PDF Emergency Medicine Grand Rounds

Emergency Medicine Grand Rounds

Updated February 2019

The Common Cold, Influenza and Sinusitis:

Keith Conover, M.D., FACEP

Evidence-Based Treatment of Acute Rhinosinusitis

Department of Emergency Medicine University of Pittsburgh

"Support your local fever."

Fever helps kill viruses and bacteria.

Suppressing fever makes you sicker

and sick longer.

Recommendations

1. Antiviral antibiotic zinc (ZiCam Rapidmelts) will shorten your cold by 1-2 days.

2. Combination cold medications, Motrin, Aleve, aspirin and acetaminophen (Tylenol) will make you feel better but get sicker.

3. Don't treat fever < 104?F (40?C); do use an electric blanket for muscle aches and to kill viruses and bacteria. Use a zap-in-themicrowave heat pack on the sinuses.

4. Use honey, naproxen and 12-hour dextromethorphan for bad cough.

5. Use oxymetazoline (Afrin) nasal spray up to 10 days, for those > 2 years old.

6. Use salt water saline nasal spray frequently. For infants, use a blue bulb syringe to suck out the nose afterwards.

7. If cold worse at 5-6 days, or lasts > 10 days for adults (14 days for kids) still with cough, nasal discharge, fever, or sinus pain, use a steroid nasal spray and consult a doctor for an antibacterial antibiotic.

It happens to us all. The common cold. It's not an "emergency," but people want an instant cure.

Causes

Colds are "caused" by rhinovirus (>100 types of picornavirus), coronavirus, adenovirus, coxsackievirus, echovirus, orthomyxovirus, paramyxovirus (parainfluenza), enterovirus, metapneumovirus, influenza (flu), and respiratory syncytial virus (RSV), which is severe in kids but mild in adults and may cause asthma. Still, we don't know the cause of ?-? of colds. Some "infected" with a cold virus don't even notice it! Colds with bacterial overgrowth (~20%, usually S. pneumoniae, H. influenzae, or M. catarrhalis) are worse; but antibiotics don't help.1 Whooping cough from Bordetella pertussis acts like a cold, with strings of bad cough that can cause vomiting, and often with red eyes; treat with azithromycin as pertussis tests are not easily available and take a long time.

Winter is cold and flu season, maybe from crowding or cold noses. Being out in the cold briefly doesn't cause colds,2 but cold feet will "cause" a cold, likely from viruses replicating better in cold, which is why I recommend an electric blanket.3 Sleep deprivation makes you twice as likely to get a cold.4 Flu vaccines make you 50% less likely to get the flu or a cold that is really mild flu. Flu vaccines also protect against heart attack and stroke,5,6 and are safe and effective for pregnant women, protecting the unborn baby.7

Stress and allergic rhinitis make colds more likely, though exercise ? except strenuous military PT ? doesn't, nor does diet or big tonsils.8 ICAM-1, the cell membrane receptor that rhinovirus uses to infect cells, increases with dust, pollen and tobacco smoke, predisposing to colds.9 Those with vitamin D deficiency are more likely to get colds,10 and vitamin D supplementation can prevent colds (but not the flu as some have said)11 Those who taste bitter better are less likely to get colds.12 If you feel lonely your cold will be worse.13

Epidemiology and Economics (US figures)

? 1 billion colds/yr

? Kids: every 6 weeks; once/month if in school/daycare9

? Adults: 2-4/yr, decreases with age

? 1.6 million (of 43.8 million) ED visits in 1998

? 22 million school days/yr lost

? >$20 billion/year work loss (>1/3 caring for sick kids)

? We spend $4 billion a year on OTC cold medications

? We spend $400 million/year on "cold" medications

Natural History/Symptoms

Onset is ~10 hours; symptoms peak in 2-3 days, and last 2-14 days, smokers 3 days longer.14 A cold is contagious from a day before symptoms to 5 days (flu: 5-7 days) after.

Symptoms depend more on you than the specific virus. It usually starts with a sore throat (usually normal on exam) ? helpful to distinguish a cold from allergy ? as well as coryza: red, swollen nasal mucosa (not pale and boggy like allergy) and clear nasal drainage. Later, there is catarrh: purulent yellow-green nasal discharge. Colored drainage does not mean bacterial infection.15 With a winter cold, adults get chills and a low body temperature, but kids < 12 usually get a fever. Even

courtesy

adults with a summer cold often get a fever for 2-3 days.16 Poor appetite, malaise, and headache are common; half get muscle aches (myalgias) but not as bad as with influenza. This is from cytokines, which is why non-steroidal anti-inflammatory drugs (NSAIDs: ibuprofen = Motrin, Advil, Nuprin and naproxen = Aleve), and acetaminophen (Tylenol), which inhibit cytokines, make you feel better temporarily.17 But, cytokines fight infection. NSAIDs and acetaminophen make you sicker, sick longer, and more likely to spread your cold or flu to others;18 British statisticians looked at US data and estimated that people taking cold/flu medicines with NSAIDs or acetaminophen kills ~700 people each US flu/cold season.19 Some argue that acetaminophen and NSAIDs make feverish kids better able to eat, but Zofran (ondansetron) nausea medicine is likely safer. Cough is universal, and the major cause of medical visits.8,15 If winter and there's fever (in adults) and bad myalgias (muscle aches), especially if vomiting or diarrhea, then it's likely influenza. Rapid influenza tests miss 1/3-2/3 of flu cases.20-24

Complications

Almost a quarter of kids with a cold get an ear infection. Pneumonia is common after a cold, often mixed viral and bacterial, especially in kids. Asthma usually gets worse with a cold. Flu makes you more likely to have a heart attack.6

Cough

Colds are the #1 cause of cough.25 Most OTC (over-thecounter) and (prescription) medicines ? including guaifenesin (Robitussin, Mucinex) and diphenhydramine (Benadryl) are useless; codeine is useless and has bad side effects, kills infants, and is addictive.26-33 Benzonatate (Tessalon) does little for cough, and if you take too much, you may seize or die.34-37 Dextromethorphan (DM) is the best of the over-the-counter and prescription cough medicines, but doesn't help much; sustained-release 12-hour syrups are best. Honey is as good as DM but works by a different mechanism so use both; avoid in kids 10 days or you'll have to use it the rest of your life to breathe through your nose (rhinitis medicamentosa).50,53

Ipratropium (Atrovent) nasal spray ( only, $56 for generic) helps a bit.53 Steroid sprays (e.g., Flonase, Nasonex) don't help colds,54 but help sinusitis.55-57 Saline (salt water) spray helps colds58 and sinusitis.59,60 Don't use a neti pot with unboiled tap water unless you want an amebic brain abscess. Sealed, pressurized saline is best.

Myalgia/Malaise/Fever

Many "colds" are mild influenza: don't take aspirin which can cause Reye's Syndrome (liver failure). Both aspirin and acetaminophen (e.g., Tylenol) make your nose more stuffy, and make you sick longer.61 Tylenol worsens asthma,62 and ibuprofen (Motrin, Advil, Nuprin) likely does too.63 NSAIDS decrease malaise, myalgias and cough.64 But fever fights infections;19,65,66 suppressing fever makes you sicker

and spreads infection. Treating the fever of the flu kills 700 people a year in the US.19 Treat only if >104?F=40?C. An electric blanket is

probably better than medicine!

Combination Cold Medications

Combination medications (e.g., Theraflu, NyQuil, DayQuil) include two or more of: acetaminophen (Tylenol; see above); an antihistamine; a decongestant; or a cough suppressant. Useless for those < 12, they also kill those under 2 who get the wrong dose.67 Manufacturers can afford expensive lobbyists; thus, they can market useless medications to children 2-12. Canada does not allow marketing to kids under 6.68 2/3 of US homes have combination cold meds;69 even in adults, there's no real evidence they help. Given bad side effects, avoid them.27

Zinc, "Alternative" Therapies and Homeopathy

ZiCam zinc nasal spray was sold as "homeopathic" (to get around FDA regulations) but it contained large concentrations of zinc. The FDA made them stop selling

it after hundreds permanently lost their sense of smell.70 ZiCam Nasal Spray is now just expensive Afrin. Zinc oral spray and lozenges (e.g. ZiCam), however, are safe and effective: if you start within 24 hours, will make you feel 10-20% better and shorten your cold (or maybe flu) by 1-2 days. It's an antiviral antibiotic.71

To make a homeopathic remedy, put a tiny bit of an ingredient that cause the symptoms you want to cure, sometimes a poison. Dilute this over and over while hitting the bottle with a leather paddle (has to be leather). This magically changes the water, even though there may not be a single molecule of the original ingredient left. Properly-prepared homeopathic remedies are harmless, though they may keep you from getting something better;72 recently one homeopathic teething gel was not properly prepared and killed 10 babies.

Hot baths are long recommended,73 and fever kills viruses,65 as may warmth on the sinuses. Breathing warm, humidified air for 20 minutes helps in the UK (where there is little central heat: colder noses?) and Israel, but not in the US.74,75

Echinacea,76 Vitamin C77 and garlic78 are useless for treatment. Vitamin C prevents colds at the risk of kidney stones.77,79 Chicken soup improves nasal mucus drainage,80 and decreases inflammation.81 Some prescribe steroids such as prednisone. I can find no evidence in the literature that oral steroids will help a common cold. However, short courses of steroids double or triple the risk of deep venous thrombosis, longbone fracture, or overwhelming bacterial sepsis.82

This work is licensed under the Creative Commons

Influenza

Attribution-Share Alike 3.0 Flu treatment is the same as for a cold, but also the prescription nausea

United States License. To view a copy of this license,

medication ondansetron (Zofran) and the OTC diarrhea medication loper-

visit . amide (Imodium-AD) may help. Oseltamivir (Tamiflu) can help influenza.83

org/licenses/by-sa/3.0/us/ For healthy people, it only helps if started within 48 hours; side effects oCSuroismteenm3d0o0an,slSe,ta1tne7r1FtrSoaenCccorinesacdtoiS,vtereet,irneccolumdme veonmdeitdinifg,ypousy'rcehaodsmis iatnteddktiodntheeyhfaoislupirtea.lE, pvreenganfatnert,4N8ahtiovuerAs,mCeDrCic-an/ California, 94105, USA. Alaskan, very old or very young, morbidly obese, nursing home resident, or

have significant chronic illness including asthma or diabetes. In 2017, H3N2

influenza killed 80,000 people in the US, and it's contagious from a day before

symptoms until 5-7 days later. Don't kill people: stay home for 7 days.

This license lets others remix,

tweak, and build upon your

Colds vs. "Sinusitis"

work even for commercial

purposes, as long as they Three days of nasal congestion, and now your snot is yellow, green or

credit you and license their new creations under the identical terms. This license is often compared

purple? An antibacterial antibiotic will not help. Really. Despite this 53% think they need an antibacterial antibiotic for a cold,84,85 and thousands of doctors give them.85 Call a cold acute viral rhinosinusitis: yes, your sinuses are

to "copyleft" free and open infected ? but with a virus and you need the antiviral antibiotic zinc. Some

source software licenses. All new works based on yours will carry the same license, so

colds have bacterial outweighed by side

superinfection,86 effects, especially

but antibacterial diarrhea.

antibiotic

benefit

is

any derivatives will also allow Sinus opacification shows on CT scans of ~90% with a cold and ~40%

commercial use. This is the without a cold, so useless for diagnosing "sinusitis," as are X-rays.16,86-88 The

license used by Wikipedia, and is recommended for

diagnosis is based on history. Precise criteria are controversial.57,89,90 The real

materials that would benefit question is: when will an antibacterial antibiotic help more than harm? (a)

from incorporating content onset with very severe symptoms or high fever for at least 3-4 days, or (b)

from Wikipedia and similarly licensed projects.

Set in Scala Sans and Minion in InDesign

worsening after 5-6 cough in kids) > 10 helps, even in kids,

days or days in but oral

(c) with ongoing nasal discharge (or daytime adults or >14 days in kids.91-93 Steroid nasal spray steroids are not recommended.16,93,94 Amoxicil-

This document may be lin, Bactrim and Zithromax no longer work due to resistant pneumococcus;

downloaded from

top choices are Augmentin, high-dose if high fever, daycare, age 65,

ftp recent hospitalization, antibiotics in the past month, or immunocompro-

mised (high-dose is 2 g BID for adults, 90 mg/kg/day for kids),

doxycycline, or Levaquin/Avelox90,93 but now with bad side

effects of quinolones like Levaquin/Avelox,95,96 cefdinir is now

second-line for kids and Ceftin is third-line for adults, both safe

with penicillin allergy.97 Those with bad nasal allergies also get

bacterial sinusitis.

1. Arroll B, Kenealy T. Antibiotics for

overdose associated with seizures and

LR, Soszynski D. The adaptive value of

the common cold and acute purulent

arrhythmias. J Toxicol Clin Toxicol

fever. Infectious disease clinics of North

rhinitis. Cochrane Database of Systematic 1998;36:713-8.

America 1996;10:1-20.

Reviews. Chichester, UK: John Wiley & 35. Cohen V, Jellinek SP, Stansfield L,

66. Camarena-Michel A. Fever in the

Sons, Ltd; 2005.

Truong H, Baseluos C, Marshall JP. Car- Emergency Department Predicts Survival

2. Douglas RGJ, Lindgren KM, Couch

diac arrest with residual blindness after of Patients with Severe Sepsis and Septic

RB. Exposure to cold environment and overdose of Tessalon(R) (benzonatate) Shock Admitted to the ICU. Journal of

rhinovirus common cold. Failure to dem- perles. J Emerg Med 2011;41:166-71.

Emergency Medicine;52:907-8.

onstrate effect. N Engl J Med 1968;279. 36. Winter ML, Spiller HA, Griffith JR. 67. Sharfstein JM, North M, Serwint JR.

3. Johnson C, Eccles R. Acute cooling of Benzonatate Ingestion Reported to the Over the counter but no longer under the

the feet and the onset of common cold National Poison Center Database System radar--pediatric cough and cold medica-

symptoms. Fam Pract 2005;22:608-13. (NPDS). J Med Toxicol 2010;6:398-402. tions. N Engl J Med 2007;357:2321-4.

4. Prather A, Janicki-Deverts D, Hall M, 37. McLawhorn MW, Goulding MR,

68. Shefrin AE, Goldman RD. Use of

Cohen S. Behaviorally Assessed Sleep

Gill RK, Michele TM. Analysis of

over-the-counter cough and cold medica-

and Susceptibility to the Common Cold. Benzonatate Overdoses Among Adults tions in children. Can Fam Physician

Sleep 2015.

and Children from 1969?2010 by the

2009;55:1081-3.

5. Smeeth L, Thomas SL, Hall AJ,

United States Food and Drug Administra- 69. Mossad SB. Treatment of the common

Hubbard R, Farrington P, Vallance P. tion. Pharmacotherapy: The Journal of cold. Bmj 1998;317:33-6.

Risk of Myocardial Infarction and Stroke Human Pharmacology and Drug Therapy 70. Jafek BW, Linschoten MR, Murrow

after Acute Infection or Vaccination.

2013;33:38-43.

BW. Anosmia after intranasal zinc gluco-

New England Journal of Medicine

38. Oduwole O, Udoh EE, Oyo-Ita A,

nate use. Am J Rhinol 2004;18:137-41.

2004;351:2611-8.

Meremikwu MM. Honey for acute cough 71. Singh M, Das RR. Zinc for the

6. Kwong JC, Schwartz KL, Campitelli

in children. Cochrane database of system- common cold. Cochrane Database of

MA, et al. Acute Myocardial Infarction atic reviews (Online) 2018;4:Cd007094. Systematic Reviews. Chichester, UK: John

after Laboratory-Confirmed Influenza 39. Sperber SJ, Hendley JO, Hayden FG, Wiley & Sons, Ltd; 2011.

Infection. N Engl J Med 2018;378:345-53. Riker DK, Sorrentino JV, Gwaltney JM, 72. Shang A, Huwiler-Muntener K,

7. Shakib JH, Korgenski K, Presson

Jr. Effects of naproxen on experimental Nartey L, et al. Are the clinical effects of

AP, et al. Influenza in Infants Born to

rhinovirus colds. A randomized, double- homoeopathy placebo effects? Compara-

Women Vaccinated During Pregnancy. blind, controlled trial. Annals of internal tive study of placebo-controlled trials

Pediatrics 2016.

medicine 1992;117:37-41.

of homoeopathy and allopathy. Lancet

8. Heikkinen T, Jarvinen A. The common 40. Kim SY, Chang YJ, Cho HM, Hwang 2005;366:726-32.

cold. Lancet 2003;361:51-9.

YW, Moon YS. Non-steroidal anti-

73. Reimann HA. Viral infections

9. Fleming DW, Cochi SL, Hightower AW, inflammatory drugs for the common cold. of respiratory tract; their treatment

Broome CV. Childhood upper respira- Cochrane database of systematic reviews and prevention. J Am Med Assoc

tory tract infections: to what degree is

(Online) 2015;9:CD006362.

1946;132:487-93.

incidence affected by day-care attendance? 41. Edwards DR, Aldridge T, Baird

74. Singh M, Singh M. Heated, humidified

Pediatrics 1987;79:55-60.

DD, Funk MJ, Savitz DA, Hartmann

air for the common cold. Cochrane Da-

10. Martineau AR, Jolliffe DA, Hooper KE. Periconceptional over-the-counter tabase of Systematic Reviews. Chichester,

RL, et al. Vitamin D supplementation to nonsteroidal anti-inflammatory drug ex- UK: John Wiley & Sons, Ltd; 2011.

prevent acute respiratory tract infections: posure and risk for spontaneous abortion. 75. Tyrrell D, Barrow I, Arthur J. Local

systematic review and meta-analysis of Obstet Gynecol 2012;120:113-22.

hyperthermia benefits natural and

individual participant data. BMJ 2017;356. 42. Ericson A, K?ll?n BA. Nonsteroidal experimental common colds. Bmj

11. Martineau AR, Jolliffe DA, Hooper anti-inflammatory drugs in early

1989;298:1280-3.

RL, et al. Vitamin D supplementation to pregnancy. Reproductive Toxicology

76. Linde K, Barrett B, Bauer R, Melchart

prevent acute respiratory tract infections: 2001;15:371-5.

D, Woelkart K. Echinacea for preventing

systematic review and meta-analysis

43. Nm J, Ms G. THe effects of im-

and treating the common cold. Cochrane

of individual participant data. BMJ

munosuppressive and anti-inflammatory Database of Systematic Reviews. Chiches-

2017;356:i6583.

medications on fertility, pregnancy, and ter, UK: John Wiley & Sons, Ltd; 2006.

12. Lee RJ, Xiong G, Kofonow JM, et al. lactation. Archives of Internal Medicine 77. Hemil? H, Chalker E, Douglas B.

T2R38 taste receptor polymorphisms un- 2000;160:610-9.

Vitamin C for preventing and treating

derlie susceptibility to upper respiratory 44. Janssen NM, Genta MS. The

the common cold. Cochrane Database of

infection. J Clin Invest 2012;122:4145-59. effects of immunosuppressive and anti- Systematic Reviews. Chichester, UK: John

13. LeRoy AS, Murdock KW, Jaremka LM, inflammatory medications on fertility, Wiley & Sons, Ltd; 2007.

Loya A, Fagundes CP. Loneliness Predicts pregnancy, and lactation. Arch Intern

78. Lissiman E, Bhasale Alice L, Cohen M.

Self-Reported Cold Symptoms After a

Med 2000;160:610-9.

Garlic for the common cold. Cochrane

Viral Challenge. Health Psychol 2017.

45. Nakhai-Pour HR, Broy P, Sheehy

Database of Systematic Reviews. Chiches-

14. Aronson MD, Weiss ST, Ben RL, Ko- O, B?rard A. Use of nonaspirin nonste- ter, UK: John Wiley & Sons, Ltd; 2009.

maroff AL. Association between cigarette roidal anti-inflammatory drugs during 79. Taylor EN, Stampfer MJ, Curhan GC.

smoking and acute respiratory tract illness pregnancy and the risk of spontaneous Dietary factors and the risk of incident

in young adults. Jama 1982;248:181-3.

abortion. Canadian Medical Association kidney stones in men: new insights after

15. Eccles R. Understanding the symp- Journal 2011;183:1713-20.

14 years of follow-up. J Am Soc Nephrol

toms of the common cold and influenza. 46. Katz J, Kargi AY, Ramasamy R. Re:

2004;15:3225-32.

Lancet Infect Dis 2005;5:718-25.

Ibuprofen Alters Human Testicular Physi- 80. Saketkhoo K, Januszkiewicz A,

16. Wald ER, Applegate KE, Bordley C, ology To Produce a State of Compensated Sackner MA. Effects of drinking hot

et al. Clinical Practice Guideline for the Hypogonadism. Eur Urol 2018.

water, cold water, and chicken soup on

Diagnosis and Management of Acute

47. Wen Y-C, Hsiao F-Y, Chan KA, Lin nasal mucus velocity and nasal airflow

Bacterial Sinusitis in Children Aged 1 to Z-F, Shen L-J, Fang C-C. Acute respira- resistance. Chest 1978;74:408-10.

18 Years. Pediatrics 2013.

tory infection and use of nonsteroidal

81. Rennard BO, Ertl RF, Gossman GL,

17. Mackowiak PA. Physiological rationale anti-inflammatory drugs on risk of acute Robbins RA, Rennard SI. Chicken soup

for suppression of fever. Clin Infect Dis myocardial infarction: a nationwide case- inhibits neutrophil chemotaxis in vitro.

2000;31 Suppl 5:S185-9.

crossover study. The Journal of infectious Chest 2000;118:1150-7.

18. Eyers S, Weatherall M, Shirtcliffe

diseases 2017;215:503-9.

82. Waljee AK, Rogers MA, Lin P, et al.

P, Perrin K, Beasley R. The effect on

48. Smucny J, Becker LA, Glazier R.

Short term use of oral corticosteroids and

mortality of antipyretics in the treatment Beta2-agonists for acute bronchitis.

related harms among adults in the United

of influenza infection: systematic review Cochrane Database of Systematic

States: population based cohort study.

and meta-analysis. Journal of the Royal Reviews. Chichester, UK: John Wiley & BMJ 2017;357:j1415.

Society of Medicine 2010;103:403-11.

Sons, Ltd; 2006.

83. Jefferson T, Jones MA, Doshi P,

19. Earn DJD, Andrews PW, Bolker BM. 49. Ebell MH, Lundgren J, Youngpairoj S. et al. Neuraminidase inhibitors for

Population-level effects of suppressing How long does a cough last? Comparing preventing and treating influenza in

fever. Proceedings of the Royal Society B: patients' expectations with data from a healthy adults and children. Cochrane

Biological Sciences 2014;281.

systematic review of the literature. Annals database of systematic reviews (Online)

20. Drexler JF, Helmer A, Kirberg H, et al. of family medicine 2013;11:5-13.

2012;1:CD008965.

Poor clinical sensitivity of rapid antigen 50. Taverner D, Latte GJ. Nasal deconges- 84. Lee GM, Friedman JF, Ross-Degnan

test for influenza A pandemic (H1N1) tants for the common cold. Cochrane Da- D, Hibberd PL, Goldmann DA. Mis-

2009 virus. Emerging infectious diseases tabase of Systematic Reviews. Chichester, conceptions about colds and predictors

2009;15:1662-4.

UK: John Wiley & Sons, Ltd; 2009.

of health service utilization. Pediatrics

21. Fader RC. Comparison of the Binax 51. Hatton RC, Hendeles L. Over-the-

2003;111:231-6.

NOW Flu A enzyme immunochromato- Counter Oral Phenylephrine: A Placebo 85. Mainous AG, 3rd, Hueston WJ, Clark

graphic assay and R-Mix shell vial culture for Nasal Congestion. The journal of al- JR. Antibiotics and upper respiratory

for the 2003-2004 influenza season. J Clin lergy and clinical immunology In practice infection: do some folks think there is a

Microbiol 2005;43:6133-5.

2015;3:709-10.

cure for the common cold. The Journal of

22. Landry ML, Cohen S, Ferguson D.

52. Winther B, Buchert D, Turner RB,

family practice 1996;42:357-61.

Comparison of Binax NOW and Directi- Hendley JO, Tschaikin M. Decreased

86. Kaiser L, Lew D, Hirschel B, et al.

gen for rapid detection of influenza A and rhinovirus shedding after intranasal

Effects of antibiotic treatment in the

B. J Clin Virol 2004;31:113-5.

oxymetazoline application in adults

subset of common-cold patients who have

23. Rahman M, Vandermause MF, Kieke with induced colds compared with

bacteria in nasopharyngeal secretions.

BA, Belongia EA. Performance of Binax intranasal saline. Am J Rhinol Allergy

Lancet 1996;347:1507-10.

NOW Flu A and B and direct fluorescent 2010;24:374-7.

87. Schwartz RH, Pitkaranta A, Winther

assay in comparison with a composite

53. Eccles R, Martensson K, Chen SC.

B. Computed tomography imaging of the

of viral culture or reverse transcription Effects of intranasal xylometazoline, alone maxillary and ethmoid sinuses in children

polymerase chain reaction for detection or in combination with ipratropium, in with short-duration purulent rhinorrhea.

of influenza infection during the 2006 to patients with common cold. Curr Med Otolaryngology--head and neck surgery :

2007 season. Diagn Microbiol Infect Dis Res Opin 2010.

official journal of American Academy of

2008;62:162-6.

54. Puhakka T, Makela MJ, Malmstrom Otolaryngology-Head and Neck Surgery

24. Smit M, Beynon KA, Murdoch DR, K, et al. The common cold: effects of intra- 2001;124:160-3.

Jennings LC. Comparison of the NOW nasal fluticasone propionate treatment. J 88. Gwaltney JM, Jr., Phillips CD, Miller

Influenza A & B, NOW Flu A, NOW Flu Allergy Clin Immunol 1998;101:726-31. RD, Riker DK. Computed tomographic

B, and Directigen Flu A+B assays, and 55. Intranasal steroids alone effective for study of the common cold. The New Eng-

immunofluorescence with viral culture acute uncomplicated sinusitis. The Journal land journal of medicine 1994;330:25-30.

for the detection of influenza A and

of family practice 2006;55:190.

89. Lanza DC, Kennedy DW. Adult

B viruses. Diagn Microbiol Infect Dis

56. Zalmanovici A, Yaphe J. Intranasal rhinosinusitis defined. Otolaryngology-

2007;57:67-70.

steroids for acute sinusitis. Cochrane

-head and neck surgery : official journal of

25. Pratter MR. Cough and the common database of systematic reviews (Online) American Academy of Otolaryngology-

cold: ACCP evidence-based clinical prac- 2009:CD005149.

Head and Neck Surgery 1997;117:S1-7.

tice guidelines. Chest 2006;129:72S-4S. 57. Williamson IG, Rumsby K, Benge S, 90. Garbutt JM, Banister C, Spitznagel

26. Croughan-Minihane MS, Petitti DB, et al. Antibiotics and topical nasal steroid E, Piccirillo JF. Amoxicillin for acute

Rodnick JE, Eliaser G. Clinical trial exam- for treatment of acute maxillary sinusitis: rhinosinusitis: a randomized controlled

ining effectiveness of three cough syrups. J a randomized controlled trial. JAMA

trial. Jama 2012;307:685-92.

Am Board Fam Pract 1993;6:109-15.

2007;298:2487-96.

91. Benninger MS, Sedory Holzer SE, Lau

27. Smith MB, Feldman W. Over-the-

58. Slapak I, Skoupa J, Strnad P, Hornik P. J. Diagnosis and treatment of uncom-

counter cold medications. A critical

Efficacy of isotonic nasal wash (seawater) plicated acute bacterial rhinosinusitis:

review of clinical trials between 1950 and in the treatment and prevention of rhinitis summary of the Agency for Health Care

1991. Jama 1993;269:2258-63.

in children. Arch Otolaryngol Head Neck Policy and Research evidence-based

28. Smith SM, Schroeder K, Fahey T.

Surg 2008;134:67-74.

report. Otolaryngology--head and neck

Over-the-counter (OTC) medications

59. Wang Y-H, Yang C-P, Ku M-S, Sun

surgery : official journal of American

for acute cough in children and adults in H-L, Lue K-H. Efficacy of nasal irrigation Academy of Otolaryngology-Head and

ambulatory settings. Cochrane Database in the treatment of acute sinusitis in chil- Neck Surgery 2000;122:1-7.

of Systematic Reviews. Chichester, UK: dren. International journal of pediatric 92. Ahovuo-Saloranta A, Rautakorpi

John Wiley & Sons, Ltd; 2008.

otorhinolaryngology 2009;73:1696-701. U-M, Borisenko OV, Liira H, Williams

29. Taylor JA, Novack AH, Almquist JR, 60. Rabago D, Zgierska A, Mundt M,

JJW, M?kel? M. Antibiotics for acute

Rogers JE. Efficacy of cough suppressants Barrett B, Bobula J, Maberry R. Efficacy maxillary sinusitis. Cochrane Database of

in children. J Pediatr 1993;122:799-802. of daily hypertonic saline nasal irrigation Systematic Reviews. Chichester, UK: John

30. Eccles R, Morris S, Jawad M. Lack

among patients with sinusitis: a random- Wiley & Sons, Ltd; 2008.

of effect of codeine in the treatment

ized controlled trial. The Journal of family 93. Chow AW, Benninger MS, Brook I,

of cough associated with acute upper

practice 2002;51:1049.

et al. IDSA Clinical Practice Guideline

respiratory tract infection. J Clin Pharm 61. Graham NM, Burrell CJ, Douglas RM, for Acute Bacterial Rhinosinusitis in

Ther 1992;17:175-80.

Debelle P, Davies L. Adverse effects of

Children and Adults. Clin Infect Dis

31. Paul IM, Beiler J, McMonagle A,

aspirin, acetaminophen, and ibuprofen 2012;54:e72-e112.

Shaffer ML, Duda L, Berlin CM, Jr.

on immune function, viral shedding, and 94. Venekamp RP, Thompson MJ,

Effect of honey, dextromethorphan, and clinical status in rhinovirus-infected vol- Hayward G, et al. Systemic cortico-

no treatment on nocturnal cough and

unteers. J Infect Dis 1990;162:1277-82. steroids for acute sinusitis. Cochrane

sleep quality for coughing children and 62. McBride JT. The association of acet- database of systematic reviews (Online)

their parents. Arch Pediatr Adolesc Med aminophen and asthma prevalence and 2011:CD008115.

2007;161:1140-6.

severity. Pediatrics 2011;128:1181-5.

95. Daneman N, Lu H, Redelmeier DA.

32. Paul IM, Yoder KE, Crowell KR, et

63. Sheehan WJ, Mauger DT, Paul IM,

Fluoroquinolones and collagen associated

al. Effect of dextromethorphan, diphen- et al. Acetaminophen versus Ibuprofen severe adverse events: a longitudinal

hydramine, and placebo on nocturnal

in Young Children with Mild Persistent cohort study. BMJ Open 2015;5:e010077.

cough and sleep quality for coughing

Asthma. New England Journal of

96. Lee CC, Lee MT, Chen YS, et al.

children and their parents. Pediatrics

Medicine 2016;375:619-30.

Risk of Aortic Dissection and Aortic

2004;114:e85-90.

64. Kim Sy, Chang Y-J, Cho HM,

Aneurysm in Patients Taking Oral Fluo-

33. Freestone C, Eccles R. Assessment

Hwang Y-w, Moon YS. Non-steroidal

roquinolone. JAMA internal medicine

of the antitussive efficacy of codeine in anti-inflammatory drugs for the common 2015;175:1839-47.

cough associated with common cold. J cold. Cochrane Database of Systematic 97. Pichichero ME, Casey JR. Safe use of

Pharm Pharmacol 1997;49:1045-9.

Reviews. Chichester, UK: John Wiley & selected cephalosporins in penicillin-aller-

34. Crouch BI, Knick KA, Crouch DJ,

Sons, Ltd; 2009.

gic patients: a meta-analysis. Otolaryngol

Matsumura KS, Rollins DE. Benzonatate 65. Kluger MJ, Kozak W, Conn CA, Leon Head Neck Surg 2007;136:340-7.

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