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Der Pneumologe

, Volume 13, Issue 4, pp 262–273 | Cite as

Ganzheitliche Therapieoptionen bei akuten Atemwegsinfekten

  • M. Croessmann
  • M. A. RoseEmail author
Pädiatrische Pneumologie

Zusammenfassung

Hintergrund

„Erkältungen“ sind ein Hauptgrund für ärztliche Inanspruchnahme. Sie sind meist durch Viren verursacht, werden symptomatisch behandelt und Antibiotika sind zu vermeiden.

Ziel der Arbeit

Übersicht zu konventionellen und alternativmedizinischen Therapien akuter Atemwegsinfektionen.

Material und Methoden

Systematische Suche von Medline, eMbase und der Cochrane-Datenbank von Januar 1985 bis Dezember 2015 mit den Schlüsselwörtern „Erkältung“, „akute Atemwegsinfektion“ und „Therapie“.

Ergebnisse

Bei Kindern gibt es für häufig als Erkältungsmittel angewandte Substanzen wie Hustensäfte oder Echinaceapräparate keine konsistente Datenlage. Potenziell nützlich sind ätherische Einreibungen (Vapor rub, cave: Reizungen), Zink, Pelargonium sidoides und Honig. Bei Erwachsenen besteht für Antihistaminika, intranasale Steroide, Codein, nasale Salzwasserspülungen und Dampfbäder keine konsistente positive Empfehlungssituation. Topische Dekongestiva, intranasales Ipratropium und Zink konnten leicht die Symptomschwere und -dauer vermindern. Nichtsteroidale Antiphlogistika und einige Phytotherapeutika milderten geringfügig die Symptome. Konsequente Hygiene vermindert die Übertragung der ursächlichen Viren.

Diskussion

Bei Kindern haben Selbstmedikationspräparate gegen Husten und Erkältung keine belegten Wirkungen, aber Potenzial für erhebliche Nebenwirkungen und sollten daher v. a. bei Jüngeren vermieden werden. Nützen können Paracetamol und nichtsteroidale Antiphlogistika sowie evtl. Antihistiminika-Dekongestiva-Kombinationen und intranasales Ipratropium. Ibuprofen scheint bei Kindern stärker antipyretisch zu wirken als Paracetamol. Zu den ganzheitlichen Ansätzen gibt es moderate Nutzenevidenz für Nahrungsergänzung mit Zink und Probiotika bei Erwachsenen sowie bei Kindern ebenfalls für Probiotika und jenseits des Säuglingsalters Honig zur Nacht. Hausmittel, wie z. B. Knoblauch oder Gurgeln, verdienen gut geplante, prospektive Studien.

Schlüsselwörter

Akute Atemwegsinfektionen Erkältungen Therapie Evidenzbasierte Medizin Selbstmedikation 

Holistic therapeutic options for the common cold

Abstract

Background

Common colds are a major reason for physician visits. Being mainly of viral origin, treatment is symptomatic and antibiotics should be avoided.

Objectives

To review the evidence for conventional and alternative treatments of the common cold.

Material and Methods

Medline, eMbase, and the Cochrane database were searched from January 1985 to December 2015 combining the keywords “common cold” or “acute respiratory tract infection” with “treatment”.

Results

In children, commonly used medications such as cough syrups or Echinacea have not consistently been proven to be efficacious as treatment for the common cold. Products that potentially improve symptoms in children include vapour rub, zinc sulphate, pelargonium sidoides extract, and buckwheat honey. For adults, antihistamines, intranasal corticosteroids, codeine, nasal saline irrigation, and steam inhalation could not consistently proove efficacy at relieving cold symptoms. Topical decongestants, intranasal ipratropium, and zinc modestly reduced symptom severity and duration. NSAIDs and some herbal preparations slightly improved symptoms. Hand hygiene reduces the spread of viruses that cause cold illnesses.

Conclusions

In children, there is a potential for harm and no benefits with over-the-counter cough and cold medications; therefore, they should not be used, especially in the young. Beneficial effects exist for paracetamol and NSAIDS and potentially for antihistamine-decongestive combinations and intranasal ipratropium. Ibuprofen seems to be stronger antipyretic than paracetamol in paediatric patients. Among holistic strategies, there is moderate evidence for beneficial effects of zinc and probiotics in adults. In children, probiotics are also beneficial and – beyond the first year of life – honey at night. Commonly used strategies (e. g., garlic, gargling) warrant further research.

Keywords

Acute respiratory infections Common cold Therapy Evidence based medicine OTC 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Croessmann und M. A. Rose geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
  2. 2.
    Albalawi ZH, Othman SS, Alfaleh K (2011) Intranasal ipratropium bromide for the common cold. Cochrane Database Syst Rev 7:CD008231PubMedGoogle Scholar
  3. 3.
    Allan GM, Arroll B (2014) Prevention and treatment of the common cold: making sense of the evidence. CMAJ 186(3):190–199CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Allan GM, Korownyk C, Kolber M (2011) Do cough suppressants or honey help pediatric cough? Can Fam Physician 57:435PubMedPubMedCentralGoogle Scholar
  5. 5.
    Anonymus (1999) Garlic fights more than vampires. Environ Health Perspect 107(3):A136Google Scholar
  6. 6.
    Arroll B, Kenealy T (2005) Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev 3:CD000247PubMedGoogle Scholar
  7. 7.
    Bachert C, Chuchalin AG, Eisebitt R et al (2005) Aspirin compared with acetaminophen in the treatment of fever and other symptoms of upper respiratory tract infection in adults: a multicenter, randomized, double-blind, double-dummy, placebo-controlled, parallel-group, single-dose, 6‑hour dose-ranging study. Clin Ther 27:993–1003CrossRefPubMedGoogle Scholar
  8. 8.
    Ball TM, Holberg CJ, Aldous MB et al (2002) Influence of attendance at day care on the common cold from birth through 13 years of age. Arch Pediatr Adolesc Med 156:121–126CrossRefPubMedGoogle Scholar
  9. 9.
    Bramley TJ, Lerner D, Sames M (2002) Productivity losses related to the common cold. J Occup Environ Med 44:822–829CrossRefPubMedGoogle Scholar
  10. 10.
    Cohen S, Doyle WJ, Alper CM et al (2009) Sleep habits and susceptibility to the common cold. Arch Intern Med 169:62–67CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Cohen HA, Rozen J, Kristal H et al (2012) Effect of honey on nocturnal cough and sleep quality: double-blind a. randomized, placebo-controlled study. Pediatrics 130:465–471CrossRefPubMedGoogle Scholar
  12. 12.
    Cohen S, Tyrrell DA, Smith AP (1991) Psychological stress and susceptibility to the common cold. N Engl J Med 325:606–612CrossRefPubMedGoogle Scholar
  13. 13.
    D’Cruze H, Arroll B, Kenealy T (2009) Is intranasal zinc effective and safe for the common cold? A systematic review and meta-analysis. J Prim Health Care 1:134–139PubMedGoogle Scholar
  14. 14.
    Dougals RM, Hemilä H, Chalker E (2007) Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 3:CD000980Google Scholar
  15. 15.
    Eccles R, Martensson K, Chen SC (2010) Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin 26:889–899CrossRefPubMedGoogle Scholar
  16. 16.
    Fendrick AM, Monto AS, Nightengale B et al (2003) The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med 163:487–494CrossRefPubMedGoogle Scholar
  17. 17.
    Goldman RD (2010) Codeine for acute cough in children. Can Fam Physician 56:1293–1294PubMedPubMedCentralGoogle Scholar
  18. 18.
    Haisvogel M, Riley DS, Heger M, Bren S, Jong M, Fischer M, Lewith GT, Jansen G, Thurneysen AE (2007) Homeopathic and conventional treatment for acute respiratory and ear complants: a comparative study on outcome in the primary care setting. BMC Complement Altern Med 7(7):1–11Google Scholar
  19. 19.
    Hatton RC, Winterstein AG, McKelvey RP et al (2007) Efficacy and safety of oral phenylephrine: systematic review and meta analysis. Ann Pharmacother 41:381–390CrossRefPubMedGoogle Scholar
  20. 20.
    Hayward G, Thompson MJ, Perera R, Mar CB del, Glasziou PP, Heneghan CJ (2015) Corticosteroids for the common cold. Cochrane Database Syst Rev 10:CD008116PubMedGoogle Scholar
  21. 21.
    Health Canada (2008) Decision on the labelling of cough and cold products for children. www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2008/13267a-eng.php. Zugegriffen: 24 Okt. 2013Google Scholar
  22. 22.
    Heikkinen T, Järvinen A (2003) The common cold. Lancet 361:51–59CrossRefPubMedGoogle Scholar
  23. 23.
    Italia S, Brand H, Heinrich J, Berdel D, Berg A von, Wolfenstetter SB (2015) Utilization of complementary and alternative medicine among children from a german birth cohort (GI-NIplus): patterns, costs, and trends of use. BMC Complement Altern Med 15(49):2–10Google Scholar
  24. 24.
    Ivers N, Arroll B, Allan GM (2011) Delayed antibiotic prescriptions for URTIs. Can Fam Physician 57:1287PubMedPubMedCentralGoogle Scholar
  25. 25.
    Jafek BW, Linschoten MR, Murrow BW (2004) Anosmia after intranasal zinc gluconate use. Am J Rhinol 18:137–141PubMedGoogle Scholar
  26. 26.
    Karpa KD, Felix TM, Lewis PR (2015) Adverse effects of common drugs: children and adolescents. FP Essent 436:17–22PubMedGoogle Scholar
  27. 27.
    Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K (2014) Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev 2:CD000530PubMedPubMedCentralGoogle Scholar
  28. 28.
    Kim SY, Chang YJ, Cho HM, Hwang YW, Moon YS (2015) Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst Rev 9:CD006362PubMedGoogle Scholar
  29. 29.
    King D, Mitchell B, Williams CP, Spurling GK (2015) Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev 4:CD006821PubMedGoogle Scholar
  30. 30.
    King S, Glanville J, Sanders ME, Fitzgerald A, Varley D (2014) Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis. Br J Nutr 112(1):41–54CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Kollar C, Schneider H, Waksman J et al (2007) Meta-analysis of the efficacy of a single dose of phenylephrine 10 mg compared with placebo in adults with acute nasal congestion due to the common cold. Clin Ther 29:1057–1070CrossRefPubMedGoogle Scholar
  32. 32.
    Kvaerner KJ, Nafstad P, Jaakkola JJ (2000) Upper respiratory morbidity in preschool children: a cross-sectional study. Arch Otolaryngol Head Neck Surg 126:1201–1206CrossRefPubMedGoogle Scholar
  33. 33.
    Lange de Klerk ES de, Blommers J, Kuik DJ et al (1994) Effect of homoeopathic medicines on daily burden of symptoms in children with recurrent upper respiratory tract infections. BMJ 309:1329–1332CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Li G, Cai L, Jiang H, Dong S, Fan T, Liu W, Xie L, Mao B (2015) Compound formulas of traditional chinese medicine for the common cold: systematic review of randomized, placebo-controlled trials. Altern Ther Health Med 21(6):48–57PubMedGoogle Scholar
  35. 35.
    Lissiman E, Bhasale AL, Cohen M (2014) Garlic for the common cold. Cochrane Database Syst Rev 11:CD006206PubMedGoogle Scholar
  36. 36.
    Mäkelä MJ, Puhakka T, Ruuskanen O et al (1998) Viruses and bacteria in the etiology of the common cold. J Clin Microbiol 36:539–542PubMedPubMedCentralGoogle Scholar
  37. 37.
    Meda Pharma (2006) Fachinformation TRANSBRONCHIN, Stand Aug. 2006Google Scholar
  38. 38.
    Monto AS (2002) Epidemiology of viral respiratory infections. Am J Med 112(Suppl 6 A):4S–12SCrossRefPubMedGoogle Scholar
  39. 39.
    Nicholson KG, Kent J, Hammersley V et al (1997) Acute viral infections of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden. BMJ 315:1060–1064CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Paul IM, Beiler J, McMonagle A et al (2007) Effect of honey, dextro methorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 161:1140–1146CrossRefPubMedGoogle Scholar
  41. 41.
    Paul IM, Beiler JS, King TS et al (2010) Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms. Pediatrics 126:1092–1099CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Perrott DA, Piira T, Goodenough B et al (2004) Efficacy and safety of acetaminophen vs. ibuprofen for treating children’s pain or fever: a meta–analysis. Arch Pediatr Adolesc Med 158:521–526CrossRefPubMedGoogle Scholar
  43. 43.
    Pierce CA, Voss B (2010) Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review. Ann Pharmacother 44:489–506CrossRefPubMedGoogle Scholar
  44. 44.
    Pierre Fabre (2010) Fachinformation FLUIMUCIL Kindersaft, Stand Apr. 2010Google Scholar
  45. 45.
    Science M, Johnstone J, Roth DE et al (2012) Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 184:E551–E561CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Shadkam MN, Mozaffari-Khosravi H, Mozayan MR (2010) A comparison of the effect of honey, dextromethorphan, and diphen hydramine on nightly cough and sleep quality in children and their parents. J Altern Complement Med 16:787–793CrossRefPubMedGoogle Scholar
  47. 47.
    Singh M, Singh M (2011) Heated, humidified air for the common cold. Cochrane Database Syst Rev 5:CD001728PubMedGoogle Scholar
  48. 48.
    Smith A, Thomas M, Whitney H (2000) Effects of upper respiratory tract illnesses on mood and performance over the working day. Ergonomics 43:752–763CrossRefPubMedGoogle Scholar
  49. 49.
    Smith AP, Jamson S (2012) An investigation of the effects of the common cold on simulated driving performance and detection of collisions: a laboratory study. BMJ Open 2:e001047CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Smith SM, Schroeder K, Fahey T (2014) Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev 11:CD001831PubMedGoogle Scholar
  51. 51.
    Steinsbekk A, Bentzen N, Fønnebø V et al (2005) Treatment with one of three self-selected, ultramolecular homeopathic medicines for the prevention of upper respiratory tract infections in children. A double-blind randomized placebo controlled trial. Br J Clin Pharmacol 59:447–455CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Steinsbekk A, Fønnebø V, Lewith G et al (2005) Homeopathic care for the prevention of upper respiratory tract infections in children: a pragmatic, randomised, controlled trial comparing individualised homeopathic care and waiting-list controls. Complement Ther Med 13:231–238CrossRefPubMedGoogle Scholar
  53. 53.
    de Sutter AI, Saraswat A, Driel ML van (2015) Antihistamines for the common cold. Cochrane Database Syst Rev 11:CD009345PubMedGoogle Scholar
  54. 54.
    de Sutter AI, Driel ML van, Kumar AA, Lesslar O, Skrt A (2012) Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database Syst Rev 2:CD004976PubMedGoogle Scholar
  55. 55.
    Taverner D, Latte J (2007) Nasal decongestants for the common cold. Cochrane Database Syst Rev 1:CD001953PubMedGoogle Scholar
  56. 56.
    Timmer A, Günther J, Motschall E, Rücker G, Antes G, Kern WV (2013) Pelargonium sidoides extract for treating acute respiratory tract infections. Cochrane Database Syst Rev 10:CD006323PubMedGoogle Scholar
  57. 57.
    Ulukol B, Köksal Y, Cin S (1999) Assessment of the efficacy and safety of paracetamol, ibuprofen and nimesulide in children with upper respiratory tract infections. Eur J Clin Pharmacol 55:615–618CrossRefPubMedGoogle Scholar
  58. 58.
    Vingilis ER, Brown U, Sarkella J et al (1999) Cold/flu knowledge, attitudes and health care practices: results of a two-city telephone survey. Can J Public Health 90:205–208PubMedGoogle Scholar
  59. 59.
    Vohra S, Johnston BC, Laycock KL et al (2008) Safety and tolerability of north american ginseng extract in the treatment of pediatric upper respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules. Pediatrics 122:402–410CrossRefGoogle Scholar
  60. 60.
    Wu T, Zhang J, Qiu Y (2007) Chinese medicinal herbs for the common cold. Cochrane Database Syst Rev 1:CD004782PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Sana Klinikum OffenbachOffenbachDeutschland
  2. 2.Fachbereich MedizinJohann Wolfgang Goethe-Universität Frankfurt am MainDeutschland

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