Questions have been raised about the advice given to patients with a cold and sore throat, in research published in the British Medical Journal.

A study carried out by the University of Southampton showed that compared with paracetamol, ibuprofen or a combination of both ibuprofen and paracetamol provide no advantage for patients overall with respiratory tract infections (otherwise known as colds or sore throats).

Additionally steam inhalation, another common treatment method, has no clear benefit and around 2 per cent of people get mild scalding but not bad enough to see a doctor.

Professor Paul Little, who led the study, comments: “Paracetamol, ibuprofen or a combination of both are the most common courses of treatment for respiratory tract infections. Clinicians should probably not advise patients to use steam inhalation in daily practice as it does not provide symptomatic benefit for acute respiratory infections and a few individuals are likely to experience mild thermal injury. Similarly, routinely advising ibuprofen or ibuprofen and paracetamol together than just paracetamol is also not likely to be effective. However our research has shown that ibuprofen is likely to help children, and those with chest infections.”

The research also showed that patients were more likely to come back within a month with worsening symptoms or new symptoms if they were prescribed with ibuprofen or ibuprofen with paracetamol. Between 50 per cent and 70 per cent of participants in the study who were prescribed ibuprofen or ibuprofen with paracetamol came back.

Professor Little admitted this was a surprising result and suggests the treatment may contribute to the progression of the illness. He adds: “This may have something to do with the fact the ibuprofen is an anti-inflammatory. It is possible that the drug is interfering with an important part of the immune response and leads to prolonged symptoms or the progression of symptoms in some individuals. Although we have to be a bit cautious since these were surprise findings, for the moment I would personally not advise most patients to use ibuprofen for symptom control for coughs colds and sore throat.”

The randomised control trial recruited 899 patients who presented at their GP with respiratory tract infection symptoms. They received different treatment types; paracetamol, ibuprofen or a combination of both. Participants were then told to either take it as needed or at regular intervals (four times a day) and some were also told to take steam inhalation.

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The study was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme.

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Becky Attwood
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44-075-454-22512
University of Southampton