SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

12/13/05

Non-antibiotic treatment for URI

Summary
Background - There are large numbers of prescribed and OTC remedies advertised and sold widely for symptomatic treatment of viral URI (common colds).

Findings - Arroll of the Univ of Auckland in New Zealand reviewed findings in 7 Cochrane reviews of non-antibiotic (ABx) agents as symptomatic treatment of URI. The Cochrane reviewers were very cautious about concluding a beneficial effect of any of the treatment studies because of study design problems and variable quality of the studies.

They concluded that significant symptomatic relief was found during the first dose of oral decongestants and some antihistamine decongestant combinations. Most studies of antihistamines alone showed no benefit or statistically significant benefit of uncertain clinical significance. There were problems with studies of the effects of Echinacea. Heated humidified air was beneficial in some studies (in the UK and Israel) but not in the USA. Dextromethorphan is helpful in older children and adults but not in children < 5 years old. There is insufficient data about effects of the mucolytic agents letosteine and bisolvon on cough to draw conclusions. There were inconsistent effects of guiafenesin, and antihistamine decongestant preparations on cough. Zinc lozenge may be effective though difficult to get blinded study data because of the distinctive taste of such lozenges.

Reference
Respir Med 2005;99:1477-84

Editor's Comments
The author concluded that most non-ABx treatment for URI are likely not effective with the most promising findings to date seen with dextromethorphan for cough in those 5 years or older and possibly some antihistamine-decongestant combinations. I suspect that the benefit from the latter is due to the decongestant and possibly anti-cholinergic effects of the older antihistamine agents.

 

<-- BACK