What is the treatment for the common cold and flu?

Common Cold treatment

No medications or herbal remedies have been conclusively demonstrated to shorten the duration of infection. Treatment thus comprises symptomatic relief. Getting plenty of rest, drinking fluids to maintain hydration, and gargling with warm salt water are reasonable conservative measures. Much of the benefit from treatment is, however, attributed to the placebo effect. Cold treatment.

Treatments that help alleviate symptoms include simple analgesics and antipyretics such as ibuprofen and acetaminophen/paracetamol. There is not good evidence for cough medicines. They are not recommended for use in children due to a lack of evidence supporting effectiveness and the potential for harm. In 2009, Canada restricted the use of over-the-counter cough and cold medication in children six years and under due to concerns regarding risks and unproven benefits. The misuse of dextromethorphan (an over-the-counter cough medicine) has led to its ban in a number of countries.

In adults antihistamines may improve symptoms in the first day or two; however, there is no longer-term benefit and they have adverse effects such as drowsiness. Other decongestants such as pseudoephedrine are effective in adults. Ipratropium nasal spray may reduce the symptoms of a runny nose but has little effect on stuffiness.

Due to lack of studies, it is not known whether increased fluid intake improves symptoms or shortens respiratory illness, and there is a similar lack of data for the use of heated humidified air. One study has found chest vapor rub to provide some relief of nocturnal cough, congestion, and sleep difficulty.

Antibiotics have no effect against viral infections or against the viruses that cause the common cold.

Due to their side effects, antibiotics cause overall harm but are still frequently prescribed. Some of the reasons that antibiotics are so commonly prescribed include people’s expectations for them, physicians’ desire to help, and the difficulty in excluding complications that may be amenable to antibiotics. There are no effective antiviral drugs for the common cold even though some preliminary research has shown benefits.

While there are many alternative treatments used for the common cold, there is insufficient scientific evidence to support the use of most. As of 2014 there is insufficient evidence to recommend for or against honey. As of 2015 there is tentative evidence to support nasal irrigation. Zinc has been used to treat symptoms, with studies suggesting that zinc, if taken within 24 hours of the onset of symptoms, reduces the duration and severity of the common cold in otherwise healthy people. Due to wide differences between the studies, further research may be needed to determine how and when zinc may be effective. Whereas zinc lozenges may produce side effects, there is only a weak rationale for physicians to recommend zinc for the treatment of the common cold. Some zinc remedies directly applied to the inside of the nose have led to the loss of the sense of smell.

Vitamin C‘s effect on the common cold, while extensively researched, is disappointing, except in limited circumstances: specifically, individuals exercising vigorously in cold environments. There is no firm evidence that Echinacea products provide any meaningful benefit in treating or preventing colds. It is unknown if garlic is effective. A single trial of vitamin D did not find benefit.

Since there is no cure for the common cold, treatment has two goals: to make you feel better and to help you fight off the virus.

Lots of rest is the key treating a cold. You may find you need 12 hours of sleep each night, so don’t set that alarm. You’ll be most comfortable in a warm, humid environment. It’s also important to stay hydrated by drinking lots of water and avoiding alcohol and caffeine. This makes mucus flow more freely and helps with congestion.

Although not proven to be helpful, most home remedies are safe for most people.

Some remedies may cause side effects or allergic reactions.
Certain remedies may change the way other medicines work.
Talk to your provider before trying any herbs and supplements.

Preventing the Spread of Colds

Wash your hands often. This is the best way to stop the spread of germs.
Rub soap onto wet hands for 20 seconds. Make sure to get under your fingernails. Dry your hands with a clean paper towel and turn faucet off with paper towel.
You can also use alcohol-based hand sanitizers. Use a dime size amount and rub all over your hands until they are dry.
To further prevent colds:

Stay home when you are sick.
Cough or sneeze into a tissue or into the crease of your elbow and not into the air.
Keep your vaccinations up to date.
When to Contact a Medical Professional
Try treating your cold at home first. Call your provider right away, or go to the emergency room, if you have:

Difficulty breathing
Sudden chest pain or abdominal pain
Sudden dizziness
Acting strangely
Severe vomiting that does not go away
Also call your provider if:

You start acting strangely
Your symptoms get worse or do not improve after 7 to 10 days

Influenza treatment

People with the flu are advised to get plenty of rest, drink plenty of liquids, avoid using alcohol and tobacco and, if necessary, take medications such as acetaminophen (paracetamol) to relieve the fever and muscle aches associated with the flu. Children and teenagers with flu symptoms (particularly fever) should avoid taking aspirin during an influenza infection (especially influenza type B), because doing so can lead to Reye’s syndrome, a rare but potentially fatal disease of the liver. Since influenza is caused by a virus, antibiotics have no effect on the infection; unless prescribed for secondary infections such as bacterial pneumonia. Antiviral medication may be effective, if given early, but some strains of influenza can show resistance to the standard antiviral drugs and there is concern about the quality of the research.

Antivirals:

The two classes of antiviral drugs used against influenza are neuraminidase inhibitors (oseltamivir and zanamivir) and M2 protein inhibitors (adamantane derivatives).

Neuraminidase inhibitors

Overall the benefits of neuraminidase inhibitors in those who are otherwise healthy do not appear to be greater than the risks. There does not appear to be any benefit in those with other health problems. In those believed to have the flu, they decreased the length of time symptoms were present by slightly less than a day but did not appear to affect the risk of complications such as needing hospitalization or pneumonia. Previous to 2013 the benefits were unclear as the manufacturer (Roche) refused to release trial data for independent analysis. Increasingly prevalent resistance to neuraminidase inhibitors has led to researchers to seek alternative antiviral drugs with different mechanisms of action.

M2 inhibitors

The antiviral drugs amantadine and rimantadine inhibit a viral ion channel (M2 protein), thus inhibiting replication of the influenza A virus. These drugs are sometimes effective against influenza A if given early in the infection but are ineffective against influenza B viruses, which lack the M2 drug target. Measured resistance to amantadine and rimantadine in American isolates of H3N2 has increased to 91% in 2005. This high level of resistance may be due to the easy availability of amantadines as part of over-the-counter cold remedies in countries such as China and Russia, and their use to prevent outbreaks of influenza in farmed poultry. The CDC recommended against using M2 inhibitors during the 2005–06 influenza season due to high levels of drug resistance.

Which treatments are effective for the flu?

The flu treatment you should take depends on your symptoms. For example, if you have nasal or sinus congestion, then a decongestant can be helpful.

Decongestants come oral or nasal spray forms. Decongestants are used to reduce swelling in the nasal passageways. However, nasal spray decongestants should not be used for more than a few days because, if they are used too long and then stopped, they can cause rebound symptoms.

If you have a runny nose, postnasal drip, or itchy, watery eyes — then an antihistamine may be helpful for your flu symptoms. Antihistamines block the effect of “histamine,” and help relieve such annoying symptoms as sneezing, itching, and nasal discharge.

Over-the-counter antihistamines often make people drowsy, whereas decongestants can make people hyper or keep them awake. Keep in mind that both decongestants and antihistamines can interact with other drugs you may be taking, and they may aggravate some conditions. Talk to your doctor or pharmacist about which flu symptom treatment is best for you.

If you need immediate relief for swollen, congested nasal passages, you may get relief with an over-the-counter decongestant nasal spray. It is important to stop using decongestant nasal sprays after three days to avoid the development of rebound congestion.

Some doctors suggest using a saline spray instead of a medicated spray. Saline sprays loosen thick mucus in the nasal passageways but have no rebound effect. They may be used for extended periods of time without significant side effects.

Decongestants can increase blood pressure and heart rate. Pseudoephedrine and phenylephrine are oral decongestants commonly available in over-the-counter products. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn’t be a problem as long as you monitor your blood pressure. This may not be true, however, with certain types of blood pressure medications. Check with your doctor or pharmacist about safety.

An occasional cough may clear the lung of pollutants and excess phlegm. A persistent cough should be diagnosed and treated specifically. On the pharmacy shelf, you’ll find numerous cough medicines with various combinations of decongestants, antihistamines, analgesics/antipyretics, cough suppressants, and expectorants. Ask your pharmacist which combination, if any, would be appropriate for your cough.

Children should avoid aspirin. Acetaminophen (Tylenol) or medicines like ibuprofen (Advil, Motrin) and naproxen (Aleve) are over-the-counter options for fever and pain relief. Each medication has risks. Check with your doctor or pharmacist as to which medication may be suitable for you.

Be careful not to overdose! These drugs are often mixed in with other multi-symptom cold and flu remedies you may also be taking. They may also be ingredients in other prescription medicines you may be taking. Your pharmacist can help you check for drug ingredients and interactions.

Drinking lots of fluids and using salt water gargles (made by combining a cup of warm water and a teaspoon of salt) can often be helpful for easing the pain of a sore throat. Over-the-counter pain relievers and medicated lozenges and gargles can also temporarily soothe a sore throat. Get your doctor’s approval before using any medications, including over-the-counter drugs, and don’t use lozenges or gargles for more than a few days. The medications could mask signs of strep throat, a bacterial infection that should be treated with antibiotics.

Antiviral flu drugs are taken to decrease the severity and duration of flu symptoms. In some cases they may be used to prevent flu. They are best taken within 48 hours of the onset of symptoms, but they may still offer benefits if taken later. Talk to your doctor about your health situation because most antivirals do have side effects.

At the first sign of flu symptoms, talk to your doctor about whether antiviral drugs might benefit your child. These flu drugs can help a child get better sooner and may prevent serious flu complications.

Antibiotics cannot help flu symptoms. The flu is caused by a virus, and antibiotics only treat bacterial infections. Taking antibiotics needlessly may increase your risk of getting an infection later that resists antibiotic treatment. If you get a secondary bacterial infection with the flu virus, your doctor may prescribe an antibiotic to treat the secondary infection.

Prevention

Vaccination:

The influenza vaccine is recommended by the World Health Organization and United States Centers for Disease Control and Prevention for high-risk groups, such as children, the elderly, health care workers, and people who have chronic illnesses such as asthma, diabetes, heart disease, or are immuno-compromised among others. In healthy adults it is modestly effective in decreasing the amount of influenza-like symptoms in a population.

Evidence is supportive of a decreased rate of influenza in children over the age of two. In those with chronic obstructive pulmonary disease vaccination reduces exacerbations, it is not clear if it reduces asthma exacerbations. Evidence supports a lower rate of influenza-like illness in many groups who are immunocompromised such as those with: HIV/AIDS, cancer, and post organ transplant.

In those at high risk immunization may reduce the risk of heart disease. Whether immunizing health care workers affects patient outcomes is controversial with some reviews finding insufficient evidence and others finding tentative evidence.

Due to the high mutation rate of the virus, a particular influenza vaccine usually confers protection for no more than a few years. Every year, the World Health Organization predicts which strains of the virus are most likely to be circulating in the next year, allowing pharmaceutical companies to develop vaccines that will provide the best immunity against these strains.

Vaccines can cause the immune system to react as if the body were actually being infected, and general infection symptoms (many cold and flu symptoms are just general infection symptoms) can appear, though these symptoms are usually not as severe or long-lasting as influenza.

Infection control:

Further information: Influenza prevention
Reasonably effective ways to reduce the transmission of influenza include good personal health and hygiene habits such as: not touching your eyes, nose or mouth; frequent hand washing (with soap and water, or with alcohol-based hand rubs); covering coughs and sneezes; avoiding close contact with sick people; and staying home yourself if you are sick. Avoiding spitting is also recommended. Although face masks might help prevent transmission when caring for the sick, there is mixed evidence on beneficial effects in the community. Smoking raises the risk of contracting influenza, as well as producing more severe disease symptoms.

Since influenza spreads through both aerosols and contact with contaminated surfaces, surface sanitizing may help prevent some infections. Alcohol is an effective sanitizer against influenza viruses, while quaternary ammonium compounds can be used with alcohol so that the sanitizing effect lasts for longer. In hospitals, quaternary ammonium compounds and bleach are used to sanitize rooms or equipment that have been occupied by patients with influenza symptoms. At home, this can be done effectively with a diluted chlorine bleach.

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