What are the treatments for common colds and flu?

Treatment for Common Cold and Flu

For common colds and flu, symptomatic treatment is recommended as these are primarily viral illnesses that are self-limiting, with antibiotics not indicated except in cases of bacterial complications. 1, 2

Common Cold Treatment

Non-Pharmacological Approaches

• Adequate hydration to help thin secretions and support overall recovery 2
• Nasal saline irrigation to relieve congestion and facilitate clearing of nasal secretions 2, 3
• Patient education about the viral and self-limiting nature of the disease (typically resolving within 7-10 days) 1, 2

Pharmacological Options for Common Cold

• First-generation antihistamine-decongestant combinations (e.g., brompheniramine with sustained-release pseudoephedrine) can effectively reduce congestion, rhinorrhea, and other cold symptoms 1, 2, 4
• NSAIDs (e.g., ibuprofen) can alleviate headache, malaise, and myalgia associated with the common cold 1, 2, 5
• Nasal decongestants can reduce symptoms of nasal blockage but should only be used short-term (3-5 days) to avoid rebound congestion 1, 2, 6
• Zinc administered as zinc acetate or zinc gluconate lozenges at doses ≥75 mg/day taken within 24 hours of symptom onset can significantly reduce the duration of common cold 1, 2, 7
• Acetaminophen/Paracetamol may help relieve nasal obstruction and rhinorrhea but does not appear to improve other cold symptoms 1, 3

Treatments to Avoid for Common Cold

• Antibiotics are not justified in uncomplicated common colds as they have not been shown to affect the duration of symptoms or prevent complications 1, 2
• Intranasal corticosteroids are not recommended for symptomatic relief from the common cold as there is no evidence supporting their use 1, 7
• Newer-generation non-sedating antihistamines are ineffective in treating common cold symptoms 1, 7, 8

Influenza Treatment

• Oseltamivir (Tamiflu) is indicated for treatment of acute, uncomplicated illness due to influenza A and B in patients who have been symptomatic for no more than 48 hours 9
• Treatment should be started as early as possible, ideally within 48 hours of symptom onset 9

Special Considerations

For Children

• Over-the-counter cough and cold medications should not be used in children younger than four years due to potential harm and lack of benefits 10
• Acetaminophen/paracetamol is appropriate for fever management in children 3, 10
• Nasal saline irrigation is safe and may provide symptom relief 2, 10

For Pregnant Women

• Acetaminophen is the first-line treatment for pain and fever during pregnancy 3
• Avoid or use caution with decongestants containing pseudoephedrine 3
• Non-pharmacological approaches (saline nasal irrigation, adequate hydration) are preferred 3

Warning Signs Requiring Medical Attention

• Fever persisting more than 3 days or appearing after this period 1, 2
• Persistence of symptoms (cough, rhinorrhea, nasal obstruction) after 10 days without signs of improvement 1, 2
• Development of severe symptoms such as high fever, severe shortness of breath, or unilateral facial pain with purulent nasal discharge 2, 3

Important Clinical Notes

• Approximately 25% of patients may continue with symptoms such as cough and nasal secretion up to day 14 1, 2
• The benefits of any symptomatic treatments must be weighed against potential adverse effects 1, 7, 4
• While antihistamine-decongestant combinations have shown effectiveness, they can cause side effects such as drowsiness, especially with first-generation antihistamines 1, 4