Treatment for Rhinovirus Infection
Rhinovirus infections should be managed with symptomatic treatment only, as antibiotics provide no benefit for these viral infections and contribute to antibiotic resistance.
Understanding Rhinovirus
Rhinoviruses are the primary cause of the common cold and are responsible for more than 50% of respiratory tract infections 1. These infections are typically self-limiting with symptoms lasting 5-7 days and peaking at days 3-6 2.
Diagnosis
Rhinovirus infections are typically diagnosed clinically based on symptoms:
- Sneezing
- Rhinorrhea (runny nose)
- Nasal congestion
- Hyposmia/anosmia (reduced/absent sense of smell)
- Facial pressure
- Postnasal drip
- Sore throat
- Cough
- Ear fullness 2
Imaging studies should NOT be obtained to distinguish viral from bacterial infections, as they do not contribute to diagnosis and many patients with viral URIs will have radiographic abnormalities 2.
Treatment Approach
First-line Management: Symptomatic Relief
- Nasal saline irrigation - Helps clear nasal passages 2
- Acetaminophen or ibuprofen - For fever control and pain relief 2
- Adequate hydration - Though evidence is limited 3
- Rest - To support recovery
Additional Symptomatic Treatments
- Antihistamines - May help with excessive secretions and sneezing 2
- Oral decongestants - If no contraindications exist 2
- Honey - For cough in appropriate age groups (avoid in children under 1 year) 2
What NOT to Do
- Avoid antibiotics - They provide no benefit for viral URTIs and contribute to antibiotic resistance 2, 3
- Avoid unnecessary imaging - Sinus radiography and CT scans are not recommended for uncomplicated cases 3
Special Considerations
When to Suspect Bacterial Infection
Consider bacterial infection only if:
- Symptoms persist ≥10 days without improvement
- Severe symptoms with high fever (≥39°C/102.2°F) and purulent nasal discharge for 3-4 consecutive days
- "Double-sickening" pattern (initial improvement followed by worsening) 2
Prevention Strategies
- Hand hygiene - Most effective way to prevent transmission 3, 2
- Mask use - Recommended during outbreaks 3, 2
- Social distancing - Recommended during outbreaks 3, 2
- Virucidal facial tissues - May help interrupt transmission 4
When to Seek Further Medical Care
Return for medical evaluation if:
- Fever >38°C persists for more than 48 hours
- Breathing difficulty develops
- Symptoms worsen after initial improvement 2
Pharmacist's Role
Pharmacists can provide valuable support by:
- Recommending appropriate symptomatic treatments
- Educating patients about the viral nature of the infection
- Explaining why antibiotics are not beneficial
- Providing guidance on prevention measures
- Referring patients to physicians when necessary 3
Emerging Research
While no antiviral agents for rhinovirus are currently approved for clinical use, research continues on potential treatments:
However, these remain investigational and are not currently available for clinical use.