By vgreene, 3 October, 2020 If pertussis strongly suspected based on clinical picture (less severe, typical “whoop” less freq in adolescents/adults), strongly consider tx awaiting test results8
By vgreene, 3 October, 2020 If suspect Group A strep (persistent fever, anterior cervical LN, tonsil exudates, cough absence): ✓RADT +/- cx (cx not routine in adults);2 don’t use abx unless confirmed dx2,3
By vgreene, 3 October, 2020 Vitamin/mineral/home remedies. Honey may improve cough vs placebo or diphenhydramine, but not better than dextromethorphan,7 per ACCP. Evidence lacking on vitamin/herbal remedies3 or nasal saline irrigation as cold tx.2 Insufficient evidence on zinc lozen
By vgreene, 3 October, 2020 Prescription sx relief. Evidence lacking for intranasal steroids, opioids.2 Avoid codeine in
By vgreene, 3 October, 2020 OTC sx relief. Don’t use OTC antitussives, expectorants, NSAIDs, antihistamines, mucolytics, or combos, per ACCP.7 ACP suggests sx relief (antitussives, analgesics); antihistamines alone have more side effects than benefits, yet relief seen in 1/4 pts on
By vgreene, 3 October, 2020 If URI/common cold, most recover in 7-10 days. Weigh risk/benefit of sx relief, given lack of evidence.2 Abx only for confirmed strep throat2,3
By vgreene, 3 October, 2020 Sx: cough, fever, rhinorrhea, congestion, postnasal drip, sore throat, HA, myalgia,2 malaise, sneeze3
