Clinical recommendation	Evidence rating	Comments
Over-the-counter cold medications should not be used in children younger than four years because of potential harms and lack of benefit.5,6	B	Lack of benefit in 10 RCTs in children and observational studies of adverse effects
The use of hand sanitizer or hand washing is the most effective way to prevent the common cold.8,9	B	Systematic review of cluster RCTs and observational studies with variable risk of bias
Treatments with established effectiveness for cold symptoms in adults are limited to over-the-counter analgesics and decongestantswith or without antihistamines(but not antihistamine monotherapy).6,22,25,27,31	B	Systematic reviews of RCTs of varying quality
Antibiotics are ineffective for treatment of the common cold in adults and children and should not be prescribed.46,47	A	Consistent findings of no benefit and increased adverse effects in systematic reviews of 11 RCTs
Codeine and other antitussives have not been proven effective for cough in adults.6,48,54	B	Systematic reviews and a clinical practice guideline from the American College of Chest Physicians
Safe and effective treatments for cold symptoms in children include nasal saline irrigation, menthol rub, and honey (for children 12 months and older).39,61,63,65	B	Systematic reviews of RCTs of varying quality