Respiratory Tract Infections - Uncommon Facts About Common Cold and Common Cold Treatment

World over the most common infection is that of the upper respiratory passages . Numerous man-hours are lost to common cold and its related infections. Besides being notorious for its spread, the debility associated with coryza (Common Cold) is akin to dying! Don’t believe me, just recall the time you had a bad cold.

VARIATIONS OF RESPIRATORY INFECTION

The gamut of involvement of any part of the upper respiratory tract either individually or in a related group is medically labeled as URTI or ‘Upper Respiratory Tract Infection’. Let us now begin the journey taken by a microorganism that causes cold. The invading virus reaches our nasal passage or buccal mucosa and progressively spreads inwards. Often the infection is limited as coryza or ‘flu’(influenza).
SINUSITIS - Not uncommonly the infection involves the sinuses or ‘air cells’ within the bony architecture of the skull.
TONSILLITIS- The tonsils are the sentries to the respiratory tract. They are lymphoid aggregates that become infected in the process of destroying invaders. Infection ranges from the relatively mild tonsillitis with ‘Pus Points’ to the morbid ‘Peritonsillar’ abscess (QUINCY).
PHARYNGITIS - The infection hits the upper swallowing portion of the throat- pharynx.
TRACHEOBRONCHITIS - This infection is now getting serious and spreads down to the upper airways or Lower Respiratory Tract, whereby it is commonly known as ACUTE BRONCHITIS .
PNEUMONIA - The worst of the lot, it is a LRTI or lower respiratory infection of the lung lobes or parenchyma.

CAUSES OF COMMON COLD AND RESPIRATORY INFECTION

Viruses such as Rhinovirus, Adenovirus and Influenza virus along with their variants or serotypes are the commonest agents. The severity of the cold you get and the manner in which it progresses depends upon the strain of the particular virus you catch. Hard luck if you’ve inadvertently inhaled the ‘H1N1’ variant of the Influenza virus!
Once the respiratory tract is weakened by a viral attack, it becomes susceptible to bacterial infection anywhere thus producing a myriad array of respiratory manifestations as highlighted above. ‘Streptococcus Pneumoniae’ (Pneumococcus) is the bacterium commonly responsible for community acquired infections. Hemophilus, Staphylocccus, Legionella, Pseudomonas, Mycoplasma and Pneumocystis strains are other bacteria that can cause infection in certain circumstances.

SYMPTOMS OF RESPIRATORY INFECTION

The famed prodrome of sneezing, blocked nose, a raw throat, headache and lethargy herald the arrival of the Caliph ‘Common Cold’. Running Nose (coryza/rhinitis), Headache (sinusitis), Sore throat (laryngitis), Post nasal drip with Dry cough (pharyngitis), Malaise, Bodyache, Arthralgia, Fever, Expectorant cough can all occur depending upon the site of Respiratory infection.

COMPLICATIONS OF Upper Respiratory Tract Infections (URTI)

A word of caution here, fever merits attention to find its cause. Influenza, Pneumonia and tonsillar abcess are notorious for causing fever. Middle ear infection (OTITIS MEDIA) and Meningitis (BRAIN FEVER) are complications of Respiratory Infection.

MODES OF SPREAD OF COMMON COLD OR FLU

Droplet infection is by far the most common means of virus dispersal. This includes sneezing, coughing and sighing into seemingly open spaces which can potentially infect unprotected bystanders especially at work or public places/transportation.
Fomites come in second. Infected or contaminated hands are killers, in that they reach everywhere, from handshakes and tabletops to coffee machines, mobiles, currency and paperwork. Rubbing eyes, face touching and finger- mouth gestures are sure shot modalities for virus transfer.

PREVENTION OF COMMON COLD

Knowledge of the ways in which the ‘flu’ spreads is core to preventing its spread. Wear a face mask if you’re infected. Wash your hands with soap repeatedly.
Don’t sneeze, cough or discharge your virus load in public. Use handkerchiefs, tissues or at least cup your hand over your face when sneezing.
Make no bones about openly avoiding people with the ‘flu’ cause what you can catch and possibly transmit to your family could be the deadly H1N1 virus. Last but not the least, fit people have higher immunity in the community. So smoke less, exercise more and eat fresh, green, vitamin C rich foods.

TREATMENT OF COMMON COLD - HOME REMEDIES

Grandma’s recipes do help sooth the cold. Hot chicken soup, brandy-sugar-hot water cocktail, rubbing oils (eucalyptus), steam inhalations, salt water gargles and ginger – lime-honey concoctions are only a few home remedies.

MEDICAL TREATMENT OF RESPIRATORY TRACT INFECTION

Some old medical texts often carry this proverb- ‘ A cold left untreated will take seven days to pass off, if it is treated it will cure in a week’!
Archaic wisdom notwithstanding, it is now- a- days better to treat than to suffer. A complication averted saves manpower, productivity and healthcare costs.

Non-steroidal Anti-Inflammatory Drugs (NSAIDS)

Non-steroidal anti-inflammatory drugs work magic in alleviating headache, bodyache, malaise, myalgia and arthralgia associated with the ‘flu’. Paracetamol, Ibuprofen(ADVIIL,MOTRIN), Diclofenac and Piroxicam are good examples.

ANTIHISTAMINE, DECONGESTANT, ANTI TUSSIVE FORMULAS

Chlorpheniramine, Ceterizine, Pseudoephedrine (DECONAMINE), Phenlephrine(AEROHIST PLUS, DURADRYL, DALLERGY), Phenylpropanolamine and Dextromethorphan are incorporated into cough formulas ( ALKA-SELTZER PLUS, VICKS FORMULA 44). Xylometazoline (OTRIVIN) and Oxymetazoline (AFRIN) are used as nasal drops to relieve nasal blockade from cold.

ANTIBIOTICS

Upper respiratory infection in any form will likely set in 60 % of the time with common cold or ‘flu’. Therefore it is prudent to employ pre emptive empirical antibiotic therapy at the earliest along with the above medications. The recommended drug of choice is ‘Amoxycillin’ (AMOXIL/ NOVAMOX/ TRIMOX).

AMOXICILLIN IN TREATING RESPIRATORY INFECTIONS

AMOXIL is beneficial in treating laryngitis, Pharngitis and Sinusitis. AMOXIL moreover can be use for the treatment of uncomplicated community acquired mild pneumonias as well as for other Lower Respiratory Infections like Acute Bronchitis.
It is safe for treating URTI in Pregnancy (Not preparations which have aspartame) and is available as a syrup/suspension for kids.
The recommended dosage of Amoxil is usually 250 mg thrice a day. More details on generic Amoxil are given in the presentation below.

EFFICACY OF TRIMOX

AMOXIL is a bacteriostatic that inhibits cell wall production in bacteria. Most organisms have gradually become resistant to AMOXIL. The reason is on account of their ability to produce an enzyme ‘b-lactamase’ which destroys AMOXIL. Therefore AMOXIL is nowadays combined with Clavulinate – a ‘b-lactamase inhibitor’ (AUGMENTIN) in order to improve its efficacy.

SIDE EFFECTS OF TRIMOX

Besides nausea, vomiting and antibiotic induced diarrhea (Pseudomembranous Colitis), TRIMOX can give rise to allergic or hypersensitivity drug rashes or reactions which are usually minor. Long term therapy mandates testing renal and liver functions.

OTHER BENEFITS OF AMOXIL/TRIMOX/NOVAMOX

Gonorrhoea as well as some skin and dental infections are amenable to AMOXIL therapy. A single 3g dose of AMOXIL is sufficient for uncomplicated gonorrhoea.

Common Cold Treatment - Concluding Remarks

The bottom line is, there are only a few clinical studies that demonstrate the efficacy of anti cold medication that we often buy over the counter or online. It does not mean there's no role for any of these products. It simply indicates that there are only a few good studies showing that these drugs do work!