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Simasek and Blandino review the literature on the treatment of the common cold in this issue of American Family Physician.1 the authors conclude that the ability to make confident and specific treatment recommendations is limited because of flaws in the evidence.
The American College of Chest Physicians (ACCP) recently published evidence-based guidelines for diagnosing and treating acute cough (less than three weeks in duration), subacute cough (three to eight weeks in duration), and chronic cough (more than eight weeks in duration) in adults and chronic cough in children.2 this editorial highlights key recommendations for treating adult patients with acute cough (Table 1^sup 3^). Figure 1^sup 2^ is an algorithm for the management of acute cough.
Because studies have inconsistently targeted the multiple cardinal symptoms of the common cold (e.g., rhinorrhea, nasal congestion, postnasal discharge, throat clearing, cough), the evidence on how to best treat any one symptom is not strong. T therefore, the Duke Center for Clinical H health Policy Research (which conducted an evidence-based review of the literature for the ACCP guideline committee) limited its review to cough.4 Clinically, there are several reasons why it makes sense to target cough caused by the common cold: the common cold, which is the most prevalent condition in humans, is accompanied by cough in up to 83 percent of persons5; the common cold is the most prevalent cause of acute cough6; and cough is the most common complaint seen by primary care physicians in the ambulatory setting in the U united S states,7 probably because cough adversely affects health-related quality of life.6
Although acute cough from the common cold is usually transient and minor, it may be life threatening when caused by a more serious condition (e.g., congestive heart failure, pneumonia, pulmonary embolism). therefore, the first step in managing an acute cough is to clinically determine whether it is caused by a potentially serious illness or one of a variety of non-life-threatening conditions (e.g., upper respiratory infection, bronchitis, mild asthma).
Because the common cold is the predominant cause of acute cough, it is useful to review the definition of the common cold and stress the importance of identifying acute nasal symptoms. the common cold is a minor, acute respiratory illness characterized by symptoms and signs usually...