Do sinus cocktails work?

Cough and cold season is upon us, which means I will be asked every day to give a patient a “sinus cocktail.” When I was a young doctor, I had no idea what this was. I didn’t learn about this treatment in medical school. However, I loved the name, as do many people who are miserable from a cold.A “sinus cocktail” is like your mother’s home remedy for a cold. What is in it differs depending on who makes it. As a rule of thumb, it is a mixture of an antihistamine such as Benadryl (diphenhydramine), an injectable steroid (usually a form of prednisone), and an antibiotic (most often amoxicillin).What people seem to like is that it is given as a shot. The pain of the injection seems to have a curative quality. Unfortunately, at best the ingredients have limited effectiveness, even though thousands of people swear by them. Remember, placebos work 40 percent of the time.The Benadryl is no more effective than a pill of the same medicine that you can buy over the counter. It might help for a few hours, but then you’ll need more. The steroid can briefly reduce swelling in the sinuses, but it also has limited effect with only one dose. And the antibiotic has no impact on a virus, which almost always is the cause of a cold or sinus infection.

Upper respiratory infections usually result from an infection caused by one of more than 200 viruses. They are called “colds” because they tend to flourish in low humidity and colder temperatures. There is no cure. They must run their course, which can take seven to 10 days. This means the best approach is finding ways to deal with the symptoms: sore throat, runny nose, facial pain and just feeling bad.

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The Centers for Disease Control and Prevention website strongly recommends only two treatments — rest and lots of water. But what else works? These days the in-vogue “treatment” is essential oils. There is no science that shows these work, but many people find comfort in using them. Of course, there are many choices, and they all have their champions. Acupuncture and Chinese herbs have been shown to have some positive effect, but this is something I have limited experience with.

Unfortunately, young children average between four and six colds a winter, while adults get two or three. Some are worse than others. When you have a nasty one, it is easy to understand why people seek relief in things like sinus cocktails.

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Washing your hands well during cold season is the best way to prevent colds. If you get one, treat the symptoms to make yourself more comfortable while the virus runs its course rather than expect a fast-track cure. Use acetaminophen for pain. Saline nose sprays and Neti pots can help open up sinus passages. Decongestants and antihistamines can be useful. No one brand is better than another. I always get the cheapest for myself.Before you go the route of putting your desperate hope in a one-shot sinus cocktail, remember that many truck stops offer sinus cocktails for $25. That should give you pause.

Rev. Dr. G. Scott Morris, M.D., is founder and chief executive officer of Church Health.

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