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Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics01:23

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Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
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Antihistamines for the common cold.

An I M De Sutter1, Avadhesh Saraswat, Mieke L van Driel

  • 1Department of Family Medicine and Primary Health Care, Ghent University, De Pintelaan 185, UZ 1K3, Ghent, Belgium, B-9000.

The Cochrane Database of Systematic Reviews
|November 29, 2015
PubMed
Summary
This summary is machine-generated.

Antihistamines offer a slight short-term benefit for common cold symptom severity, but lack significant long-term effectiveness or impact on individual symptoms like congestion or sneezing. Evidence for their use in children is lacking.

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Area of Science:

  • Pharmacology
  • Respiratory Medicine
  • Evidence-Based Medicine

Background:

  • The common cold, a frequent upper respiratory tract infection primarily caused by rhinoviruses, leads to considerable morbidity despite being generally self-limiting.
  • Over-the-counter antihistamines are widely used for symptom relief, yet robust evidence supporting their efficacy is limited.

Purpose of the Study:

  • To systematically evaluate the effectiveness of antihistamines in treating the common cold.
  • To assess the impact of antihistamines on overall symptom severity and individual cold symptoms.

Main Methods:

  • Conducted a comprehensive search of multiple electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, and Biosis Previews.
  • Included 18 randomized controlled trials (RCTs) involving 4342 participants, focusing on antihistamines as monotherapy for the common cold, excluding combination therapies or allergic components.

Main Results:

  • Antihistamines demonstrated a limited short-term benefit (days 1-2) in reducing overall common cold symptom severity in adults (OR 0.74, 95% CI 0.60 to 0.92).
  • No significant mid- to long-term benefits were observed. Clinically insignificant effects were noted for individual symptoms like rhinorrhoea and sneezing with sedating antihistamines.
  • Sedating antihistamines were associated with more adverse events, primarily sedation, though not statistically significant. Evidence for efficacy in children was conflicting and insufficient.

Conclusions:

  • Antihistamines provide minimal short-term relief for common cold symptoms, with no significant effect on symptom severity beyond the initial days.
  • There is no clinically meaningful impact on nasal congestion, rhinorrhoea, or sneezing. Sedating antihistamines may cause side effects, but differences were not statistically significant.
  • Current evidence does not support the use of antihistamines for treating the common cold in children.