Question

What is the efficacy of corticosteroids for the common cold in children and adults?

Relevance to nursing care

The common cold is one of the most widespread infectious diseases in the world. Nurses are often approached by patients regarding treatment options for the common cold. Therefore, it is essential for nurses to be updated on the best available evidence regarding the use of medication for the common cold.

Study characteristics

This summary is based on the results of a Cochrane systematic review.1 Two randomised, double-blind controlled trials containing 253 participants were included in the review. Participants were children and adults with the common cold, as defined by clinical diagnosis. The intervention of interest was oral or inhaled corticosteroids versus standard care such as decongestants and antihistamines or placebo. The primary outcomes measured were the proportion of participants with resolution or improvement of symptoms and time lapse before resolution. Both trials reported complete outcome data, a low risk for reporting bias and described procedures for allocation concealment; however, they did not report randomisation and blinding processes in detail.

Both studies compared intranasal corticosteroids with placebo in adults. Meta- analysis was not possible due to different formulations of intranasal steroids for different durations and the absence of comparable outcome measures. The major review findings were presented in narrative form and are as follows:

* No evidence of benefit was found in improvement of severity of symptoms, mean time to resolution of symptoms of the common cold and the duration of symptoms in patients using intranasal corticosteroid (two trials).

* No significant difference was found in the duration of sore throat and cough in participants using intranasal corticosteroid compared to placebo (one trial).

* There were no differences in the adverse effects of corticosteroids (two trials).

* There were no studies located that focused on children and corticosteroid use.

Implications for nursing care

Evidence from a systematic review of two studies does not currently support the use of intranasal corticosteroids for symptomatic relief from the common cold. Therefore, nurses are required to seek other interventions in treating the common cold and in building up the patients' immune system against it.

Implications for research

Large double-blind, placebo-controlled trials in both adult and paediatric populations are recommended to obtain an informed decision with respect to the efficacy/safety of corticosteroids in the common cold.

Reference