Saline nasal sprays, which moisten the nasal passages, can be used indefinitely, but medicated sprays can cause what’s called a rebound effect, actually making congestion worse if they’re used too long, he said. “There are more incidents of rebound congestion with the four-hour nasal sprays,” Macchia said. “The long-acting ones have fewer incidents.” His recommendation for someone who wants to use a nasal spray is a 12-hour spray.
Q: Are antibiotics an option?
A: Antibiotics are not recommended unless you have a bacterial infection — and most colds are not caused by bacteria. “Patients should avoid insisting that their family physicians or pediatricians prescribe antibiotics,” Meltzer said.
“Even educated patients insist on antibiotics and are convinced they work, but patients simply get better because the cold has run its course,” she said. “In fact, most patients never complete the antibiotic prescription. Aside from creating resistance and cost implications, patients risk side effects.”
And, she said, keep in mind that green mucus doesn’t necessarily mean that you have a bacterial infection and need antibiotics.
Q: Do you treat a child with a cold the same as an adult?
A: Avoid giving aspirin to children because it can cause serious side effects. “In both children and adults, acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen are helpful in reducing a fever and relieving headache and body aches,” Meltzer said.
Also keep in mind that cough and cold medications are usually not advised in children younger than 6 years and should not be used in children younger than 2, she added.
Q: How active, or inactive, should you be with a cold?
A: “If you have a fever, you should probably stay home from school and work,” Meltzer said. “I also do not allow athletes to exercise or compete in sports if they have a fever.”
The picture changes, though, once all that’s left of your cold are what she called “residual cold symptoms” — slight cough or runny nose without fever. For the average person whose cold has progressed to that point and who feels well, she said, going to work or school is probably OK. For athletes and active adults with only “above the neck symptoms” and no fever, Meltzer said, “it is reasonable to engage in mild or moderate exercise if he or she feels well enough.”
MCT Information Services