Upper respiratory tract infection

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Upper respiratory tract infection
Illu conducting passages.svg
Conducting passages
Specialty Infectious disease
Frequency(2015) [1]
Deaths3,100 [2]

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. [3] [4] This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold. [5] : 28  Most infections are viral in nature, and in other instances, the cause is bacterial. [6] URTIs can also be fungal or helminthic in origin, but these are less common. [7] : 443–445 

Contents

In 2015, 17.2 billion cases of URTIs are estimated to have occurred. [1] As of 2016, they caused about 3,000 deaths, down from 4,000 in 1990. [8]

Signs and symptoms

Time line for cold symptoms Cold symptoms cdc.jpg
Time line for cold symptoms

In uncomplicated colds, coughing and nasal discharge may persist for 14 days or more even after other symptoms have resolved. [6] Acute URTIs include rhinitis, pharyngitis/tonsillitis, and laryngitis often referred to as a common cold, and their complications: sinusitis, ear infection, and sometimes bronchitis (though bronchi are generally classified as part of the lower respiratory tract.) Symptoms of URTIs commonly include cough, sore throat, runny nose, nasal congestion, headache, low-grade fever, facial pressure, and sneezing. [9]

Symptoms of rhinovirus in children usually begin 1–3 days after exposure. The illness usually lasts 7–10 more days. [6]

Color or consistency changes in mucous discharge to yellow, thick, or green are the natural course of viral URTI and not an indication for antibiotics. [6]

Group A beta-hemolytic streptococcal pharyngitis/tonsillitis (strep throat) typically presents with a sudden onset of sore throat, pain with swallowing, and fever. Strep throat does not usually cause a runny nose, voice changes, or cough.[ citation needed ]

Pain and pressure of the ear caused by a middle-ear infection (otitis media) and the reddening of the eye caused by viral conjunctivitis [10] are often associated with URTIs.

Cause

In terms of pathophysiology, rhinovirus infection resembles the immune response. The viruses do not cause damage to the cells of the upper respiratory tract, but rather cause changes in the tight junctions of epithelial cells. This allows the virus to gain access to tissues under the epithelial cells and initiate the innate and adaptive immune responses. [5] : 27 

Up to 15% of acute pharyngitis cases may be caused by bacteria, most commonly Streptococcus pyogenes , a group A streptococcus in streptococcal pharyngitis ("strep throat"). [11] Other bacterial causes are Streptococcus pneumoniae , Haemophilus influenzae , Corynebacterium diphtheriae , Bordetella pertussis , and Bacillus anthracis [ citation needed ].

Sexually transmitted infections have emerged as causes of oral and pharyngeal infections. [12]

Diagnosis

URI, seasonal allergies, influenza: symptom comparison
SymptomsAllergyURI (Common Cold)Influenza (Flu)
Itchy, watery eyesCommonRare (conjunctivitis may occur with adenovirus)Soreness behind eyes, sometimes conjunctivitis
Nasal dischargeCommonCommon [6] Common
Nasal congestionCommonCommonSometimes
SneezingVery commonVery common [6] Sometimes
Sore throatSometimes (post-nasal drip)Very common [6] Sometimes
CoughSometimesCommon (mild to moderate, hacking) [6] Common (dry cough, can be severe)
HeadacheUncommonRareCommon
FeverNeverRare in adults, possible in children [6] Very common
37.8–38.9 °C (100–102 °F)(or higher in young children), lasting 3–4 days; may have chills
MalaiseSometimesSometimesVery common
Fatigue, weaknessSometimesSometimesVery common (can last for weeks, extreme exhaustion early in course)
Muscle pain NeverSlight [6] Very common (often severe)

Classification

A URTI may be classified by the area inflamed. Rhinitis affects the nasal mucosa, while rhinosinusitis or sinusitis affects the nose and paranasal sinuses, including frontal, ethmoid, maxillary, and sphenoid sinuses. Nasopharyngitis (rhinopharyngitis or the common cold) affects the nares, pharynx, hypopharynx, uvula, and tonsils generally. Without involving the nose, pharyngitis inflames the pharynx, hypopharynx, uvula, and tonsils. Similarly, epiglottitis (supraglottitis) inflames the superior portion of the larynx and supraglottic area; laryngitis is in the larynx; laryngotracheitis is in the larynx, trachea, and subglottic area; and tracheitis is in the trachea and subglottic area.[ citation needed ]

Prevention

Vaccination against influenza viruses, adenoviruses, measles, rubella, Streptococcus pneumoniae , Haemophilus influenzae , diphtheria, Bacillus anthracis , and Bordetella pertussis may prevent them from infecting the URT or reduce the severity of the infection.[ citation needed ]

Treatment

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Upper respiratory infections deaths per million persons in 2012
  0
  1
  2
  3–29

Treatment comprises symptomatic support usually via analgesics for headache, sore throat, and muscle aches. [13] Moderate exercise in sedentary subjects with a naturally acquired URTI probably does not alter the overall severity and duration of the illness. [14] No randomized trials have been conducted to ascertain benefits of increasing fluid intake. [15]

Antibiotics

Prescribing antibiotics for laryngitis is not a suggested practice. [16] The antibiotics penicillin V and erythromycin are not effective for treating acute laryngitis. [16] Erythromycin may improve voice disturbances after a week and cough after 2 weeks, but any modest subjective benefit is not greater than the adverse effects, cost, and the risk of bacteria developing resistance to the antibiotics. [16] Health authorities have been strongly encouraging physicians to decrease the prescribing of antibiotics to treat common URTIs because antibiotic usage does not significantly reduce recovery time for these viral illnesses. [16] A 2017 systematic review found three interventions which were probably effective in reducing antibiotic use for acute respiratory infections: C-reactive protein testing, procalcitonin-guided management, and shared decision-making between physicians and patients. [17] The use of narrow-spectrum antibiotics has been shown to be just as effective as broad-spectrum alternatives for children with acute bacterial URTIs, and has a lower risk of side effects in children. [18] Decreased antibiotic usage may also help prevent drug-resistant bacteria. Some have advocated a delayed antibiotic approach to treating URTIs, which seeks to reduce the consumption of antibiotics while attempting to maintain patient satisfaction. A Cochrane review of 11 studies and 3,555 participants explored antibiotics for respiratory tract infections. It compared delaying antibiotic treatment to either starting them immediately or to no antibiotics. Outcomes were mixed depending on the respiratory tract infection; symptoms of acute otitis media and sore throat were modestly improved with immediate antibiotics with minimal difference in complication rate. Antibiotic usage was reduced when antibiotics were only used for ongoing symptoms and maintained patient satisfaction at 86%. [19] In a trial involving 432 children with a URTI, amoxicillin was no more effective than placebo, even for children with more severe symptoms such as fever or shortness of breath. [20] [21]

For sinusitis while at the same time discouraging overuse of antibiotics the CDC recommends:

Cough medicine

No good evidence exists for or against the effectiveness of over-the-counter cough medications for reducing coughing in adults or children. [22] Children under 2 years old should not be given any type of cough or cold medicine due to the potential for life-threatening side effects. [23] In addition, according to the American Academy of Pediatrics, the use of cough medicine to relieve cough symptoms should be avoided in children under 4 years old, and the safety is questioned for children under 6 years old. [24]

Decongestants

Disability-adjusted life year for URTIs per 100,000 inhabitants in 2002: no data less than 10 10-30 30-60 60-90 90-120 120-150 150-180 180-210 210-240 240-270 270-300 more than 300 Upper respiratory infections world map - DALY - WHO2002.svg
Disability-adjusted life year for URTIs per 100,000 inhabitants in 2002:
  no data
  less than 10
  10–30
  30–60
  60–90
  90–120
  120–150
  150–180
  180–210
  210–240
  240–270
  270–300
  more than 300

According to a Cochrane review, a single oral dose of nasal decongestant in the common cold is modestly effective for the short-term relief of congestion in adults; however, data on the use of decongestants in children are insufficient. Therefore, decongestants are not recommended for use in children under 12 years of age with the common cold. [19] Oral decongestants are also contraindicated in patients with hypertension, coronary artery disease, and history of bleeding strokes. [26] [27]

Mucolytics

Mucolytics such as acetylcysteine and carbocystine are widely prescribed for upper and lower respiratory tract infection without chronic broncho-pulmonary disease. However, in 2013 a Cochrane review reported their efficacy to be limited. [28] Acetylcystine is considered to be safe for the children older than 2 years. [28]

Alternative medicine

Routine supplementation with vitamin C is not justified, as it does not appear to be effective in reducing the incidence of common colds in the general population. [29] The use of vitamin C in the inhibition and treatment of upper respiratory infections has been suggested since the initial isolation of vitamin C in the 1930s. Some evidence exists to indicate that it could be justified in persons exposed to brief periods of severe physical exercise and/or cold environments. [29] Given that vitamin C supplements are inexpensive and safe, people with common colds may consider trying vitamin C supplements to assess whether they are therapeutically beneficial in their case. [29]

Some low-quality evidence indicates the use of nasal irrigation with saline solution may alleviate symptoms in some people. [30] Also, saline nasal sprays can be of benefit.[ citation needed ]

Epidemiology

Children typically have two to nine viral respiratory illnesses per year. [6] In 2013, 18.8 billion cases of URTIs were reported. [31] As of 2014, they caused about 3,000 deaths, down from 4,000 in 1990. [8] In the United States, URTIs are the most common infectious illness in the general population, and are the leading reasons for people missing work and school.[ citation needed ]

Dietary research

Weak evidence suggests that probiotics may be better than a placebo treatment or no treatment for preventing upper respiratory tract infections. [32]

See also

Related Research Articles

<span class="mw-page-title-main">Sinusitis</span> An inflammation of the mucous membrane that lines the sinuses resulting in symptoms

Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include thick nasal mucus, a plugged nose, and facial pain.

<span class="mw-page-title-main">Pneumonia</span> Inflammation of the alveoli of the lungs

Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.

<span class="mw-page-title-main">Streptococcal pharyngitis</span> Medical condition

Streptococcal pharyngitis, also known as streptococcal sore throat, is pharyngitis caused by Streptococcus pyogenes, a gram-positive, group A streptococcus. Common symptoms include fever, sore throat, red tonsils, and enlarged lymph nodes in the front of the neck. A headache and nausea or vomiting may also occur. Some develop a sandpaper-like rash which is known as scarlet fever. Symptoms typically begin one to three days after exposure and last seven to ten days.

<span class="mw-page-title-main">Common cold</span> Common viral infection of the upper respiratory tract

The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear fewer than two days after exposure to the virus. These may include coughing, sore throat, runny nose, sneezing, headache, and fever. People usually recover in seven to ten days, but some symptoms may last up to three weeks. Occasionally, those with other health problems may develop pneumonia.

<span class="mw-page-title-main">Cough</span> Sudden expulsion of air from the lungs as a reflex to clear irritants

A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound.

<span class="mw-page-title-main">Otitis media</span> Inflammation of the middle ear

Otitis media is a group of inflammatory diseases of the middle ear. One of the two main types is acute otitis media (AOM), an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present. The other main type is otitis media with effusion (OME), typically not associated with symptoms, although occasionally a feeling of fullness is described; it is defined as the presence of non-infectious fluid in the middle ear which may persist for weeks or months often after an episode of acute otitis media. Chronic suppurative otitis media (CSOM) is middle ear inflammation that results in a perforated tympanic membrane with discharge from the ear for more than six weeks. It may be a complication of acute otitis media. Pain is rarely present. All three types of otitis media may be associated with hearing loss. If children with hearing loss due to OME do not learn sign language, it may affect their ability to learn.

<span class="mw-page-title-main">Pharyngitis</span> Inflammation of the back of the throat

Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse voice. Symptoms usually last 3–5 days, but can be longer depending on cause. Complications can include sinusitis and acute otitis media. Pharyngitis is a type of upper respiratory tract infection.

<span class="mw-page-title-main">Cold medicine</span> Medication taken to relieve cold symptoms

Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including analgesics, antihistamines and decongestants, among many others. It also includes drugs which are marketed as cough suppressants or antitussives, but their effectiveness in reducing cough symptoms is unclear or minimal.

<span class="mw-page-title-main">Acute bronchitis</span> Medical condition

Acute bronchitis, also known as a chest cold, is short-term bronchitis – inflammation of the bronchi of the lungs. The most common symptom is a cough. Other symptoms include coughing up mucus, wheezing, shortness of breath, fever, and chest discomfort. The infection may last from a few to ten days. The cough may persist for several weeks afterward with the total duration of symptoms usually around three weeks. Some have symptoms for up to six weeks.

<span class="mw-page-title-main">Sore throat</span> Medical condition

Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include:

<span class="mw-page-title-main">Bronchiolitis</span> Blockage of the small airways in the lungs due to a viral infection

Bronchiolitis is inflammation of the small airways in the lungs. Acute bronchiolitis is due to a viral infection usually affecting children younger than two years of age. Symptoms may include fever, cough, runny nose, wheezing, and breathing problems. More severe cases may be associated with nasal flaring, grunting, or the skin between the ribs pulling in with breathing. If the child has not been able to feed properly, signs of dehydration may be present.

<span class="mw-page-title-main">Respiratory syncytial virus</span> Species of a virus

Respiratory syncytial virus (RSV), also called human respiratory syncytial virus (hRSV) and human orthopneumovirus, is a contagious virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus. Its name is derived from the large cells known as syncytia that form when infected cells fuse.

<span class="mw-page-title-main">Laryngitis</span> Medical condition

Laryngitis is inflammation of the larynx. Symptoms often include a hoarse voice and may include fever, cough, pain in the front of the neck, and trouble swallowing. Typically, these last under two weeks.

<span class="mw-page-title-main">Tonsillitis</span> Inflammation of the tonsils

Tonsillitis is inflammation of the tonsils in the upper part of the throat. It can be acute or chronic. Acute tonsillitis typically has a rapid onset. Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and enlarged lymph nodes around the neck. Complications include peritonsillar abscess (Quinsy).

<span class="mw-page-title-main">Lower respiratory tract infection</span> Medical term

Lower respiratory tract infection (LRTI) is a term often used as a synonym for pneumonia but can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, fever, coughing and fatigue. A routine chest X-ray is not always necessary for people who have symptoms of a lower respiratory tract infection.

<span class="mw-page-title-main">Post-nasal drip</span> Medical condition

Post-nasal drip (PND), also known as upper airway cough syndrome (UACS), occurs when excessive mucus is produced by the nasal mucosa. The excess mucus accumulates in the back of the nose, and eventually in the throat once it drips down the back of the throat. It can be caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or by a disorder of swallowing. Other causes can be allergy, cold, flu, and side effects from medications.

<span class="mw-page-title-main">Rhinorrhea</span> Filling of the nasal cavity with fluid mucus

Rhinorrhea, rhinorrhoea, or informally runny nose is the free discharge of a thin mucus fluid from the nose; it is a common condition. It is a common symptom of allergies or certain viral infections, such as the common cold or COVID-19. It can be a side effect of crying, exposure to cold temperatures, cocaine abuse, or drug withdrawal, such as from methadone or other opioids. Treatment for rhinorrhea may be aimed at reducing symptoms or treating underlying causes. Rhinorrhea usually resolves without intervention, but may require treatment by a doctor if symptoms last more than 10 days or if symptoms are the result of foreign bodies in the nose.

<span class="mw-page-title-main">Respiratory disease</span> Disease of the respiratory system

Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bronchioles, alveoli, pleurae, pleural cavity, the nerves and muscles of respiration. Respiratory diseases range from mild and self-limiting, such as the common cold, influenza, and pharyngitis to life-threatening diseases such as bacterial pneumonia, pulmonary embolism, tuberculosis, acute asthma, lung cancer, and severe acute respiratory syndromes, such as COVID-19. Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause of the disease.

<span class="mw-page-title-main">Respiratory tract infection</span> Infectious disease affecting nose, throat and lungs

Respiratory tract infections (RTIs) are infectious diseases involving the lower or upper respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection or a lower respiratory tract infection. Lower respiratory infections, such as pneumonia, tend to be far more severe than upper respiratory infections, such as the common cold.

Chronic cough is long-term coughing, sometimes defined as more than several weeks or months. Generally a cough lasting for more than eight weeks for an adult would meet the clinical definition of a chronic cough; and for children this threshold is lower. The term can be used to describe the different causes related to coughing, the three main ones being upper airway cough syndrome, asthma and gastroesophageal reflux disease. It occurs in the upper airway of the respiratory system. Generally, a cough lasts around one to two weeks; however, chronic cough can persist for an extended period of time defined as six weeks or longer. People with chronic cough often experience more than one cause present. Due to the nature of the syndrome, the treatments used are similar; however, there are a subsequent number of treatments available, and the clinical management of the patients remains a challenge. Risk factors include exposure to cigarette smoke, and exposure to pollution, especially particulates.

References

  1. 1 2 Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC   5055577 . PMID   27733282.
  2. ↑ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC   5388903 . PMID   27733281.
  3. ↑ Guibas GV, Papadopoulos NG (2017). "Viral Upper Respiratory Tract Infections". In Green RJ (ed.). Viral Infections in Children, Volume II. Cham: Springer International Publishing. pp. 1–25. doi:10.1007/978-3-319-54093-1_1. ISBN   978-3-319-54093-1. PMC   7121526 .
  4. ↑ Ellis ME (12 February 1998). Infectious Diseases of the Respiratory Tract. Cambridge University Press. p. 453. ISBN   978-0-521-40554-6.
  5. 1 2 Pokorski M (2015). Pulmonary infection. Cham: Springer. ISBN   978-3-319-17458-7.
  6. 1 2 3 4 5 6 7 8 9 10 11 12 "Rhinitis Versus Sinusitis in Children" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 16 February 2017. Retrieved 19 December 2016.PD-icon.svg This article incorporates text from this source, which is in the public domain .
  7. ↑
    • Heymann D (2015). Control of communicable diseases manual: an official report of the American Public Health Association. APHA Press, the American Public Health Association. ISBN   978-0-87553-018-5.
  8. 1 2 Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. (December 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. hdl: 10536/DRO/DU:30050819 . PMC   10790329 . PMID   23245604. S2CID   1541253.
  9. ↑ Dasaraju PV, Liu C (1996). "Chapter 93: Infections of the Respiratory System". In Baron S (ed.). Medical Microbiology (4th ed.). University of Texas Medical Branch at Galveston. ISBN   978-0-9631172-1-2. PMID   21413304 . Retrieved 10 July 2021– via National Center for Biotechnology Information, U.S. National Library of Medicine.
  10. ↑ "Conjunctivitis". The Lecturio Medical Concept Library. 23 July 2020. Retrieved 10 July 2021.
  11. ↑ Bisno AL (January 2001). "Acute pharyngitis". The New England Journal of Medicine. 344 (3): 205–11. doi:10.1056/nejm200101183440308. PMID   11172144.
  12. ↑ "Human papillomavirus (HPV) and Oropharyngeal Cancer, Sexually Transmitted Diseases". Centers for Disease Control and Prevention. 4 November 2016. Archived from the original on 16 December 2016. Retrieved 19 December 2016.
  13. ↑ "Common Cold: Treatments and Drugs". Mayo Clinic. Archived from the original on 12 February 2010. Retrieved 9 January 2010.
  14. ↑ Weidner T, Schurr T (August 2003). "Effect of exercise on upper respiratory tract infection in sedentary subjects". British Journal of Sports Medicine. 37 (4): 304–6. doi:10.1136/bjsm.37.4.304. PMC   1724675 . PMID   12893713.
  15. ↑ Guppy MP, Mickan SM, Del Mar CB (February 2004). ""Drink plenty of fluids": a systematic review of evidence for this recommendation in acute respiratory infections". The BMJ. 328 (7438): 499–500. doi:10.1136/bmj.38028.627593.BE. PMC   351843 . PMID   14988184.
  16. 1 2 3 4 Reveiz L, Cardona AF (May 2015). "Antibiotics for acute laryngitis in adults". The Cochrane Database of Systematic Reviews. 2015 (5): CD004783. doi:10.1002/14651858.CD004783.pub5. PMC   6486127 . PMID   26002823.
  17. ↑ Tonkin-Crine SK, Tan PS, van Hecke O, Wang K, Roberts NW, McCullough A, et al. (September 2017). "Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews". The Cochrane Database of Systematic Reviews. 2019 (9): CD012252. doi:10.1002/14651858.CD012252.pub2. PMC   6483738 . PMID   28881002.
  18. ↑ Gerber JS, Ross RK, Bryan M, Localio AR, Szymczak JE, Wasserman R, et al. (December 2017). "Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections". JAMA. 318 (23): 2325–2336. doi:10.1001/jama.2017.18715. PMC   5820700 . PMID   29260224.
  19. 1 2 Spurling GK, Dooley L, Clark J, Askew DA (October 2023). "Immediate versus delayed versus no antibiotics for respiratory infections". The Cochrane Database of Systematic Reviews. 2023 (10): CD004417. doi:10.1002/14651858.CD004417.pub6. PMC  10548498. PMID   37791590.
  20. ↑ Little P, Francis NA, Stuart B, O'Reilly G, Thompson N, Becque T, et al. (June 2023). "Antibiotics for lower respiratory tract infection in children presenting in primary care: ARTIC-PC RCT". Health Technology Assessment. 27 (9): 1–90. doi:10.3310/DGBV3199. PMC   10350739 . PMID   37436003.
  21. ↑ "Antibiotics make little difference to children's chest infections". NIHR Evidence. UK: National Institute for Health and Care Research (NIHR). 27 November 2023. doi:10.3310/nihrevidence_60506.
  22. ↑ Smith SM, Schroeder K, Fahey T (November 2014). "Over-the-counter (OTC) medications for acute cough in children and adults in community settings". The Cochrane Database of Systematic Reviews. 2014 (11): CD001831. doi:10.1002/14651858.CD001831.pub5. PMC   7061814 . PMID   25420096.
  23. ↑ Center for Drug Evaluation and Research. "Special Features – Use Caution When Giving Cough and Cold Products to Kids". Food and Drug Administration. Archived from the original on 12 January 2017. Retrieved 23 January 2017.
  24. ↑ Goldsobel AB, Chipps BE (March 2010). "Cough in the pediatric population". The Journal of Pediatrics. 156 (3): 352–8. doi:10.1016/j.jpeds.2009.12.004. PMID   20176183.
  25. ↑ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002. Archived from the original on 16 January 2013.
  26. ↑ Tietze KJ (2004). "Disorders related to cold and allergy". In Berardi RR (ed.). Handbook of Nonprescription Drugs (14th ed.). Washington, DC: American Pharmacists Association. pp. 239–269. ISBN   978-1-58212-050-8. OCLC   56446842.
  27. ↑ Covington TR, ed. (2002). "Common cold". Nonprescription Drug Therapy: Guiding Patient Self-care (1st ed.). St Louis, MO: Facts & Comparisons. pp. 743–769. ISBN   978-1-57439-146-6. OCLC   52895543.
  28. 1 2 Chalumeau M, Duijvestijn YC (May 2013). "Acetylcysteine and carbocysteine for acute upper and lower respiratory tract infections in paediatric patients without chronic broncho-pulmonary disease". The Cochrane Database of Systematic Reviews (5): CD003124. doi:10.1002/14651858.CD003124.pub4. PMID   23728642.
  29. 1 2 3 Hemilä H, Chalker E (January 2013). "Vitamin C for preventing and treating the common cold". The Cochrane Database of Systematic Reviews. 2013 (1): CD000980. doi:10.1002/14651858.CD000980.pub4. PMC   1160577 . PMID   23440782.
  30. ↑ King D, Mitchell B, Williams CP, Spurling GK (April 2015). "Saline nasal irrigation for acute upper respiratory tract infections" (PDF). The Cochrane Database of Systematic Reviews. 2015 (4): CD006821. doi:10.1002/14651858.CD006821.pub3. PMC   9475221 . PMID   25892369.
  31. ↑ Global Burden of Disease Study 2013 Collaborators (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 386 (9995): 743–800. doi:10.1016/s0140-6736(15)60692-4. PMC   4561509 . PMID   26063472.
  32. ↑ Zhao Y, Dong BR, Hao Q (August 2022). "Probiotics for preventing acute upper respiratory tract infections". The Cochrane Database of Systematic Reviews. 2022 (8): CD006895. doi:10.1002/14651858.CD006895.pub4. PMC   9400717 . PMID   36001877.
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