Colds

The common cold is an acute, mild and a self-limiting condition. The most frequent symptoms are nasal discharge, nasal obstruction, sore or irritating throat, headache, and cough. Roughness, loss of taste and smell, as well as a loss of feeling of pressure in the ears as a result of obstruction and/or mucosal swelling may also occur. incidences rise in the UK  between December and January and symptoms typically resolve in seven to ten days but can last for up to three weeks

Differential diagnoses
  • Non-allergic rhinitis would present with chronic nasal discharge, again of watery consistency.
  • Influenza is characterised by systemic symptoms, including an increased temperature, fevers, severe aches and headaches.
  • Symptoms of meningitis should be checked in infants and refer urgently or call 999 if in any doubt.


Red Flags
  • Infants less than three months old are susceptible to secondary bacterial infection. Should also also refer them if having difficulty feeding.
  • If pneumonia is suspected for example if an infant or elderly person who appears significantly more unwell than usual 
  • If meningitis or septicaemia is suspected
  • Children who may have a foreign body in their nose – purulent discharge, usually from only one side of the nose and without other cold symptoms.


Paracetamol is the first-line choice; its anti-pyretic and analgesic properties will help to relieve symptoms.

Care must be taken to avoid duplication of doses of paracetamol as it is contained in many OTC compound preparations.

Reinforce the maximum dose of paracetamol which may be taken in 24 hours when supplying paracetamol to patients.

Ibuprofen and aspirin may be recommended as alternatives.

Aspirin should not be used in children under the age of 16 years due to Reye’s syndrome.

Topical nasal decongestants, e.g. ephedrine, oxymetazoline and xylometazoline (not used aged under 12 years), have an immediate beneficial effect on reducing nasal stuffiness.

Prolonged regular use may cause rebound congestion resulting in continued inappropriate use.

Simple cough remedies (containing glycerine, honey, or lemon) are still licensed for use. Alternatively, for children over the age of one year, a warm drink of honey and lemon could be given.