A single dose of nasal decongestant in the common cold is moderately effective for the short-term relief of congestion in adults
- Lindbaek, Morten MD, PhD
OBJECTIVE
To assess the effectiveness and adverse effects of nasal decongestants.
METHOD
Systematic review of randomized controlled trials.
FUNDING SOURCE
Cochrane Acute Respiratory Infections Review Group, Australia.
LITERATURE REVIEW
A comprehensive strategy in which MEDLINE, EMBASE and Current Contents were searched up to May 1999. The Cochrane Acute Respiratory Infections Group's trials Register was searched; citations were tracked; and known principal investigators and pharmaceutical companies were contacted.
INCLUSION AND EXCLUSION CRITERIA
Randomized, placebo-controlled trials of single-active oral and topical nasal decongestants in adults and children suffering from the common cold. The outcomes of nasal congestion (subjective and objective) and adverse events were particularly targeted.
DATA EXTRACTION AND SYNTHESIS
Data were independently extracted by two reviewers. Meta-analysis was employed.
MAIN RESULTS
A number of studies were excluded because they contained multiple active agents. Four studies in adults, but none in children, fit all inclusion criteria. In three studies addressing single-dose use, there was a significant 13% decrease in subjective symptoms after decongestant was compared with placebo. This was supported by a significant decrease in nasal airways resistance. Repeated doses of nasal decongestant were not significantly better than placebo at relieving symptoms of nasal congestion.
AUTHORS' CONCLUSIONS
A single dose of nasal decongestant in the common cold is moderately effective for the short-term relief of congestion in adults, while there is no evidence available to show benefit after repeated use over several days. These medications are not recommended for use in young children with the common cold.