Case Presentation URTI EBM , URTI TreatmentPresented byDr.Ibrahim Alasmari , R1 family medicine.Supervised byDr.Yaia Matter , Family medicine consultant .
32 years old driver Indonesian manpresented with history of cough andgeneralized body ache for 3 days.
HPIPatient was well till three days back when he developedcough ; intermittent , dry ,associated with throatpain, aggravating by exposure to cold fluids and thereis no relieving factors .He is smoker for 10 years .No history of fever .No history of contact with people having chronic cough
No history of contact with T.B patientNo marked decreasing the weightNo history of recent travellingFamily history : non remarkableNo drug history
ExaminationPatient looks well ; not distressed or tachypnicVital Signs : normalNeck : no cervical lymphadenopathyThroat : mildly congestedChest : clearAbdomen : NADNeuromuscular : grossly intact
Treatment :Paracetamol 1gm tab. TID for 5 daysDextromethrphan 10 ml TID for 5 days
EBM for Treatment URTIAntibiotics are not recommended for treatment C.C Inchildren and adult .Evidence ADextromethorphan is a treatment option for adults withcough caused by c.c. Evidence BOral decongestant is the treatment for adult andadolescent for 3 days . Evidence B
Topical ipratropium (Atrovent) is ttt option for nasalcongestion in children older than 6 years and adults.Evidence BCodeine (Robitussin AC) and other narcotics,dextromethorphan (Delsym), antihistamines, andcombination antihistamine/decongestants are notrecommended to treat cough or other coldsymptoms in children. Evidence B
Older first-generation antihistamines and combinationantihistamine/decongestants are treatmentoptions for cough and cold symptoms in adults if thebenefits outweigh the adverse effects. Evidence BAmong available complementary treatments, vitamin Cprophylaxis may decrease the severity andduration of cold symptoms; however, vitaminC, zinc, and Echinacea are not recommended foractive treatment. Evidence B
Nasal irrigation is an effective adjunctive therapy forsymptoms of chronic rhinosinusitis. Evidence ABased on limited evidence, nasal irrigation may be aneffective adjunctive treatment for symptoms of irritantrhinitis, allergic rhinitis, and viral upper respiratorytract infection; and for postoperative care afterendoscopic sinus surgery. Evidence B
Nasal irrigation has been recommended for mild tomoderate rhinitis of pregnancy ,acute rhinosinusitis,sinonasal sarcoidosis,and Wegener granulomatosis.Evidence C .
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