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Evidence summaries

Antibiotics for the Common Cold and Acute Purulent Rhinitis

Antibiotics are of no significant benefit in the common cold or acute purulent rhinitis, but patients in antibiotic treatment suffer from an increase in adverse effects. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 11 trials with more than 1 800 subjects.

People with common cold receiving antibiotics do no better in terms of lack of cure or persistence of symptoms than those on placebo (RR 0.95, 95% CI 0.59 to 1.51), based on a pooled analysis of six trials with a total of 1 047 participants. The RR of adverse effects in the antibiotic group was 1.8, 95% CI 1.01 to 3.21. Adult participants had a significantly greater risk of adverse effects with antibiotics than with placebo (RR 2.62, 95% CI 1.32 to 5.18) while there was no greater risk in children (RR 0.91, 95% CI 0.51 to 1.63).

The pooled RR for persisting acute purulent rhinitis with antibiotics compared to placebo was 0.73 (95% CI 0.47 to 1.13), based on four studies with 723 participants. There was an increase in adverse effects in the studies of antibiotics for acute purulent rhinitis (RR 1.46, 95% CI 1.10 to 1.94).

    References

    • Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev 2013;6():CD000247. [PubMed].

Primary/Secondary Keywords