Abstract
OBJECTIVE: To determine if antihistamines provided clinically significant relief from the symptoms of the common cold.
METHODS: Structured literature review following standardized guidelines of primary studies published after 1975.
MEASUREMENTS: Improvements in symptom scores for total symptoms and nasal symptoms over the first three days of a common cold.
RESULTS: Three of five studies reporting on sneezing found a statistically significant improvement in the antihistamine group; similarly, three of seven studies reporting on nasal discharge found a statistically significant improvement with therapy. No study reported improvement in total symptom score at the level of p<.05. The validity of these findings was weakened by several flaws in the literature such as inattention to clinical significance and functional impact, inappropriate use of statistical tests, and poorly described methodology. The clinical significance of these improvements was not demonstrated.
CONCLUSIONS: The primary literature offers little support for the use of antihistamines in the common cold.
Similar content being viewed by others
References
West S, Brandon B, Stolley P, Rumrill R. A review of antihistamines and the common cold. Pediatrics. 1975;56:100–7.
Proud D, Reynolds CJ, Lacapra S, et al. Nasal provocation with bradykinin Induces symptoms of rhinitis and a sore throat. Am Rev Respir Dis. 1988;137:613–6.
Naclerio RM, Proud D, Lichtenstein LM, et al. Kinins are generated during experimental rhinovirus colds. J Infect Dis. 1988;157(1):133–42.
Proud D, Naclerio RM, Gwaltney JM, Hendley JO. Kinins are generated in nasal secretions during natural rhinovirus colds. J Infect Dis. 1990;161:120–3.
Federal Register. Establishment of a monograph for OTC cold, cough, allergy, bronchodilator and antiasthmatic products. Fed Reg. 1976;383:12–24.
Hendeles L. Efficacy and safety of antihistamines and expectorants in nonprescription cough and cold preparations. Pharmaco-therapy. 1993;13(2):154–8.
Oxman AD, Guyatt GH. Guidelines for reading literature reviews. Can Med J. 1988;138:697–703.
Berkowitz RB, Tinkelman DG. Evaluation of oral terfenadine for treatment of the common cold. Ann Allergy. 1991;67:593–8.
Crutcher JE, Kantner TR. The effectiveness of antihistamines in the common cold. J Clin Pharmacol. 1981;21:9–15.
Bye CE, Cooper J, Empey DW, et al. Effects of pseudoephedrine and triprolidine, alone and in combination, on symptoms of the common cold. BMJ. 1980;281:189–90.
Doyle WJ, McBride TP, Skoner DP, et al. A double-blind, placebo-controlled clinical trial of the effect of chlorpheniramine on the response of the nasal airway, middle ear and eustachian tube to provocative rhinovirus challenge. Pediatr Infect Dis J. 1988;7(3):229–38.
Gaffey MD, Gwaltney JM Jr, Sastre A, et al. Intranasally and orally administered antihistamine treatment of experimental rhinovirus colds. Am Rev Respir Dis. 1987;136:556–60.
Gaffey MJ, Kaiser DL, Hayden FG. Ineffectiveness of oral terfenadine in natural colds: evidence against histamine as a mediator of common cold symptoms. Pediatr Infect Dis. 1988;7:233–8.
Hennauer SA, Gluck U. Efficacy of terfenadine in the treatment of the common cold. A double-blind comparison with placebo. Eur J Clin Pharmacol. 1988;34:35–40.
Howard JC, Kanter TR, Lilienfeld LS, et al. Effectiveness of antihistamines in the symptomatic management of the common cold. JAMA 1979;242:2414–7.
Huegenin M, Martin Du Pan R, Oppikofer-Doody AM. Astemizole In the treatment of acute rhinopharyngitis (common cold). A double-blind study in pediatrics [in French]. Rev Med Suisse Romande. 1988;108(11):961–6.
McGuinnes BW. Trial of a long-acting antihistamine in the treatment of coryza. Br J Clin Pract. 1976;30(1):15–6.
Sakchainanont B, Ruangkanchanasetr S, Chantarojanasiri T, Tapasart C, Suwanjutha S. Effectiveness of anti-histamines in common cold. J Med Assoc Thai. 1990;73(2):96–100.
Sperber SJ, Hayden FG. Chemotherapy of rhinovirus colds. Anti-microb Agents Chemother. 1988;32:409–19.
Jackson GG, Dowling HF, Speisman IG. Boan AV. Transmission of the common cold to volunteers under controlled conditions: I. The common cold as a clinical entity. Arch Intern Med. 1958;101:267–78.
Smith MB, Feldman W. Over-the-counter cold medications: a critical review of the clinical trials between 1950 and 1991. JAMA 1993;269(17):2258–63.
Anderson KN, Anderson LE, Glanze WD, eds. Mosby’s Medical, Nursing, and Allied Health Dictionary, 14th ed. St. Louis, CV Mosby, 1994.
Norusis MJ. SPSS/PC+ Advanced Statistics V2.0. Chicago: SPSS Inc., 1988.
National Center for Health Statistics. Current estimates from the National Health Interview Survey, United States, 1982. Vital and Health Statistics Series 10, No. 150, PHS 85-1578. Washington, DC: U.S. Department of Health and Human Services, 1985.
Garibaldi RA. Epidemiology of community-acquired respiratory tract infections in adults: incidence, etiology, and impact. Am J Med. 1985;78(6B):32–7.
Dixon RE. Economic costs of respiratory tract infections in the United States. Am J Med. 1985;78(6B):45–51.
Andrewes CH. Adventures among viruses: III. The puzzle of the common cold. N Engl J Med. 1950;242:235–40.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Luks, D., Anderson, M.R. Antihistamines and the common cold. J Gen Intern Med 11, 240–244 (1996). https://doi.org/10.1007/BF02642483
Issue Date:
DOI: https://doi.org/10.1007/BF02642483