Friday, February 3, 2012

The common cold and its treatment

     We are in the middle of the common cold (viral upper respiratory infection) season. Runny nose, cough, and congestion are the common symptoms. It is hard to go anywhere at this time of the year without being exposed to the virus.
     The over-the-counter medications are available in the stores and are tempting to use to reduce the symptoms. Millions of dollars every year are spent in the U.S. on these medications. Although there is much information about these medications available elsewhere (including on Hilliard Pediatrics website at, I want to provide an update on some of the latest medication information.
     Antihistamines such as chlorpheniramine and diphenhydramine are often labelled as for sneezing and runny nose. Although they can cause drowsiness, these are quite safe. And most studies have shown they are the most effective over the counter medication for cold and cough. They probably help a cough by slowing down any drainage that is causing the cough. Another thing folks find helpful about the antihistamines is simply that you may sleep better as a side effect (and getting more rest is a good thing).
     Expectorants increase mucous production -- that does not sound like a good thing, does it? While these medicines can help you cough and clear your mucous (and reduce congestion in the sinuses), they will not help you cough less. As a matter of fact, they generally increase how frequently you cough. The
expectorants do not taste good and can cause an upset stomach. They are probably best used during the day to help clear mucous. Good scientific studies do not demonstrate much benefit to kids with using expectorants.
     There is some good scientific research that shows that acetaminophen (for fever and achiness) suppresses a normal immune response our body has to an upper respiratory virus. This can result is worse nasal symptoms and a longer period of being contagious to others. So be cautious about routinely using acetaminophen for the pain or achiness of upper respiratory infections.
     Both echinacea and zinc are commonly used at the beginning of a "cold" to keep from getting worse and to get better faster. However, every scientific study done with children has not shown any benefit. That does not mean to stop these if your family finds it helpful. If you have found them helpful, it is quite possible that the illness was just going to be less severe and shorted that illness.
     I recall having Vicks(r) VapoRub slathered on my chest and under my nose during colds. However, I have been not often recommended the menthol vapor rub to my patients because no good scientific study had ever shown any promise -- until now. In 2-11 year olds with a cold and cough, there was improved sleep, less cough, and less congestion when compared to children who just used petrolatum or no treatment. So using these products may certainly help you fight your child's symptoms while they have a cold.
     We still like to recommend using saline drops and nasal suction for the infants and vaporizers for all ages to help reduce the cough and congestion by mouisturizing the air.
     Good luck. I hope you find this information helpful!


  1. Thanks Dr. Tim. I look forward to many more posts. Your information is always very helpful.