From the Research
Introduction to Managing Influenza-Like Illness or Upper Respiratory Tract Infections
Influenza-like illness (ILI) and upper respiratory tract infections (URTIs) are common conditions that affect people of all ages. Managing these conditions effectively is crucial to alleviate symptoms, reduce the risk of complications, and improve quality of life.
Symptoms and Diagnosis
Common Symptoms
- Cough
- Nasal congestion
- Rhinorrhea
- Sneezing
- Fever
- General feeling of illness
Diagnostic Considerations
Diagnosis is typically based on clinical presentation, and laboratory tests are not usually necessary for diagnosis. However, in certain cases, such as suspected influenza or bacterial infections, diagnostic tests may be performed.
Treatment Options
Over-the-Counter Medications
- Antihistamines: may have a limited short-term beneficial effect on severity of overall symptoms in adults, but no clinically significant effect on individual symptoms such as nasal congestion, rhinorrhea, or sneezing 1
- Decongestants: can relieve nasal symptoms in adolescents and adults for up to three days 2
- Analgesics: such as acetaminophen or ibuprofen, can help alleviate pain and fever symptoms 3
- Cough suppressants: such as dextromethorphan, may be beneficial in adults with cough, but its effectiveness has not been demonstrated in children and adolescents 2
Prescription Medications
- Anticholinergics: such as ipratropium, can relieve nasal symptoms in older children and adults 2
Non-Pharmacological Interventions
- Humidified air and fluid intake may be useful in alleviating symptoms without adverse side effects 2
- Vitamin C prophylaxis may modestly reduce the duration and severity of the common cold in the general population 2
Special Considerations
Children
- Over-the-counter cough and cold medications are not effective in treating children with the common cold and might cause serious side effects, including death 4
- New recommendations restrict use in Canada to those older than 6 years of age 4
- Antihistamines have no evidence of effectiveness in children 1
Adults
- Antihistamine-decongestant-analgesic combinations may have some general benefit in adults, but the benefits must be weighed against the risk of adverse effects 5
Caveats and Differentials
- Antibiotics have not been shown to improve symptoms or shorten illness duration in viral URTIs 2
- Complementary and alternative therapies, such as Echinacea, vitamin C, and zinc, are not recommended for treating common cold symptoms 2
Conclusion
Managing ILI and URTIs requires a comprehensive approach that takes into account the patient's age, symptoms, and medical history. While over-the-counter medications and non-pharmacological interventions can alleviate symptoms, it is essential to weigh the benefits and risks of each treatment option and consider special considerations, such as the use of medications in children.