Edward M. Gardner
Date: August 30, 1996
21 yo previously healthy college student presents with 1 day complaint of runny nose, low grade fever, nasal congestion, and malaise.
Clinical Bottom Lines:
1. Use of intranasal ipratropium bromide for the common cold has been shown to yield statistically significant subjective improvement in symptoms.
2. Clinical relevance of these modest improvements remains unclear.
1. A randomized, double-blind, placebo-controlled trial in 274 patients with the common cold of intranasal ipratropium bromide (84ug/nostril) vs. buffered saline carrier 3-4 times daily for four days.
|mean hourly nasal
|hourly avg. change VAS||% improvement||global assess. improve|
|day 1||day 2||day 5|
|ipratropium bromide (n=137)||1.24||26%
1. Clinically relevant outcomes such as missed days of work or school were not assessed.
2. Patient population was primarily young, otherwise healthy individuals.
3. Diagnosis of common cold" had no confirmation with viral cultures.
4. Some data on nasal discharge weights was not included in the analysis.
5. The treatment group had highest use of concomitant treatment with cough suppressants and acetaminophen.
6. Adverse reactions, while not severe, were much more common with treatment:
a. blood tinged discharge 16.8% vs. 3.6% (p=0.0005)
b. nasal dryness 11.7% vs.3.6% (p=0.012)
c. headache 8.8% vs. 1.5% (p=0.011)
1. Hayden FG, Diamond L, Wood PB, et al. Effectiveness and Safety of Intranasal
Ipratropium Bromide in Common Colds: A randomized, Double-Blind, Placebo-Controlled Trial.
Ann Intern Med. 1996;125:89-97.