What is considered the best therapy for the common cold?
—Mohammad Yousuf, MD, Dyersburg, Tenn.
This is an ongoing hot topic. Some examples of recent literature to guide evidence-based practice include these therapies: zinc gluconate glycine lozenges (Cold-Eeze) (Am J Ther. 2003;10:324-329); ruprintrivir nasal spray (experimental formulation) (Antimicrob Agents Chemother. 2003;47:3907-3916); and ibuprofen (effective for aches/pains/fevers/sore throat but not nasal symptoms) (Am J Rhinol. 2001;15:239-242).
The evidence doesn’t support using the following: echinacea (Altern Ther Health Med. 2004;10:16, and others); antihistamines (Cochrane Database Syst Rev.2003;:CD001267); antibiotics (Cochrane Database Syst Rev.2000;:CD000247); megadose vitamin C (Med J Aust. 2001;175:359-362); antiviral medications (restricted to those currently available) (Cochrane Database Syst Rev. 2001;:CD002743); and nasal steroid (no beneficial or deleterious effect) (Rhinology. 2001;39:9-12). I recommend symptomatic management with a decongestant (if safe for the patient), expectorant, and cough suppression, if needed. “Tincture of time” remains the best available cure. Full recovery is expected within 21 days.
—Karen E. Brown, MD (113-20)