| Background |
 |
The common cold is caused by viral pathogens, such as rhinovirus, parainfluenza, adenovirus, RSV, and
influenza. |
|
Bacterial rhinosinusitis complicates only about 2% of cases. |
| Diagnosis |
|
Although sore throat, nasal symptoms, and cough may be present, there is no prominent symptom or sign. |
|
Symptoms may last up to 14 days with an average of 7 to 11 days (J Clin Microbiol 1997;35:2864; JAMA 1967;202:158). |
|
Purulent nasal secretions do not predict bacterial sinusitis unless accompanied by other signs and symptoms of bacterial infection. |
|
| Treatment |
|
Studies have found the common cold resolves without antibiotic treatment. |
|
Treatment with an antibiotic does not shorten the duration of illness or prevent bacterial rhinosinusitis. |
|
Patients with purulent green or yellow secretions do not benefit from antibiotic treatment. |
|
Over-the-counter cough suppressants have limited efficacy for relief of cough due to upper respiratory infection (Chest 2006; 129:95S-103S). |
|
Acute cough associated with the common cold may be relieved by first-generation antihistamines and decongestants (Chest 2006;129:95S-103S). |
|
TIPS TO REDUCE
ANTIBIOTIC USE |
|
Tell patients that antibiotic use increases the risk of an antibioticresistant infection. |
|
Identify and validate patient concerns. |
|
Recommend specific symptomatic therapy. |
|
Spend time answering questions and offer a contingency plan if symptoms worsen. |
|
Provide patient education materials on antibiotic resistance. |
|
REMEMBER: Effective communication is more important than an antibiotic for patient satisfaction. |
|
See www.cdc.gov/getsmart or contact your local health department for more information and patient education materials. |
|
|
