recommended for treating common cold symptoms, except that vitamin C prophylaxis may modestly reduce the duration and severity of the common cold in the general population 4.
• Over-the-counter cold medications should not be used in children younger than four years 5.

Additional Measures

• Informing patients about the self-limited nature of the common cold can help manage expectations, limit antibiotic use, and avoid over-the-counter purchases that may not help 5.
• Counseling patients about the importance of good hand hygiene is the best way to prevent transmission of cold viruses 5.