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Antihistamines for the common cold.
Cochrane Database Syst Rev 2003; (3):CD001267CD

Abstract

BACKGROUND

Although antihistamines are prescribed in large quantities for the common cold, there is little evidence to whether these drugs are effective.

OBJECTIVES

To assess in patients with a common cold the effects of antihistamines in alleviating nasal symptoms, or in shortening of illness duration.

SEARCH STRATEGY

We searched the Cochrane Acute Respiratory Infections Group Specialized Register and EMBASE up to December 2002; Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE up to February 2003. We also followed up references in identified papers. We appealed for further articles at a major international conference on Acute Respiratory Infections (1997). We corresponded with experts and got in touch with pharmaceutical companies.

SELECTION CRITERIA

Randomised, placebo-controlled trials on treatment of common cold with antihistamines, used either singly or in combination, in adults or children.

DATA COLLECTION AND ANALYSIS

Data were extracted by two reviewers and authors were contacted for further data. Trials were subdivided into monotherapy and combination therapy. Data on general recovery, nasal obstruction, rhinorrhea, sneezing, and side-effects were extracted and summarized in a systematic review.

MAIN RESULTS

We included thirty two papers describing 35 comparisons; 22 trials studied monotherapy, 13 trials a combination of antihistamines with other medication. A total of 8930 people suffering from the common cold were included. There were large differences in study designs, participants, interventions, and outcomes. There was no evidence of any clinically significant effect - in children or in adults - on general recovery of antihistamines in monotherapy. First generation - but not non-sedating - antihistamines have a small effect on rhinorrhea and sneezing. In trials with first generation antihistamines the incidence of side effects (especially sedation) is significantly higher with active treatment. Two trials, studying a combination of antihistamines with decongestives in small children, both failed to show any effect. Of the eleven trials on older children and adults, the majority show an effect on general recovery and on nasal symptom severity.

REVIEWER'S CONCLUSIONS

Antihistamines in monotherapy - in children as well as in adults - do not alleviate to a clinical extend nasal congestion, rhinorrhoea and sneezing, or subjective improvement of the common cold. First generation antihistamines also cause more side-effects than placebo, in particular they increase sedation in cold sufferers. Combinations of antihistamines with decongestives are not effective in small children. In older children and adults most trials show a beneficial effect on general recovery as well as on nasal symptoms. It is however not clear whether these effects are clinically significant.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

12917904

Citation

Sutter, A I M., et al. "Antihistamines for the Common Cold." The Cochrane Database of Systematic Reviews, 2003, p. CD001267.
Sutter AI, Lemiengre M, Campbell H, et al. Antihistamines for the common cold. Cochrane Database Syst Rev. 2003.
Sutter, A. I., Lemiengre, M., Campbell, H., & Mackinnon, H. F. (2003). Antihistamines for the common cold. The Cochrane Database of Systematic Reviews, (3), p. CD001267.
Sutter AI, et al. Antihistamines for the Common Cold. Cochrane Database Syst Rev. 2003;(3)CD001267. PubMed PMID: 12917904.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antihistamines for the common cold. AU - Sutter,A I M, AU - Lemiengre,M, AU - Campbell,H, AU - Mackinnon,H F, PY - 2003/8/15/pubmed PY - 2003/9/26/medline PY - 2003/8/15/entrez SP - CD001267 EP - CD001267 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 3 N2 - BACKGROUND: Although antihistamines are prescribed in large quantities for the common cold, there is little evidence to whether these drugs are effective. OBJECTIVES: To assess in patients with a common cold the effects of antihistamines in alleviating nasal symptoms, or in shortening of illness duration. SEARCH STRATEGY: We searched the Cochrane Acute Respiratory Infections Group Specialized Register and EMBASE up to December 2002; Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE up to February 2003. We also followed up references in identified papers. We appealed for further articles at a major international conference on Acute Respiratory Infections (1997). We corresponded with experts and got in touch with pharmaceutical companies. SELECTION CRITERIA: Randomised, placebo-controlled trials on treatment of common cold with antihistamines, used either singly or in combination, in adults or children. DATA COLLECTION AND ANALYSIS: Data were extracted by two reviewers and authors were contacted for further data. Trials were subdivided into monotherapy and combination therapy. Data on general recovery, nasal obstruction, rhinorrhea, sneezing, and side-effects were extracted and summarized in a systematic review. MAIN RESULTS: We included thirty two papers describing 35 comparisons; 22 trials studied monotherapy, 13 trials a combination of antihistamines with other medication. A total of 8930 people suffering from the common cold were included. There were large differences in study designs, participants, interventions, and outcomes. There was no evidence of any clinically significant effect - in children or in adults - on general recovery of antihistamines in monotherapy. First generation - but not non-sedating - antihistamines have a small effect on rhinorrhea and sneezing. In trials with first generation antihistamines the incidence of side effects (especially sedation) is significantly higher with active treatment. Two trials, studying a combination of antihistamines with decongestives in small children, both failed to show any effect. Of the eleven trials on older children and adults, the majority show an effect on general recovery and on nasal symptom severity. REVIEWER'S CONCLUSIONS: Antihistamines in monotherapy - in children as well as in adults - do not alleviate to a clinical extend nasal congestion, rhinorrhoea and sneezing, or subjective improvement of the common cold. First generation antihistamines also cause more side-effects than placebo, in particular they increase sedation in cold sufferers. Combinations of antihistamines with decongestives are not effective in small children. In older children and adults most trials show a beneficial effect on general recovery as well as on nasal symptoms. It is however not clear whether these effects are clinically significant. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/12917904/Antihistamines_for_the_common_cold_ L2 - https://doi.org/10.1002/14651858.CD001267 DB - PRIME DP - Unbound Medicine ER -