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Decongestants should not be administered to children under 6 years of age, nor be cautious to children under 12 years of age, as there is no evidence that they relieve symptoms such as a stuffy or runny nose, and that their security is uncertain, say the experts in Bmj aujourd & # 39; hui.
Instead, they advise doctors to reassure patients that a cold is painful but that symptoms should go away after a few days.
The common cold is usually caused by viruses and is usually spontaneously resolving (symptoms go away in 7 to 10 days), but it can have a huge impact on work, education, use of health services and expenses. drugs. Children have between 6 and 8 colds a year and adults between 2 and 4.
Professor Mieke van Driel and her colleagues analyzed the published evidence on the effectiveness of cold treatments.
For adults, evidence suggests that using decongestants alone, or with antihistamines or painkillers, for up to 3 to 7 days may have a weak effect on nasal symptoms.
However, side effects may include increased risk of insomnia, drowsiness, headaches or stomach upset – and long-term use of decongestants can lead to chronic nasal congestion, which is difficult to treat.
Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) are sometimes prescribed to relieve pain, but they do not seem to improve nasal congestion or runny nose. Other treatments, such as inhalation of steam, echinacea, steam friction, eucalyptus oil and the increase of l? fluid intake, are not effective or have not been studied at all.
Trials are also lacking for children, especially those younger than 12 who are most affected by colds.
Decongestants or drugs containing antihistamines should not be administered to children under 6, say the authors, and they advise to be cautious between 6 and 12 years. "There is no evidence that these treatments relieve nasal symptoms and they can cause side effects such as drowsiness or gastrointestinal upset (stomach)," they write. In children under 2 years old, they have been associated with seizures, fast heart rate and death.
None of the other commonly used over – the – counter and home – use treatments, such as heated moistened air, pain relievers, eucalyptus oil or echinacea, are supported by sufficient evidence, they add.
"If parents are concerned about their child's comfort, saline nasal irrigations or drops can be used safely, but that may not give the desired relief," they write.
Finally, they argue that ongoing research is unlikely to provide relevant evidence or remove the uncertainty surrounding cold treatments. "Based on the evidence currently available, rest assured that the symptoms are shrinking by themselves, that's what you can best offer to patients, although the use Short-term decongestants in the adult can bring relief to a stuffy nose, "they conclude.
Explore further:
How long should you stay away when you have a cold or the flu?
More information:
Mieke L van Driel et al. What treatments are effective against colds in adults and children? BMJ (2018). DOI: 10.1136 / bmj.k3786
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