What are the recommended treatments for a cold?

Recommended Treatments for the Common Cold

For common cold treatment, the most effective approach includes symptom-based management with over-the-counter medications like paracetamol or NSAIDs for pain/fever, zinc lozenges started within 24 hours of symptoms, and targeted treatments for specific symptoms like nasal congestion and cough. 1

First-Line Treatments

Pain and Fever Management

• Paracetamol (acetaminophen): 500-1000mg every 4-6 hours (max 4000mg daily) for nasal obstruction, rhinorrhea, and pain 1
• NSAIDs (e.g., ibuprofen): Alternative for headache, ear pain, and muscle/joint pain 1, 2
  • Both are equally effective for cold symptoms with no evidence of differences in safety or efficacy when used at recommended doses 2

Nasal Symptoms

• Nasal saline irrigation: Safe and effective for nasal congestion in both adults and children 1, 3
• Decongestants (e.g., xylometazoline):
  • Effective for short-term relief of nasal congestion 1
  • Important caution: Use for ≤3 days to avoid rebound congestion 1
• Ipratropium bromide nasal spray: Effective for rhinorrhea (runny nose) 1

Cough Management

• For dry cough: Dextromethorphan-containing products provide short-term relief 1, 4
• For productive cough: Guaifenesin helps loosen phlegm and thin bronchial secretions 5
• For children over 1 year: Honey is recommended for cough relief 1, 3

Specific Effective Treatments

• Zinc lozenges (zinc acetate or gluconate): ≥75 mg/day started within 24 hours of symptom onset significantly reduces cold duration 6, 1
• Vapor rub containing camphor, menthol, and eucalyptus oils: Effective for children (topical application) 3

Age-Specific Considerations

For Adults

• All treatments listed above are appropriate
• Pseudoephedrine, phenylephrine, inhaled ipratropium, and zinc modestly reduce severity and duration of symptoms 7
• Some herbal preparations like Pelargonium sidoides extract may improve symptoms 6, 7

For Children

• IMPORTANT: Over-the-counter cold medications should NOT be used in children younger than 4 years 1, 7, 3
• Safe and effective treatments for children include:
  • Acetylcysteine
  • Honey (for children 1 year and older)
  • Nasal saline irrigation
  • Intranasal ipratropium
  • Topical application of ointment containing camphor, menthol, and eucalyptus oils 3

Prevention Strategies

• Hand hygiene: Most effective way to prevent transmission of cold viruses 3
• Regular moderate-intensity exercise: May help prevent common colds 1
• Probiotics: May reduce incidence of colds, though evidence quality is low 1
• Zinc supplementation: May help prevent colds 7

Important Cautions

• Antibiotics are NOT effective for the common cold and increase risk of adverse effects 1, 7
• Avoid exceeding recommended dosages of medications, particularly paracetamol, which can cause liver damage 1
• Be aware of duplicate ingredients in combination cold products 1, 8
• When to seek medical attention: If symptoms persist beyond 2 weeks, high fever develops after initial days, severe facial pain occurs, or breathing difficulties arise 1

Treatment Algorithm

1. Identify main symptoms (pain/fever, nasal congestion, cough)
2. For pain/fever: Use paracetamol or NSAIDs
3. For nasal congestion: Start with saline irrigation, add short-term decongestant if needed
4. For cough: Use dextromethorphan for dry cough or guaifenesin for productive cough
5. Consider adding zinc lozenges within 24 hours of symptom onset
6. Ensure adequate hydration and rest
7. Monitor for improvement - symptoms should resolve within 7-10 days

Remember that the common cold is self-limiting and typically resolves within 7-10 days, though symptoms can sometimes last up to 2 weeks 1.