Colds, flu and coughing: a review of over-the-counter cold and flu medicines

Abstract

The common cold is the most frequent human illness, and may be caused by several families of viruses, particularly the more than 100 serotypes of rhinoviruses. Inaccurate perceptions that antibiotics improve patient outcomes fuel the number of doctor visits and requests for antibiotics. The inappropriate use of antibiotics for minor, self-limiting, usually viral, upper-respiratory tract infections does not alter the course of the disease, and adds to the burden of antibiotic resistance. In addition, there is also no evidence to suggest that antibiotics prevent secondary bacterial complications following viral upper-respiratory tract infections. While most over-the-counter cold and flu remedies have no proven efficacy, they appear to attenuate the immune response to the infecting virus, and there is little doubt that appropriate symptomatic treatment can make the patient feel better. Therefore, symptomatic therapy remains the mainstay of common cold treatment. This article briefly reviews the components of cold and flu remedies, and provides a symptom-based assessment for the selection of appropriate over-the-counter medicine.

Colds and flu – an overview of the management

“…Literature has stated that antihistamines used alone are of very little benefit in treating symptoms of the common cold and flu, but they do offer symptomatic relief when used in combination with decongestants and antitussive agents 5 .…”

“…Oral sympathomimetic, systemic decongestants, like pseudoephedrine phenylpropanolamine and phenylephrine are now mainly available in combination in South Africa 5 . Oral decongestants should only be used for a short period of time and as symptomatic relief for acute coryza, as part of flu and influenza.…”

“…Nasal congestion, a result of vasodilation and oedema of the nasal mucosa, can be alleviated using alpha-1 adrenergic agonists topically (nasal sprays) or orally. These topical decongestants are actually vasoconstrictors and compared to a placebo have shown a reduction in airway resistance 1,5,13,17 .…”

“…The influenza virus is transmitted via air droplets when a person comes into close contact with an infected person or via selfinfection when a person comes into direct contact with an infected person or object 5 .…”

Seasonal Influenza and Low Flu Vaccination Coverage as Important Factors Modifying the Costs and Availability of Hospital Services in Poland: A Retrospective Comparative Study

“…Conventional influenza therapy is mostly based on symptomatic treatment, often with over-the-counter (OTC) medications [ 3 ]. OTC treatments are ineffective in preventing flu and only relieve symptoms during an infection, with no effects on the virus itself.…”