The Common Cold:Treatment

Only symptomatic treatment is available for uncomplicated cases of the common cold: bed rest, plenty of fluids, gargling with warm salt water, petroleum jelly for a raw nose, and aspirin or acetaminophen to relieve headache or fever.

A word of caution: several studies have linked the use of aspirin to the development of Reye's syndrome in children recovering from influenza or chickenpox. Reye's syndrome is a rare but serious illness that usually occurs in children between the ages of three and 12 years. It can affect all organs of the body, but most often injures the brain and liver. While most children who survive an episode of Reye's syndrome do not suffer any lasting consequences, the illness can lead to permanent brain damage or death. The American Academy of Pediatrics recommends children and teenagers not be given aspirin or any medications containing aspirin when they have any viral illness, particularly chickenpox or influenza. Many doctors recommend these medications be used for colds in adults only when headache or fever is present. Researchers, however, have found that aspirin and acetaminophen can suppress certain immune responses and increase nasal stuffiness in adults.

Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some cold symptoms but will not prevent, cure, or even shorten the duration of illness. Moreover, most have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, and should be taken with care.

Nonprescription antihistamines may have some effect in relieving inflammatory responses such as runny nose and watery eyes that are commonly associated with colds.

Antibiotics do not kill viruses. These prescription drugs should be used only for rare bacterial complications, such as sinusitis or ear infections, that can develop as secondary infections. The use of antibiotics "just in case" will not prevent secondary bacterial infections.

Does vitamin C have a role? Many people are convinced that taking large quantities of vitamin C will prevent colds or relieve symptoms. To test this theory, several large-scale, controlled studies involving children and adults have been conducted. To date, no conclusive data has shown that large doses of vitamin C prevent colds. The vitamin may reduce the severity or duration of symptoms, but there is no definitive evidence.

Taking vitamin C over long periods of time in large amounts may be harmful. Too much vitamin C can cause severe diarrhea, a particular danger for elderly people and small children. In addition, too much vitamin C distorts results of tests commonly used to measure the amount of glucose in urine and blood. Combining oral anticoagulant drugs and excessive amounts of vitamin C can produce abnormal results in blood-clotting tests.

Inhaling steam also has been proposed as a treatment of colds on the assumption that increasing the temperature inside the nose inhibits rhinovirus replication. Recent studies found that this approach had no effect on the symptoms or amount of viral shedding in individuals with rhinovirus colds. But steam may temporarily relieve symptoms of congestion associated with colds.

Interferon-alpha has been studied extensively for the treatment of the common cold. Investigators have shown interferon, given in daily doses by nasal spray, can prevent infection and illness. Interferon, however, causes unacceptable side effects such as nosebleeds and does not appear useful in treating established colds. Most cold researchers are concentrating on other approaches to combatting cold viruses.