'Tis the season: Upper Respiratory Illnesses (URIs)

Most upper respiratory illnesses (URIs) are viral in nature, which means that antibiotics are not useful and can sometimes even cause harm, such as rash, severe diarrhea, or allergic reactions. Instead, we focus on reducing your symptoms so that your immune system can do its job and take care of the infection on its own.

Source: NIH National Institute on Aging:
https://www.nia.nih.gov/health/covid-19/it-cold-flu-or-covid-19

Review the above graphic for a quick comparison between Cold vs Flu vs COVID-19!

Here are signs that it could be bacterial instead of viral and that you may need an antibiotic:

• Moderate-to-severe symptoms lasting more than 10-14 days (NOTE: cough may linger for weeks due to a viral URI)
• You get “second sickening,” which means you start to get better and then all of a sudden get a lot worse
• Strep throat – normally seen with high fever, pus pockets on the tonsils, and swollen glands in the neck. There is NO cough, congestion, or runny nose. Presence of these other symptoms makes it much more likely to be viral.

First and foremost, for any viral URI, GET PLENTY OF SLEEP, wash your hands frequently, and use hand sanitizer to prevent spreading the virus. Give it some time for your body to fight the virus. If not getting better, then let your PCP know. Other treatments may be recommended or restricted based on your personal medical history and medications.

TREATMENT BASED ON SYMPTOMS

Congestion

• Nasal Sinus Rinse: Neti pots are sold over-the-counter and can help greatly with congestion. Make sure you use boiled or bottled water ONLY in these pots and wash & dry them thoroughly after each use.
• Antihistamines: Zyrtec (10 mg once daily; non-sedating) and Benadryl (25-50 mg every 6 hours as needed; sedating). These work best for those who also have allergies.
• Sudafed (30-60 mg every 6-8 hours)* is a decongestant. You must show your ID at the pharmacy counter. It can increase your blood pressure, so check with your doctor before you take this.
• Afrin (one spray per nostril twice daily for NO MORE THAN 3 days)* is a decongestant that can help with a severely stuffy nose, especially at night.
• For children: NO DECONGESTANTS. Vaporub can be helpful on the chest or feet, nasal saline (Little Noses) and suctioning with a bulb suction or “Nosefrida” is best for infants, especially before each feeding.

Cough

• Honey reduces both cough and sore throat. It is also helpful in warm drinks like tea. According to research, honey, particularly when mixed with lemon, can be as effective as OTC cough syrups in relieving coughs.
• For kids over 1 year of age: 1 tsp of honey before bed-time or a honey-containing cough medication like Zarbees or Chestal Honey works well.
• Dextromethorphan (20 mg every 6 hours) contained in Delsym or Robitussin cough syrup may be as beneficial as codeine-containing syrups with fewer side effects.
• Tessalon Perles (200 mg every 8 hours) reduces the cough reflex by anesthetizing the lung and trachea.
• Mucinex (1200 mg twice daily) helps to thin out the mucous. You can also use Mucinex DM which combines Mucinex with dextromethorphan.

Sore Throat

• Honey as above (see Cough).
• Warm salt water gargles help soothe the throat: mix one teaspoon of table salt in warm water and gargle for 30 seconds 3 times per day. You may add 1 tsp of baking soda to also soothe the throat, break up mucus, and help with throat-irritating acid reflux.
• Chloraseptic spray or cepacol lozenges numb the back of the throat.
• Vaporub on the neck, covered loosely with a bandana or scarf overnight, creates a cooling sensation due to its active ingredients like menthol and camphor.

Pain/Aches/Chills – ask your PCP about children's dosing

• Anti-inflammatories: Ibuprofen (600-800 mg every 8 hours) can be taken as long as you are not on any other anti-inflammatory medications and don’t have kidney disease.
• Acetaminophen: Tylenol (1000 mg every 6-8 hours) can be taken as long as you are not taking combination medications that contain Tylenol and don’t have liver disease.
• Advil Cold and Sinus (1-2 tablets every 4-6 hours)* – this combines ibuprofen with Sudafed.
• Tylenol Cold and Flu (2 capsules every 4 hours)* – this combines Tylenol with dextromethorphan, Sudafed, and Mucinex.

* NOTE: Be particularly cautious about combining medications that contain decongestants like pseudoephedrine or phenylephrine with other medications, especially if you are taking blood pressure medication, antidepressants, or MAO inhibitors, as these combinations can lead to dangerous interactions; always consult your PCP before taking any cold medication, especially if you are on other prescriptions.

DISCLAIMER: This general information is for educational purposes and not intended to diagnose any medical condition or to replace your healthcare professional.