From the Guidelines
Rhinovirus infections should be managed with supportive therapies, such as analgesics, anti-inflammatory agents, nasal saline, decongestants, and antihistamines, to improve quality of life, as antibiotics are ineffective and may cause unnecessary harm. The primary goal of treatment is to relieve symptoms, as the infection is self-limited and typically resolves within 10 to 14 days 1.
Symptoms and Diagnosis
Rhinovirus infections are characterized by cough, sneezing, rhinorrhea, sore throat, and nasal congestion, with symptoms peaking within 3 days and gradually declining thereafter 1. It is essential to differentiate between viral and bacterial infections, as the presentation can be similar, but clinical emphasis on duration, illness pattern, and severity of symptoms can help guide diagnosis 1.
Treatment Options
Palliative medications, such as acetaminophen or ibuprofen, may be used for pain or fever relief, while nasal saline can provide symptomatic relief with minimal risk of adverse reactions 1. Oral decongestants, like pseudoephedrine, can also provide relief, but their use should be limited to 3 to 5 days to avoid rebound congestion and rhinitis medicamentosa 1. Topical intranasal steroids may have a role in managing rhinovirus infections, although their effect is modest, and the decision to use them should be based on patient preference 1.
Prevention and Complications
Preventive measures, such as frequent handwashing and avoiding close contact with infected individuals, can help reduce the spread of rhinovirus infections 1. While most infections resolve without complications, rhinovirus can sometimes lead to secondary bacterial infections or exacerbate conditions like asthma or COPD in vulnerable individuals 1.
Key considerations for managing rhinovirus infections include:
- Avoiding unnecessary antibiotic use, as it is ineffective against viral infections and may cause harm 1
- Using supportive therapies to relieve symptoms and improve quality of life 1
- Differentiating between viral and bacterial infections to guide diagnosis and treatment 1
- Implementing preventive measures to reduce the spread of infection 1
From the Research
Rhinovirus Overview
- Rhinoviruses are a common cause of upper respiratory tract infections, also known as the common cold 2
- They are divided into three species: rhinovirus A, B, and C, and are significant pathogens of acute exacerbations of chronic airway diseases such as asthma and chronic obstructive pulmonary disease 2
Treatment and Management
- Antihistamines have a limited short-term beneficial effect on severity of overall symptoms, but not in the mid to long term 3
- Anticholinergic-sympathomimetic combinations, such as pseudoephedrine hydrochloride and atropine sulfate, may have some beneficial effects on nasal congestion, but can also have side effects such as sedation and impaired nasal mucociliary clearance 4
- Over-the-counter analgesic/antipyretic medications, such as aspirin and acetaminophen, may suppress serum neutralizing antibody response and increase nasal symptoms and signs 5
- Specific therapeutic antiviral strategies against rhinovirus infection do not exist, and the development of vaccines remains a challenge due to the large variety of subtypes 2
Diagnosis and Prevention
- Diagnosis of rhinovirus infection is difficult due to unspecific clinical symptoms, and laboratory detection is sophisticated 2
- Early diagnosis and treatment of viral infections are crucial in immunocompromised patients, as these infections can be more severe and have a worse prognosis 6
- Rapid molecular testing has helped improve early diagnosis of viral infections and understanding of the role of prolonged shedding and viral loads 6