Among the advice, published in Annals of Internal Medicine:
—Acute bronchitis is airway inflammation, irritation that makes you cough, sometimes as long as six weeks. The guidelines say not to perform special testing or prescribe antibiotics unless pneumonia is suspected, something often accompanied by a fast heartbeat, fever or abnormal breathing sounds.
Over-the-counter symptom relief includes cough suppressants such as dextromethorphan; mucus-thinning expectorants such as guaifenesin; and antihistamines or decongestants.
—Sore throats are hugely common but adults are far less likely than children to have the strep throat that requires an antibiotic. A rapid strep test is available if patients have suspicious symptoms such as persistent fever, night sweats or swollen tonsils.
Pain-relieving options for adults include aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs such as ibuprofen, and throat lozenges.
—Sinus infections can be very painful but usually clear up without antibiotics even if bacteria are to blame. The guidelines say antibiotics should be reserved for patients with no signs of improvement after 10 days, severe symptoms such as fever higher than 102, or what’s called double-sickening, when someone starts to recover and then gets worse.
Possible symptom relievers include decongestants, nasal sprays, saline nasal irrigation and pain medications.
Riley often has to explain how to tell if cough and cold relievers contain a sedating antihistamine, and that nasal sprays clear congestion quickly but that using them for too many days can trigger rebound symptoms. He asks if patients are taking multiple products that contain acetaminophen, best known as Tylenol, because too much can damage the liver. Often, his patients say an over-the-counter drug isn’t working when in fact, they didn’t take it as directed.
“There is a dizzying array” of drugstore symptom relievers, so don’t make miserable patients sort through them without help, said CDC’s Hicks.
“There isn’t a right answer that works for everybody,” she said. But sometimes something as basic as a humidifier “can make a difference in terms of how you feel when you wake up in the morning.”