Common cold: too many unnecessary or even dangerous drug prescriptions

Sore throat, runny nose or stuffy nose… It is estimated that between 20 and 25% of the population is affected by a cold each year. An infection that is almost always mild, but which is nevertheless the subject of too many, unnecessary or even dangerous drug prescriptions, “representing both a danger in terms of public health and risk of individual adverse effects, and an unjustified cost in terms of health expenditure”. This is what the National Academy of Medicine and the National Academy of Pharmacy denounce in a report published on October 22, 2020.

Common cold: treatments with unproven effectiveness and potentially dangerous

While the common cold generally resolves spontaneously in less than 15 days and complications are rare (less than 2%), it leads to the taking of treatments, most often on the advice of a pharmacist or on self-medication, “not having demonstrated real efficacy and inducing potentially serious undesirable effects”: Antibiotic resistance, heart attack and stroke with nasal decongestants, etc. “Antibiotics are ineffective as a first-line treatment in this indication and the benefit / risk ratio is not very favorable to them; oral or local corticosteroid therapy is not justified; nasal decongestants are effective on nasal obstruction but their prescription should be limited due to side effects”, Says the report.

A significant economic cost

This “inappropriate drug use“, with “over 11 million boxes of antibiotics”Sold each year in France during the winter, also entails a significant economic cost:“The observed correlation between the consumption of antibiotics or corticosteroids with the seasonality of ‘flu-like symptoms’ suggests that the cost of winter infections could be estimated at 26.6 million euros per year for amoxicillin and amoxicillin with acid clavulanic and more than 41 million euros per year including pristinamycin”, Notes the report, which underlines that“these are only a part of the drugs consumed in such clinical situations, whereas these infections do not usually justify the prescription of drug”.

Towards better information for the general public and healthcare professionals

Reporting “a worrying discrepancy between a trivial condition, which resolves spontaneously in the vast majority of cases, manifestly excessive drug consumption, and a major cost in terms of public health expenditure”, The Academy of Medicine and the Academy of Pharmacy recommend the creation of a National Cold Observatory (ONR), “in order to collect reliable data in terms of epidemiology and drug consumption”From pharmacists and doctors.

They further suggest that the latter are better informed about the proper use of cold medicine, by limiting in particular “the use of vasoconstrictors because of their adverse effects, suggesting that they should only be dispensed on medical prescription“, as well as “the use of corticosteroid therapy most often unsuitable”.

Finally, they believe that the general public must be better informed “the dangers of self-medication and the dangerousness and ineffectiveness of many treatments used for colds. This information could be provided by the ANSM”. The National Medicines Safety Agency has published a document in this regard giving “practical advice and precautions to take with regard to certain medications in case of a cold”. Furthermore, “for the second year in a row, patients who wish to use a vasoconstrictor drug to relieve the symptoms of their cold will be given by their pharmacist an information sheet on the risks associated with these treatments and the precautions to be observed during their use. Likewise, pharmacists will have a dispensing aid document. “

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