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PEDIATRICS Vol. 101 No. 1 Supplement January 1998, pp. 181-184

The Common Cold---Principles of Judicious Use of Antimicrobial Agents

Received Aug 8, 1997; accepted Sep 11, 1997.

Nancy Rosenstein*, William R. Phillips§, Michael A. Gerberparallel , S. Michael MarcyDagger , Benjamin Schwartz*, and Scott F. Dowell*

From the * Childhood and Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia; Dagger  Kaiser Permanente, Panorama City, California; § Northwest Family Medicine, Seattle, Washington; and parallel  Connecticut Children's Medical Center, Hartford, Connecticut.

Most children will suffer between 3 and 8 colds per year, and over half of patients seen for the common cold are given an antimicrobial prescription. Unnecessary antimicrobial therapy can be avoided by recognizing the signs and symptoms that are part of the usual course of these diseases. Controlled trials of antimicrobial treatment of the common cold are reviewed. These trials consistently fail to show that treatment changes the course or outcome. Furthermore, antimicrobial therapy for patients with viral rhinosinusitis is not an effective way to prevent bacterial complications. Mucopurulent rhinitis (thick, opaque, or discolored nasal discharge) frequently accompanies the common cold and is part of the natural course of viral rhinosinusitis. It is not an indication for antimicrobial treatment unless it persists without improvement for >10 to 14 days.

Key words: common cold, upper respiratory tract infection, mucopurulent rhinitis, diagnosis, antimicrobial therapy.
.




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