Efficacy and safety of paracetamol, phenylephrine, chlorpheniramine maleate and sodium citrate in Indian paediatric patients with common cold: an active post-marketing surveillance study

Background: The common cold, mainly caused by viruses, brings discomfort to children with symptoms like sneezing, congestion, runny nose, and sore throat. As no specific antiviral treatments are available to relieve common cold symptoms, it is typically managed using decongestants, antihistamines, and antipyretics. This study aims to assess the safety and efficacy of a fixed-dose combination (FDC) of paracetamol, phenylephrine, chlorpheniramine maleate and sodium citrate in children aged 2 to 12 years with common cold. Methods: This non-randomized, open-label, non-comparative, active post-marketing surveillance (PMS) study was conducted across multiple centres in India, involving 417 patients. The study assessed efficacy using the total symptom score (TSS) scale over 5 days with visits on days 1, 3, and 5. Safety was evaluated based on adverse events reported by patients on days 3 and 5 of the trial. Results: Initially, 417 patients were enrolled in the active PMS, of which 309 completed the study. The mean TSS showed a notable decrease from 8.95 at visit 1 to 0.19 at visit 3, depicting a significant reduction i.e., 97.90% as compared to baseline. At visit 1, most patients (95.79%) exhibited severe symptoms, whereas by visit 3, 83.82% were symptom-free, with only 16.18% experiencing mild symptoms. Conclusions: This active PMS study examined the safety and efficacy of an FDC of paracetamol, phenylephrine, chlorpheniramine maleate and sodium citrate in treating common cold in children in India. The findings indicate a significant reduction in symptoms, with many patients becoming symptom-free by the third visit, demonstrating its efficacy and safety.

Safety and efficacy of a fixed dose combination of oral drops of paracetamol, phenylephrine hydrochloride, and chlorpheniramine maleate in the symptomatic treatment of common cold in children: an active post-marketing surveillance study

Background: Common cold often accompanied by mild fever and systemic symptoms in children, poses a significant social burden. Scientific evidence suggests that the pathogenesis of colds involves the activation of multiple inflammatory pathways, rendering single-molecule treatment ineffective against the symptoms. This active post-marketing surveillance study evaluated the safety and efficacy of a fixed-dose combination containing paracetamol, phenylephrine hydrochloride, and chlorpheniramine malate in treating common cold in children aged 2 to 5 years.Methods: In this clinical study, 200 children with common cold symptoms were enrolled. Maxtra� P oral drops, a fixed-dose combination containing paracetamol (125 mg), phenylephrine hydrochloride (2.5 mg), and chlorpheniramine maleate (1 mg) per ml drops, were administered as 1 ml every 4 to 6 hours for 5 days. Safety was assessed using the global tolerability assessment based on responses from parents and investigators. Efficacy was evaluated based on symptom severity scores categorised as absent, mild, moderate, severe, or very severe.Results: Complete remission from common cold symptoms was achieved in 82% (164 patients) of 200 patients. Statistically significant reductions (p<0.001) in symptom severity scores were observed for all common cold symptoms from day 1 to day 5. No adverse events were observed. Maxtra� P oral drops were regarded as good to excellent for treating common cold symptoms by 92.5% of parents and 97.5% of investigators.Conclusions: The observations of study indicate that Maxtra� P oral drops are efficacious and well- tolerated for treating common cold in children aged 2 to 5 years.

Efficacy and safety of Regan Syrup in treatment of common cold (wind-heat syndrome):a multicenter, randomized, double-blind, double-dummy, placebo and positive drug-controlled, parallel, phase Ⅱb clinical trial / 中国中药杂志

Regan Syrup has the effect of clearing heat, releasing exterior, benefiting pharynx and relieving cough, and previous phase Ⅱ clinical trial showed that the efficacy of Regan Syrup high-dose and low-dose groups was better than that of the placebo group, and there was no statistically significant difference in the safety between the three groups. The present study was conducted to further investigate the efficacy and safety of the recommended dose(20 mL) of Regan Syrup in the treatment of common cold(wind-heat syndrome). Patients who met the inclusion and exclusion criteria were selected and divided into the test group(Regan Syrup+Shufeng Jiedu Capsules placebo), positive drug group(Regan Syrup placebo+Shufeng Jiedu Capsules) and placebo group(Regan Syrup placebo+Shufeng Jiedu Capsules placebo) at a 1∶1∶1 using a block randomization method. The course of treatment was 3 days. A total of 119 subjects were included from six study centers, 39 in the test group, 40 in the positive drug group and 40 in the placebo group. The onset time of antipyretic effect was shorter in the test group than in the placebo group(P≤0.01) and the positive drug group, but the difference between the test group and the positive drug group was not significant. The test group was superior to the positive drug group in terms of fever resolution(P<0.05), and had a shorter onset time of fever resolution than the placebo group, but without obvious difference between the two groups. Compared to the positive drug group, the test group had shortened disappearance time of all symptoms(P≤0.000 1). In addition, the test group was better than the positive drug group and the placebo group in relieving symptoms of sore throat and fever(P<0.05), and in terms of clinical efficacy, the recovery rate of common cold(wind-heat syndrome) was improved in the test group compared to that in the placebo group(P<0.05). On the fourth day after treatment, the total TCM syndrome score in both test group and positive drug group was lower than that in the placebo group(P<0.05). There was no significant difference in the incidence of adverse events between three groups and none of them experienced any serious adverse events related to the study drug. The results indicated that Regan Syrup could shorten the onset time of antipyretic effect, reduce the time of fever resolution, alleviate the symptoms such as sore throat and fever caused by wind-heat cold, reduce the total score of Chinese medicine symptoms, and improve the clinical recovery rate with good safety.

A Prospective, Interventional, Multicentre, Post-marketing Clinical Study of a fixed-dose combination of Paracetamol (125 mg), Phenylephrine HCL (5 mg), Chlorpheniramine Maleate (1 mg) and Sodium Citrate (60 mg/5 mL) for the Treatment of Common Cold and Flu Syndrome in Children

Background : Common cold is an acute, self-limiting viral infection of the upper respiratory tract involving the nose, sinuses, pharynx, and larynx. According to various studies, the combination of analgesics, decongestants, and antihistamines provides better relief for multiple symptoms in the common cold. Fixed dose combination of Paracetamol as an analgesic, anti-inflammatory, and antipyretic, Chlorpheniramine maleate, an anti-histaminic, and Phenylephrine as a nasal decongestant is primarily used in the treatment of the common cold. Hence the present post-marketing surveillance study was planned to find any unwanted adverse effects and efficacy of commercially available combination in treating the common cold in children. Methodology : The prospective, single-arm, multicenter, post-marketing clinical study included 224 children from four different study sites, of which 204 completed the study. Subjects were given this fixed dose combination for three days and then monitored for the next six days. During the study, the efficacy was evaluated using VAS score changes from the beginning to the end of the treatment. Incidence of Adverse Events (AE) and Serious Adverse Events (SAE) was assessed. The product's safety was also evaluated using blood biomarkers such as Hemoglobin, Platelet count, SGOT, SGPT, and creatinine level. Results : The reduction in symptomatic score of common cold and flu syndrome was observed after 3rd followup visit [(0.384±0.168 (visit 1) to 0.001±0.009 (Visit 3), (p<0.001)]. No intervention-related or serious adverse events (SAE) were observed in the study or follow-up period. The study found no major changes in the levels of haemoglobin, platelets, SGOT, SGPT, and creatinine. Conclusions : Fixed-dose combination of Paracetamol (125 mg), Phenylephrine HCL (5 mg), Chlorpheniramine Maleate (1 mg) and Sodium Citrate (60 mg/5 mL) is safe and effective in treating children's common cold and flu syndrome.

Therapeutic effects of dialectical addition and subtraction treatment based on self-made Qufeng Zhike Decoction on cough caused by wind dryness invading the lung / 中国基层医药

Objective:To investigate the therapeutic effects of dialectical addition and subtraction treatment based on self-made Qufeng Zhike Decoction on cough caused by wind dryness invading the lung. Methods:Thirty patients with cough after catching a cold who were admitted by Huainan Hospital of Traditional Chinese Medicine from May 2021 to May 2022 were included in this study. These patients were treated with self-made Qufeng Zhike Decoction (first decocting the ochre for 30 minutes, then decocting inula flower in cloth bags, or traditional Chinese medicine drug granules for drinking with boiled warm water), 1 dose per day, 5 doses in total at first diagnosis. During the follow-up visit, patients were given an dialectical addition and subtraction treatment according to the improvement of cough. Five days of dialectical addition and subtraction treatment were taken as one course of treatment, and two or three courses of treatment were used. Therapeutic effects and adverse reactions were recorded. Scores of cough, expectoration and pharyngeal itching before and 15 days after treatment were recorded. Results:All 30 patients actively cooperated with the treatment. Among 30 patients, treatment was remarkably effective in 19 patients, effective in 9 patients, and ineffective in 2 patients, with a total response rate of 93.33% (28/30). Among 30 patients, two complained of mild stomach discomfort (relieved after taking medicine 1 hour after a meal). No obvious adverse reactions were found in the remaining patients. Compared with before treatment, scores of cough, expectoration and pharyngeal itching were significantly decreased after treatment [cough: (2.38 ± 0.51) points vs. (1.00 ± 0.85) points; expectoration: (0.88 ± 0.54) points vs. (0.29 ± 0.08) points; pharyngeal itching: (0.98 ± 0.67) points vs. (0.65 ± 0.33) points, t = 2.36, 2.98, 2.01, all P < 0.05]. Conclusion:Dialectical addition and subtraction treatment based on self-made Qufeng Zhike Decoction for treatment of cough caused by wind dryness invading the lung has a promising curative effect, without obvious adverse reactions.

Ganduqing Granules in Treatment of Common Cold Due to Qi Deficiency and Pathogen Invasion / 中国实验方剂学杂志

Objective:To observe and evaluate the efficacy and safety of Ganduqing Granules in the treatment of common cold due to qi deficiency and pathogen invasion. Method:A multi-center， randomized， double-blind， and placebo-controlled clinical trial was conducted. One hundred and twenty patients were randomly divided into an experimental group （<italic>n</italic>=60） and a control group （<italic>n</italic>=60）. Patients in the experimental group were treated with oral Ganduqing Granules， 6 g per time， 3 times per day， while those in the control group received placebo， 6 g per time， 3 times per day. After treatment for 5 successive days in both groups， the overall remission rate， total score of primary symptoms， total score of secondary symptoms， total score of all symptoms， time required for overall symptom remission， and therapeutic efficacy against traditional Chinese medicine （TCM） syndrome in the two groups were analyzed in both full analysis set （FAS） and per-protocol set （PPS）， followed by the evaluation of safety in the safety set （SS）. Result:No drop-out was found in the experimental group， whereas 3 cases in the control group dropped out. After 5 days of treatment， the overall remission rate of the experimental group was significantly higher than that of the control group （<italic>P</italic><0.01）. The analysis in FAS and PDS revealed identical results. The experimental group was obviously better than the control group in improving the total scores of primary symptoms， secondary symptoms， and all symptoms （<italic>P</italic><0.01）. The analysis results in FAS and PDS were consistent. There was no significant difference in overall remission time between the two groups. The experimental group was remarkably superior to the control group in alleviating such symptoms as aversion to wind and cold， nasal congestion， runny nose， fatigue， shortness of breath， laziness to speak， dry throat， sore throat， cough， and expectoration （<italic>P</italic><0.05，<italic>P</italic><0.01）. The analysis results in FAS were the same as those in PDS. All the patients did not present with significant abnormalities in vital signs， blood routine test， or liver and kidney function tests after medication. There was no significant difference in the incidence of adverse events between the experimental group and the control group. Conclusion:Ganduqing Granules effectively alleviate the symptoms of patients with common cold and shorten the course of disease， without inducing obvious side effects.

Analysis of Material Basis and Mechanism of Sangjiang Ganmao Injection in Treatment of Common Cold Based on UPLC-Q-Orbitrap HRMS and Network Pharmacology / 中国实验方剂学杂志

Objective:To explore the material basis and mechanism of Sangjiang Ganmao injection （SG） in the treatment of common cold by ultra-performance liquid chromatography-quadrupole/electrostatic field orbitrap high resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） and network pharmacology. Method:UPLC-Q-Orbitrap HRMS was used to identify the chemical components of SG with mobile phase of acetonitrile （A）-0.1% formic acid aqueous solution （B） for gradient elution （0-10 min， 4%-15%A； 10-35 min， 15%-30%A； 35-45 min， 30%-33%A； 45-55 min， 33%-60%A； 55-58 min， 60%A）， flow rate of 0.2 mL·min^-1， electrospray ionization （ESI） and scanning range of <italic>m</italic>/<italic>z</italic> 100-1 500 under positive and negative ion modes. Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and GeneCards 5.0 database were used to screen and predict the potential targets of chemical components in SG， STRING 11.0 database and Cytoscape 3.7.2 software were used to construct protein-protein interaction （PPI） network model， gene ontology （GO） analysis and pathway analysis were performed on potential targets by Metascape 3.5， Reactome database and Kyoto Encyclopedia of Genes and Genomes （KEGG）， Cytoscape 3.7.2 software was used to build the network of "herbs-ingredients-key targets". Result:A total of 54 components in SG were identified， and 80 potential targets of SG for treatment of common cold were predicted and screened based on this. SG exerted therapeutic effects by acting on targets such as interleukin （IL）-6， tumor necrosis factor （TNF） and IL-10， and signaling pathways such as IL-17 signaling pathway， TNF signaling pathway and interaction of cytokine receptors. Conclusion:SG may interfere with the expression of inflammatory cytokines by acting on related targets and pathways such as inflammation and immune system， and regulate the immune function of the body as a whole， thereby exerting a therapeutic effect.

Efficacy and Safety of a Fixed Dose Combination of Paracetamol, Chlorpheniramine Maleate, Phenylephrine and Caffeine in Treatment of Common Cold: A Phase IV, Open-Labelled, Multi-Centric Study

Common cold affects the upper airways, sometimes in association with low-grade fever and systemic symptoms, and usually presents with at least two of the following symptoms: cough, dysphonia, throat discomfort, sore throat, nasal congestion, rhinorrhoea, sneezing, headaches, myalgia and fever. It also leads to reduction in subjective alertness and impaired psychomotor functioning. A combination of Paracetamol as an analgesic, anti-inflammatory and antipyeretic, Chlorpheniramine maleate, an anti-histaminic, and Phenylephrine as a nasal decongestant is popular in the treatment of common cold. Addition of caffeine enhances alertness and psychomotor functioning. Hence the present study was planned to evaluate efficacy and safety of this combination in treatment of common cold. Methods: This was a phase IV, open-labelled, multicentric study in 262 patients. Efficacy assessment was done by analyzing the reduction in mean TSS at each follow-up visit and safety assessment was done by analyzing the adverse events during the study. Results: There was reduction in mean TSS from 7.67 (day 1) to 3.78 (day 3) and 0.66 (day 5). Most of the patients had >50% reduction in total symptom score at visit 3 and 59.16 % patients had complete relief from the symptoms at the end of study. Out of 262 patients, 46 i.e. 17.56% experienced adverse event. Sedation and drowsiness (12.21%) was the most common adverse event seen in patients. Conclusion: A fixed dose combination of Chlorpheniramine maleate, Paracetamol, Phenylephrine and Caffeine is safe and effective in the treatment of common cold.

Efficacy and safety of a fixed dose combination of paracetamol, chlorpheniramine maleate and phenylephrine in treatment of common cold: a phase IV, open-labelled, multi-centric study

Background: Acute coryza or common cold affects the upper airways, sometimes in association with low-grade fever and systemic symptoms, and usually presents with at least two of the following symptoms: cough, dysphonia, throat discomfort, sore throat, nasal congestion, rhinorrhoea, sneezing, headaches, myalgia and fever. A triple combination of analgesics, decongestants and antihistamines provides better relief for multiple symptoms in common cold and allergic rhinitis according to various studies. A combination of Paracetamol as an analgesic, anti-inflammatory and antipyretic, Chlorpheniramine maleate, an anti-histaminic and Phenylephrine as a nasal decongestant is popular in the treatment of common cold. Hence the present study was planned to evaluate efficacy and safety of this combination in treatment of common cold.Methods: This was a phase IV, open-labelled, multicentric study in 159 patients. Efficacy assessment was done by analyzing the reduction in mean TSS at each follow-up visit and safety assessment was done by analyzing the adverse events during the study.Results: There was reduction in mean TSS from 6.62 (day 1) to 3.56 (day 3) and 0.69 (day 5). Most of the patients had >50% reduction in total symptom score at visit 3 and 58.49% patients had complete relief from the symptoms at the end of study. Out of 159 patients, 26 i.e. 16.36% experienced adverse events. Sedation and drowsiness (6.29%) were the most common adverse event seen in patients.Conclusions: A fixed dose combination of Chlorpheniramine maleate, Paracetamol, and Phenylephrine is safe and effective in the treatment of common cold.

The Experience of the Upper Respiratory Infection of the Elite Winter Sports Athletes and Its Effect on Training and Competition / 대한스포츠의학회지

PURPOSE: This study aimed to investigate the experience of the upper respiratory infection of the elite winter sports athletes and its effect on training and competition. METHODS: We conducted survey on elite athletes preparing for the 2018 PyeongChang Winter Olympic Games. The general characteristics, training and competition loss due to upper respiratory infection were analyzed by descriptive statistics. Multiple regression analysis was performed to find out the factors that influence on training loss due to upper respiratory infection. A p-value less than 0.05 was considered statistically significant and data were analyzed using SPSS ver. 24.0. RESULTS: A total 65 players answered the questionnaire. Sixteen players (24.7%) reported that they got an upper respiratory infection more than three times a year. The month mainly affected by upper respiratory infection was September to November. Main symptom of upper respiratory infection was rhinorrhea mostly, followed by sore throat, cough, sputum. Six players (9.2%) answered that they were excluded from training more than three times due to upper respiratory infection for 1 year. Seven players (10.7%) answered that they were excluded from competition one time due to upper respiratory infection for 1 year. The factors that influence on training loss due to upper respiratory syndrome were the numbers of getting upper respiratory infection for 1 year and age. CONCLUSION: Elite winter athletes are vulnerable to upper respiratory and it has a bad effect on training and competition. So we need to take care of elite athletes' illness like upper respiratory infection.

Successful Treatment Using Shomakakkonto in two Patients with Common Cold / 日本東洋医学雑誌

Shomakakkonto is usually used for the treatment in patients with initial cold or dermatitis symptoms. We herein reported our experience with two cases of common cold accompanied by watery eyes and floating pulse that were successfully treated with shomakakkonto. The patients were an 81-year-old man and a 69-year-old woman who presented with common cold-like symptoms and watery eyes at our clinic, and were diagnosed with common cold of middle yang. Both patients were successfully treated with shomakakkonto. Common cold with watery eyes may be considered as an indication for treatment with shomakakkonto.

Factors Associated with Knowledge of the Common Cold and Desire for Medical Treatment: A Cross-sectional Study of Citizens Undergoing Health Checkups / 日本プライマリ・ケア連合学会誌

Introduction: We investigated the relationship between knowledge of the common cold and desire for medical treatment.Methods: We administered an anonymous self-questionnaire about the common cold to citizens receiving health checkups in City X, Ibaraki Prefecture, between August and September 2012. We assessed citizens' knowledge about the common cold and whether they sought medical treatment for it, in addition to their demographic attributes.Results: We included 1079 citizens (response rate, 74.5%) in the analysis. The majority of participants believed that receiving intravenous (IV) infusions or injections for the common cold led to faster recovery times (75.9%). Roughly half of the participants (42.0%) did not believe that antibiotics are not effective against virus-based colds, while 28.6% were unsure. Finally, endorsement of the questionnaire items "taking cold medications early leads to faster recovery" (OR: 1.61) and "IV infusions or injections lead to faster recovery times" (OR: 1.86) were associated with a desire for medical treatment.Conclusion: Our results indicate that patients' knowledge about the common cold and their understanding of treatment options available at medical institutions were inadequate. Furthermore, we found that an awareness of how cold medicines, IV infusions, or injections may shorten treatment duration was associated with a desire for treatment.

Clinical experience of Xiangxi Liu's infantile tuina for exogenous fever in children / 针灸推拿医学（英文版）

Xiangxi (the western part of Hunan province) Liu's infantile tuina,as one main school of current infantile tuina in China,highlights the compatibility of the specific points of Wujing in children,the idea of treatment by syndrome differentiation,and produces unique efficacy in the treatment of common diseases in children.Exogenous fever in children can be treated with this method with excellent efficacy.Based on the clinical experience and effective cases treated by this tuina school,the authors elaborated the clinical thought and experience from the perspective view of tuina,for the promotion of Xiangxi Liu's infantile tuina in clinic.

Current status of antibiotic use for common cold and related factors / 中华全科医师杂志

Common cold is the most common upper respiratory tract infection.No antibiotic use for common cold has been international consensus,while the irrational antibiotic use and subsequent antibiotic resistance become an important issue of public health security.This article reviews the current status of antibiotic use for common cold and its related factors.

¿Cuál es el efecto del tratamiento con vitamina C en la duración y severidad del resfrío común? / What are the effects of vitamin C on the duration and severity of the common cold?

Resumen INTRODUCCIÓN: El resfrío común causa una gran morbilidad en todo el mundo y no se cuenta con agentes terapéuticos eficaces contra éste. Existe la creencia de que ingerir vitamina C durante un episodio de resfrío ayuda a disminuir la duración y severidad de los síntomas, sin embargo existe controversia respecto a esta afirmación. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos cuatro revisiones sistemáticas que en conjunto incluyeron ocho estudios primarios, de los cuales siete son ensayos aleatorizados. Concluimos que la vitamina C tiene un impacto mínimo o nulo en la duración del resfrío y en los días en casa o sin trabajar.

Abstract INTRODUCTION: The common cold causes great morbidity throughout the world and there are no effective therapeutic agents against it. There is a belief that consuming vitamin C during a cold episode would help reduce duration and severity of symptoms. However, there is controversy about this claim. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified four systematic reviews that included eight primary studies overall, of which seven were randomized trials. We concluded vitamin C has minimal or no impact on the duration of common cold or in the number of days at home or out of work.

Clinical Research Guidelines for Treatment of Common Cold with New Uyghur Medicine (Draft) / 中国中医药信息杂志

In this study, retrospective multi-center study on medical records of Uyghur Medicine diagnosis and treatment program of common cold was done and demographic, diagnostic, therapeutic, efficacy evaluation and nursing data and other information were collected, sorted out and analyzed to determine the diagnostic cretiria of Uygur Medicine syndrome factors. Syndrome differentiation standard with the syndrome factors of the enrties of main syndromes and sub-syndromes and symptomatic diagnosis chart was established. Combined with the symptoms of common cold, the efficacy evaluation standards were established. On this basis, in accordance with the technical requirements of the national new medicine review, the study developed clinical research guidelines for the treatment of common cold with new Uyghur Medicine (draft).

Prescription practice of antihistamines for acute upper respiratory tract infections in pediatric patients in a local emergency department in Hong Kong / 世界急诊医学杂志（英文）

@#BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice. METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included. RESULTS: Among the 162 cases, 141 (87%) patients were prescribed one antihistamine of any group. Sixty (37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be significantly (P<0.001) associated with multiple antihistamine prescription (OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription (OR=4.654, 95%CI=2.20 to 9.84, P<0.001). CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.

A commentary of literature research of traditional Chinese medicine for acute upper respiratory tract infection in children / 中国中药杂志

Acute upper respiratory tract infection is the most common infectious disease in children's respiratory system. The pathogen to the main virus, can account for more than 90% of the primary upper respiratory tract infectio. However, there is no specific anti-viral drugs specifically for the disease, in addition to the existence of excessive, widespread use or even abuse of antibiotics.Long-term clinical practice has confirmed that Chinese medicine is safe and effective in treating acute upper respiratory tract infection in children. The author reviews the literatures of multiple databases, and analyzes the advantages of Chinese patent medicine in the treatment of acute upper respiratory tract infection in children from the perspective of clinical research and experimental basic research. It also puts forward the existing problems and possible research directions of Chinese patent medicine in the treatment of acute upper respiratory tract infection in children.

A Case of Bilateral Acute Angle Closure Attack Induced by Common Cold Medication

PURPOSE: The authors report a case of bilateral simultaneous acute angle closure attack following administration of an over-the-counter common cold medication (ingredients: chlorpheniramine maleate, phenylephrine hydrochloride, and belladonna alkaloid). CASE SUMMARY: A 67-year-old man visited the emergency room with a sudden onset of bilateral blurred vision and ocular pain accompanied by headache, nausea, and vomiting. He had taken an over-the-counter common cold medication three times per day for three days before the visit. His visual acuity was 0.3 and 0.7 and intraocular pressure (IOP) was 50 mm Hg and 40 mm Hg in right and left eye, respectively. The refraction in manifest refractive test was +0.75 D sph = -0.75 D cyl x 100 in right eye and +1.25 D sph = -1.25 D cyl x 80 in left eye. The anterior chamber depth was three times the corneal thickness in center and less than 1/4 of the corneal thickness in periphery in both eyes on van Herick method. The angles of both eyes were closed on gonioscopy. He was treated with ocular hypotensive medication and miotics followed by withdrawal of common cold medications. After 10 days, bilateral neodymium-doped yttrium aluminium garnet (Nd:YAG) laser peripheral iridotomies were done. During four months of follow-up, there was no recurrence of angle closure attack, and normal IOP was maintained without glaucoma medications. CONCLUSIONS: Common cold medications which are easily accessible can induce acute angle closure attack in those who are predisposed to develop angle closure attacks, hence attention must be taken in those people when taking common cold medications.

Viral aetiology of common colds of outpatient children at primary care level and the use of antibiotics

Although antibiotics are ineffective against viral respiratory infections, studies have shown high rates of prescriptions worldwide. We conducted a study in Brazil to determine the viral aetiologies of common colds in children and to describe the use of antibiotics for these patients. Children up to 12 years with common colds were enrolled from March 2008-February 2009 at a primary care level facility and followed by regular telephone calls and medical consultations. A nasopharyngeal wash was obtained at enrollment and studied by direct fluorescence assay and polymerase chain reaction for nine different types of virus. A sample of 134 patients was obtained, median age 2.9 years (0.1-11.2 y). Respiratory viruses were detected in 73.9% (99/134) with a coinfection rate of 30.3% (30/99). Rhinovirus was the most frequent virus (53/134; 39.6%), followed by influenza (33/134; 24.6%) and respiratory syncytial virus (8/134; 13.4%). Antibiotic prescription rate was 39.6% (53/134) and 69.8% (37/53) were considered inappropriate. Patients with influenza infection received antibiotics inappropriately in a greater proportion of cases when compared to respiratory syncytial virus and rhinovirus infections (p = 0.016). The rate of inappropriate use of antibiotics was very high and patients with influenza virus infection were prescribed antibiotics inappropriately in a greater proportion of cases.