Clinical Review Fortnightly review

Treatment of the common cold

BMJ 1998; 317 doi: http://dx.doi.org/10.1136/bmj.317.7150.33 (Published 04 July 1998) Cite this as: BMJ 1998;317:33
  1. Sherif B Mossad, clinical associate.
  1. Department of Infectious Diseases, Cleveland Clinic Foundation, Cleveland, Ohio, USA

    The common cold is the most frequent illness managed in general practice. Despite a long search for a cure only potential treatments for the symptoms have been established. Colds afflict most adults two to four times a year and children four to eight times a year, and the resulting hours of absenteeism from work or school have enormous economic bearings. Several viruses can cause the common cold, but rhinoviruses are by far the most common. Studies evaluating various treatments for the common cold are divided into experimentally induced and naturally occurring colds. Treatments studied included symptomatic measures, pharmacological blockers, and specific antiviral agents, as well as drugs with yet unestablished mechanism of action. A systematic, evidence based assessment of this literature is imperative for rational selection of treatment—if any—for patients with a common cold.

    Summary points

    Alleviation of symptoms remains the only proved way to treat the common cold. First generation antihistamines, anticholinergics, and α agonists effectively reduce rhinorrhea and sneezing, but have minimal effects on other symptoms. Antitussive agents are probably of minimal benefit

    Over-the-counter cold treatments are effective only in adults and adolescents

    Antiviral drugs such as interferon alfa-2b are effective only if taken before symptoms develop

    Zinc may reduce the duration and intensity of symptoms but a safe effective dose is not yet established

    Mast cell stabilisers have shown promising results but have not been evaluated in large trials

    Overuse of cold treatments by both doctors and patients is a major problem requiring education of both parties

    Methods

    I reviewed articles cited in Medline between 1966 and 1997 using the keywords common cold, treatment, therapy, and drug treatment. I selected well designed randomised, double blind, placebo controlled trials and authoritative review articles on specific topics in treatment of the common cold. Articles published within the past five years were selected …

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