Upper respiratory tract infection
Upper respiratory tract infections are considered to be the infection of
the airway above the glottis or vocal cords. This includes the nose,
sinuses, pharynx, and larynx, including the infection of tonsillitis,
pharyngitis, laryngitis, sinusitis, otitis media, etc,.
F. Treatments
F.1. In conventional medicine perspective
1. No specific treatment if the infection is resulted of viral
infection, but certain medication can be prescribed to reduce the
symptoms, such as
a. Acetaminophen and Nonsteroidal used to reduce fever and body aches.
In the study to evaluate the risk factors for developing allergic
reactions to alternative drugs such as acetaminophen and nimesulide in
367 patients intolerant of nonsteroidal anti-inflammatory drugs (NSAID)
compared to 243 healthy controls, showed that test doses (TD) TD was
positive in 49 of 367 (14%) NSAID-allergic patients and in one (0.4%) of
the controls (P<0.001). No difference was found in age and sex
between the TD-positive and TD-negative subjects, although a
significantly larger number of females were NSAID allergic
(P<0.01)(31).
b. Antihistamines used to decrease nasal secretions and congestion
There is no evidence to determine whether the use of antihistamines,
decongestants or nasal irrigation is efficacious in children with acute
sinusitis(32).
c. Nasal ipratropium for diminishing nasal secretions
Rhinorrhea and nasal congestion are simultaneous symptoms associated
with the common cold. Both the ipratropium combination treatments had
significantly lower tissue use than the xylometazoline treatment group
(p < 0.0001). Adverse events were distributed equally between the
treatments, except mucus tinged with blood, epistaxis, nasal passage
irritation, and nasal dryness, which had a higher incidence in the three
groups that received medicines containing ipratropium(33).
d. Cough suppressants to reduce cough
In an observational study on acute cough associated with upper
respiratory tract infection (URTI) in children, showed that acute cough
disturbs sleep in most children and their parents. Both levodropropizine
and central antitussives reduced cough intensity, with levodropropizine
producing a higher cough resolution rate(34).
e. Steroids
Intranasal corticosteroids offer a small therapeutic benefit in acute
sinusitis, which may be greater with high doses and with courses of 21
days’ duration(35).
f. Etc.
2. Antibiotics
Antibiotics are used only in treating upper respiratory infections
caused by bacterial infection. In the study to examine the use of
antibiotics and other prescription medications for the common cold in a
Medicaid population seen in ambulatory care settings, showed that
majority of persons receiving medical care for the common cold are given
prescriptions for an unnecessary antibiotic. Unchecked, this practice
may lead to greater antibiotic resistance and unnecessary use of health
care resources(36).
3. Inhaled epinephrine
Epinephrine, a hormone and a neurotransmitter, is sometimes used
in children with bronchospasm to reduce spasm. According to the study
by Royal Aberdeen Children’s Hospital, Aberdeen, functional airway
problems (laryngospasm, bronchospasm, insufficient depth of anesthesia
and muscle rigidity, gastric hyperinflation, and alveolar collapse)
require urgent recognition and treatment algorithms due to insufficient
oxygen reserves. Early muscle paralysis and epinephrine administration
aids resolution of these functional airway obstructions(37).
4. Surgery
Rarely, surgical procedures may be necessary in cases of complicated
sinus infections. Maxillary sinus inflammation, when untreated or
incorrectly treated, may extend locoregionally, the remaining paranasal
sinuses being the first affected anatomical structures. Inflammations of
the paranasal sinuses are susceptible to develop complications in
certain conditions and threaten the patient’s life due to the proximity
of vital structures(38).
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Sources
(31) http://www.ncbi.nlm.nih.gov/pubmed/9788690
(32) http://www.ncbi.nlm.nih.gov/pubmed/22972113
(33) http://www.ncbi.nlm.nih.gov/pubmed/17283559
(34) http://www.ncbi.nlm.nih.gov/pubmed/22269875
(35) http://www.ncbi.nlm.nih.gov/pubmed/22585889
(36) http://www.ncbi.nlm.nih.gov/pubmed/8627203
(37) http://www.ncbi.nlm.nih.gov/pubmed/22499162
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