Importance of Early Treatment
Early Continuous Treatment Strategy
The best strategy for treating a cold is to start treatment as soon as there is the recognition that a cold is beginning and to continue treatment on a regular basis until it appears that the cold is over (3-7 days).
The rationale for early continuous cold treatment is based on 1) the known time course of uncomplicated and untreated colds and 2) the known spread of the cold from the nasal passages into the sinuses and middle ear.
Cold symptoms appear as early as 10 hours after a cold infection has started and increase in frequency and severity for 48 hours. (2, 13) After 48 hours, the symptoms usually begin to decline as the result of the natural course of the illness. For this reason, a cold treatment will do the most good when taken at the first recognition of symptoms. The treatment is thus applied over the period when most illness is expected (the first 3 days of infection).
A CAT scan of a patient with a cold involving the sinuses. The arrows point to thick fluid in the sinus cavities. Normally, the sinuses are full of air and appear black (see Anatomy).
A second reason for adopting early continuous cold treatment is that colds routinely involve the sinuses. Up to 87% of patients with early uncomplicated colds had thick fluid in the sinus cavity on CT scan examination. (40) Nose blowing creates high pressure in the nose and propels nasal fluid into the sinuses. (41) Nose blowing may be a cause of sinus disease in colds. Early continuous treatment reduces the frequency of sneezing and the amount of nasal secretions, thus reducing the need for nose blowing. (21-23)
During colds, up to 75% of patients have abnormal function of the eustachian tube (the tube connecting the back of the throat to the middle ear) and abnormal pressures in the middle ear. (42-45) Early and continuous treatment of colds may also reduce the frequency of ear complications, but no studies have been done on this question.