The key is to avoid over-prescribing of antibiotics but at the same time not missing a life-threatening infection. Because of the diverse causes and presentation, upper respiratory tract infections are best managed by an interprofessional team. The infection may vary from the common cold to a life-threatening illness like acute epiglottitis. Upper respiratory tract infections are one of the most common illnesses that healthcare workers will encounter in an outpatient setting. Generally, antiviral chemoprophylaxis is used during periods of influenza activity for (1) high-risk persons who cannot receive vaccination (due to contraindications) or in whom recent vaccination does not, or is not expected to, afford a sufficient immune response (2) controlling outbreaks among high-risk persons in institutional settings and (3) high-risk persons with influenza exposures. Antiviral chemoprophylaxis is also helpful in preventing influenza (70% to 90% effective) and should be considered as an adjunct to vaccination in certain scenarios or when vaccination is unavailable or not possible. Vaccination is the most effective method of preventing influenza illness. Įarly antiviral treatment for influenza infection shortens the duration of influenza symptoms, decreases the length of hospital stays, and reduces the risk of complications. When taken therapeutically after the onset of symptoms, however, high-dose vitamin C has not shown clear benefit in trials. , There is also a lack of convincing evidence supporting the use of dextromethorphan for acute cough.Īccording to a Cochrane Review, vitamin C used as daily prophylaxis at doses of =0.2 grams or more had a "modest but consistent effect" on the duration and severity of common cold symptoms (8% and 13% decreases in duration for adults and children, respectively). , Evidence-based data does not support the use of antibiotics in the treatment of the common cold because they do not improve symptoms or shorten the course of illness. Topical and oral nasal decongestants (i.e., topical oxymetazoline, oral pseudoephedrine) have moderate benefit in adults and adolescents in reducing nasal airway resistance. First-generation antihistamines are sedating, so advise the patient about caution during their use. H1-receptor antagonists may offer a modest reduction of rhinorrhea and sneezing during the first 2 days of a cold in adults. Decongestants and combination antihistamine/decongestant medications can limit cough, congestion, and other symptoms in adults. The goal of treatment for the common cold is symptom relief. These events result in nasal obstruction and rhinorrhea whereas cholinergic stimulation prompts mucus production and sneezing. Nasal mucosal infection and the host's subsequent inflammatory response cause vasodilation and increased vascular permeability. The mean duration of symptoms is 7 to 10 days, but symptoms can persist for as long as 3 weeks. As soon as 10 to 12 hours after inoculation, symptoms may begin. After deposition in the anterior nasal mucosa, rhinovirus replication and infection are thought to begin upon mucociliary transport to the posterior nasopharynx and adenoids. Dozens of rhinovirus serotypes and frequent antigenic changes among them make identification, characterization, and eradication complex. The rhinovirus, a species of the Enterovirus genus of the Picornaviridae family, is the most common cause of the common cold and causes up to 80% of all respiratory infections during peak seasons. The pathogens are responsible for causing the common cold include rhinovirus, adenovirus, parainfluenza virus, respiratory syncytial virus, enterovirus, and coronavirus. Most evidence-based data suggest that direct contact and droplet transfer are the predominant modes of transmission for influenza. It is believed that influenza can be transferred among humans by direct contact, indirect contact, droplets, or aerosolization. Viral shedding can occur 1 day before the onset of symptoms. The incubation period for influenza is 1 to 4 days, and the time interval between symptom onset is estimated to be 3 to 4 days. The adenoids and tonsils also contain immunological cells that attack the pathogens. Barriers that prevent the organism from attaching to the mucosa include 1) the hair lining that traps pathogens, 2) the mucus which also traps organisms 3) the angle between the pharynx and nose which prevents particles from falling into the airways and 4) ciliated cells in the lower airways that transport the pathogens back to the pharynx. The organism is usually acquired by inhalation of infected droplets. A URTI usually involves direct invasion of the upper airway mucosa by the organism.
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