From the Guidelines
Treatment for acute viral rhinovirus is primarily supportive, focusing on relieving symptoms and improving quality of life, as antibiotics are ineffective against viruses. The most recent and highest quality study, published in 2020 in the journal Rhinology 1, provides evidence-based recommendations for the treatment of acute viral rhinosinusitis.
Key Recommendations
- Rest and adequate hydration are essential components of recovery.
- Over-the-counter medications can help manage symptoms:
- Acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours can reduce fever and relieve pain.
- Antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours can help with runny nose and sneezing but may cause drowsiness.
- Decongestants may have a small positive effect on subjective measures of nasal congestion in adults.
- Zinc lozenges started within 24 hours of symptom onset may reduce duration and severity.
- Saline nasal sprays and humidifiers can moisturize nasal passages and thin mucus.
- Most rhinovirus infections resolve within 7-10 days without complications.
Important Considerations
- Antibiotics should not be prescribed for acute viral rhinovirus as they are ineffective and can cause harm 1.
- Nasal corticosteroids may have a small effect on reducing total symptom score in adults suffering from acute post-viral rhinosinusitis, but their use should be considered on a case-by-case basis 1.
- Systemic corticosteroids are not recommended due to their potential harm and lack of significant benefit 1.
Monitoring and Follow-Up
If symptoms worsen significantly, persist beyond 10 days, or include high fever, severe headache, or difficulty breathing, medical attention should be sought as these may indicate a secondary bacterial infection or different condition.
From the Research
Treatment Options for Acute Viral Rhinovirus
- Over-the-counter analgesics, such as acetaminophen or ibuprofen, can help alleviate symptoms like headache and fever 2, 3, 4
- Nasal decongestants with or without antihistamines can help relieve nasal congestion 2
- Ipratropium can be used to treat cough 2, 5
- Saline nasal irrigation can help moisturize the nasal passages and loosen mucus 2, 5
- Honey can be used to soothe a sore throat in children over one year old 2
- Topical application of ointment containing camphor, menthol, and eucalyptus oils can help relieve nasal congestion 2
Important Considerations
- Antibiotics are not effective against viral rhinovirus infections and should only be used in cases of suspected bacterial infection 2, 4, 5
- Over-the-counter cold medications should not be used in children under four years old 2
- Counseling patients about good hand hygiene is essential to prevent the transmission of cold viruses 2
Symptom Management
- Symptoms of acute viral rhinovirus infection can be managed with symptomatic treatment, such as analgesics and decongestants 2, 5
- Monitoring the duration and severity of symptoms can help determine the best course of treatment 6
- A decrease in symptom severity by day 5 of the illness can indicate a non-bacterial origin of the infection 6