Brisbane, Australia—When pharmacists are asked how to treat the common cold, the most accurate answer probably won’t provide much comfort. A new study suggests that cold sufferers be told that their symptoms are generally self-limiting and usually resolve in a few days.

The report in The BMJ advises that, for adults, decongestants taken alone or with antihistamines or analgesics to alleviate bothersome nasal symptoms, may provide some relief.

The situation is more complex with children, however. The study team, led by researchers from the University of Queensland, is adamant that decongestants not be used in children younger than age 6 years and that they should be administered with caution in those under age 12 years because evidence of benefit is limited and adverse effects could occur. Side effects include an increased risk of insomnia, drowsiness, headache, or stomach upset, the authors point out, whereas long-term use of decongestants can lead to chronic nasal congestion.

“Many over-the-counter (OTC) treatments for the common cold claim to alleviate nasal symptoms, such as congestion, rhinorrhea (runny nose), and sneezing,” the article states. It adds, however, that “evidence for the effectiveness of these treatments is limited and of low quality, and clear guidance is lacking.”

To reach those conclusions, researchers mined the Cochrane Library for systematic reviews that investigated the effectiveness of treatments for the common cold. Reviews included were on treatments such as decongestants, antihistamines, analgesics, intranasal corticosteroids, herbal remedies, and vitamins and minerals—such as zinc—in adults with the common cold.

The study found that paracetamol (acetaminophen, in the United States) and anti-inflammatory drugs (NSAIDs) are sometimes prescribed for pain relief, but noted that the drugs appear to have no effect on nasal congestion or runny nose. Other old-fashioned remedies—steam inhalation, echinacea, vapor rub, eucalyptus oil, and increased fluid intake—either have been determined ineffective or have not been studied, researchers point out.

Trials also are lacking for children, the study notes, adding, “If parents are concerned about their child’s comfort, saline nasal irrigations or drops can be used safely, but this may not give the desired relief.”

In terms of other advice, the study authors conclude, “Based on the currently available evidence, reassurance that symptoms are self-limiting is the best you can offer patients, although short term use of decongestants in adults can provide some relief from a blocked nose.”

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