Cough Update: Management Of Common Cold And Acute Rhinosinusitis(ARs) |
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Cough Update: Management Of Common Cold And Acute Rhinosinusitis(ARs)

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ARS is a very commonly encountered condition with symptoms as nasal blockage or congestion and anterior or posterior rhinorrhea. Occurrence of facial pain or pressure and loss of smell are common in adults while cough is cardinal in children. Tests arent needed and the diagnosis is clinical.

Bacterial and non-bacterial sinusitis nearly have similar symptoms, so sparing the symptomatic treatment antibiotics use must be limited only to bacterial sinusitis. the differentiating features between the 2 include the presence of- fever, unilateral focality, local pain, and elevation of CPR/ERS in Bacterial ARS.

Regimen for the common cold-

use of paracetamol; non-steroidal anti-inflammatory drugs (NSAIDs); second-generation antihistamines with short-term benefit for the first 2 days; nasal decongestants in adults; a combination of analgesics and nasal decongestants; ipratropium bromide for reducing rhinorrhea; probiotics; zinc; nasal saline irrigations as the recommended symptomatic therapy.

Restriction in use of antibiotics, intranasal corticosteroids (INCS), heated humidified air, echinea products, homoeopathy products probiotics and regular exercise gives additional preventive benefit and thus is a recommended preventive therapy.

Regimen for Postviral ARS:

Use of intranasal corticosteroids (INCS) if required; sinfrontal, a homoeopathy product, herbal compounds such as Cyclamen europaeumPelagorium sidoides, and BNO 1016, for nasal congestion as the recommended symptomatic treatment.

Restriction in use of antibiotics, systemic corticosteroids; nasal decongestants; second-generation antihistamines 

Regimen for Bacterial ARS:

use of antibiotics, especially amoxicillin/penicillin (beta-lactams) in adult patients, Sodium hyaluronate plus saline solution for an additive effect to antibiotics, Oral corticosteroids with antibiotics for reducing facial pain are the recommended symptomatic treatment options.

use of topical and oral corticosteroids, antihistamines, decongestants, and saline and steam inhalation needs further investigation in the treatment of Bacterial ARS.

The use of antibiotics for the treatment of Bacterial ARS must be done cautiously as it can lead to antibiotic resistance among the groups and also some major complications. 

Source: Jaume, F., Valls-Mateus, M. & Mullol, J. Common Cold and Acute Rhinosinusitis: Up-to-Date Management in 2020. Curr Allergy Asthma Rep 20, 28 (2020).

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