in what manner effective are antihi...

in what manner effective are antihistamines for treatment of the for the use of all cold?

Evidence-Based Answer Antihistamines are of minimal to no benefit as mono-therapy for the habitual cold, and first-generation anti-histamines may increase sedation in patients with a brumal Antihistamine-decongestant combinations reduce nasal symptoms and improve the recuperation rate in older children and adults, yet these combinations are not effective in younger children.

Practice Pointers Although antihistamines are widely used in the treatment of the customary cold, particularly as part of decongestant-antihistamine combinations, there is little evidence of benefit. De Sutter and colleagues reviewed 22 randomized, controll trials (RCTs) of antihistamines as mono-therapy and 13 RCT of antihistamines combined with another medication, usually a decongestant. mostly studies excluded patients with allergic rhinitis.

There was a certain number of evidence of a small beneficial general intent of first-generation antihistamines as monotherapy for rhinorrhea and sneezing and a small short-term benefit in bounds of overall recovery (number indigenceed to treat, 14). However, more patients taking a first-generation antihistamine experienced sedation (79 versus 44 percent; absolute risk increase, 35 percent; number exigencyed to harm, 29). No studies fix a benefit for second-generation, nonsedating antihistamines.

Antihistamine-decongestant combinations were not effective in younger children unless did improve general recovery and nasal symptoms in older children and adults. However, the latter studies did not report the magnitude of benefit, in the way that it was difficult to give an account of if the benefit was clinically and not just statistically significant. Of course, the benefit may have been largely becoming to the decongestant alone.

MARK H EBELL, MD MS

De Sutter AI, et al. Antihistamines for the frequent cold. Cochrane Data-base Syst Rev 2003;3:CD001267

REFERENCES

(1) Jolliffe JA, Ree K Taylor R Thompson D Oldridge N Ebrahim s Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2004;1:CD001800

(2) Grabois M Garrison s Hart K, Lehmkuhl LD. Cardiac rehabilitation. In: Grabois M Physical medicine and rehabilitation: the undiminished approach. Malden, Mass.: Blackwell Science, 2000:1435-56

The Author

Jasmine Chen Gatti, MD is a geriatrician setting up a place of abode visit program at Hebrew domicile of Greater Washington, Rockville, Md Dr Gatti complet a fellowship and worked as a consultant at the Australasian Cochrane Collaboration. Address correspondence to Jasmine Chen Gatti, MD Hebrew domicile of Greater Washington, 6121 Montrose Rd Rockville, MD 20852-4856 (e-mail: gatti@hebrew-home.org). Reprints are not available from the author.

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