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Cited by 177Respiratory viral infections researchHerbal Medicine Research StudiesPediatric health and respiratory diseases

Antihistamines for the common cold

Open access
De Sutter, An IM, Saraswat, Avadhesh, van Driel, Mieke L·2015·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd009345.pub2PMC PMC9468790
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Abstract

BACKGROUND: The common cold is an upper respiratory tract infection, most commonly caused by a rhinovirus. It affects people of all age groups and although in most cases it is self limiting, the common cold still causes significant morbidity. Antihistamines are commonly offered over the counter to relieve symptoms for patients affected by the common cold, however there is not much evidence of their efficacy. OBJECTIVES: To assess the effects of antihistamines on the common cold. SEARCH METHODS: We searched CENTRAL (2015, Issue 6), MEDLINE (1948 to July week 4, 2015), EMBASE (2010 to August 2015), CINAHL (1981 to August 2015), LILACS (1982 to August 2015) and Biosis Previews (1985 to August 2015). SELECTION CRITERIA: We selected randomised controlled trials (RCTs) using antihistamines as monotherapy for the common cold. We excluded any studies with combination therapy or using antihistamines in patients with an allergic component in their illness. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We collected adverse effects information from the included trials. MAIN RESULTS: We included 18 RCTs, which were reported in 17 publications (one publication reports on two trials) with 4342 participants (of which 212 were children) suffering from the common cold, both naturally occurring and experimentally induced. The interventions consisted of an antihistamine as monotherapy compared with placebo. In adults there was a short-term beneficial effect of antihistamines on severity of overall symptoms: on day one or two of treatment 45% had a beneficial effect with antihistamines versus 38% with placebo (odds ratio (OR) 0.74, 95% confidence interval (CI) 0.60 to 0.92). However, there was no difference between antihistamines and placebo in the mid term (three to four days) to long term (six to 10 days). When evaluating individual symptoms such as nasal congestion, rhinorrhoea and sneezing, there was some beneficial effect of the sedating antihistamines compared to placebo (e.g. rhinorrhoea on day three: mean difference (MD) -0.23, 95% CI -0.39 to -0.06 on a four- or five-point severity scale; sneezing on day three: MD -0.35, 95% CI -0.49 to -0.20 on a four-point severity scale), but this effect is clinically non-significant. Adverse events such as sedation were more commonly reported with sedating antihistamines although the differences were not statistically significant. Only two trials included children and the results were conflicting. The majority of the trials had a low risk of bias although some lacked sufficient trial quality information. AUTHORS' CONCLUSIONS: Antihistamines have a limited short-term (days one and two of treatment) beneficial effect on severity of overall symptoms but not in the mid to long term. There is no clinically significant effect on nasal obstruction, rhinorrhoea or sneezing. Although side effects are more common with sedating antihistamines, the difference is not statistically significant. There is no evidence of effectiveness of antihistamines in children.

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Crossref · 10.1002/14651858.cd009345.pub2

Cites

79 of 79 references verified0 citation errors · 0 not checkable

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  • Analgesics, decongestants, and antihistamines have some effect in monotherapy.

    “Analgesics, decongestants, and antihistamines have some effect in monotherapy (Deckx 2016; De Sutter 2015; Eccles 2006b).”

    From Oral antihistamine-decongestant-analgesic combinations for the common cold (2022) · cites this paper as De Sutter 2015

    The sections on antihistamine monotherapy for adults and rhinorrhoea report small effects of sedating antihistamines on rhinorrhoea and sneezing. But the review finds no clinically significant overall benefit, and non-sedating antihistamines showed no effect on rhinorrhoea. Because this citation is one of three attached to the sentence, this verdict concerns its support for antihistamines, not the separately cited analgesics and decongestants. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • There is no evidence of H1 antihistamine efficacy in the common cold.

    “Similarly, there is no evidence of efficacy in the common cold [145].”

    From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [145]

    The Authors’ Conclusions say there is insufficient evidence to support using antihistamines to alleviate common-cold symptoms, but they also report a limited benefit during the first two days of treatment. Thus, saying there is *no* evidence of efficacy overstates the review’s conclusion. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • First-generation antihistamines have a limited effect on rhinorrhoea and sneezing.

    “There is a small amount of evidence that first‐generation antihistamines have a limited effect on rhinorrhoea and sneezing (De Sutter 2015).”

    From Oral antihistamine-decongestant-analgesic combinations for the common cold (2022) · cites this paper as De Sutter 2015

  • De Sutter 2015 concluded that antihistamines have a limited short-term beneficial effect on severity of overall symptoms.

    “De Sutter 2015 concluded that antihistamines have a limited short‐term beneficial effect on severity of overall symptoms”

    From Oral antihistamine-decongestant-analgesic combinations for the common cold (2022) · cites this paper as De Sutter 2015

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Cites

2 retracted

Flagged first, then by citations

5 of the 84 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Innes JA, Reid PT. Respiratory disease. Davidson's Principles & Practice of Medicine. 20th Edition. Churchill Livingstone Elsevier, 2006:687-9.
  2. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.

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Authors
De Sutter, A. I., Saraswat, A., & van Driel, M. L.
Affiliations
  • Ghent University; Department of Family Medicine and Primary Health Care; De Pintelaan 185 UZ 1K3 Ghent Belgium B-9000
  • Queensland Health (AU)
ORCID
Saraswat, Avadhesh
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2015-11-29
Volume
2015
Issue
11
Pages
CD009345-CD009345
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd009345.pub2
PMC
PMC9468790
OpenAlex
W2163813716
Cited by
177
References
84
Citations by year
2026: 2 · 2025: 5 · 2024: 5 · 2023: 16 · 2022: 11 · 2021: 15 · 2020: 13 · 2019: 6 · 2018: 9 · 2017: 13 · 2016: 8 · 2015: 5 · 2014: 10 · 2013: 6 · 2012: 5
FWCI
1.52
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
  • Health Sciences › Medicine › Complementary and alternative medicine › Herbal Medicine Research Studies
  • Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
Keywords
antihistamines, common cold, upper respiratory tract infection, rhinovirus, symptom severity, nasal congestion, rhinorrhea, sneezing, sedating antihistamines, over-the-counter drugs, adverse effects, children, adults, placebo comparison, monotherapy
MeSH terms
Adult, Child, Common Cold, Histamine Antagonists, Humans, Time Factors, Randomized Controlled Trials as Topic

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