Dr. Town’s Recommended Treatments for Upper Respiratory Infections (URIs)

Most URIs are viral in nature which means that antibiotics are not useful and can sometimes even cause harm, such as rash, severe diarrhea, or allergic reactions. Instead, we focus on reducing your symptoms so your immune system can do its job and take care of the infection on its own. 

Signs that it could be bacterial instead of viral and you may need an antibiotic:

• Symptoms last more than 10-14 days

• You get “second sickening” which means you start to get better and then all of a sudden get a lot worse

• Strep throat – normally seen with high fever, pus pockets on the tonsils, and swollen glands in the neck. There is NO cough, congestion, or runny nose. Presence of these makes it much more likely to be viral.

Treatment based on symptoms:

• Congestion

  • Sudafed (30-60 mg every 6-8 hours) is a decongestant. You must show your ID at the pharmacy counter. It can increase your blood pressure so check with Dr. Town before you take this.

  • Afrin (one spray per nostril twice daily for NO MORE THAN 3 days) is a decongestant that can help with a severely stuffy nose, especially at night.

  • Antihistamines: Zyrtec/Claritin/Allegra (once daily; non-sedating) and Benadryl (25-50 mg every 6 hours as needed; sedating). These work best for those that also have allergies

  • Nasal Sinus Rinse: Neti pots are sold over the counter and can help greatly with congestion. Make sure you use boiled or bottled water ONLY in these pots and wash them thoroughly after each use.

  • For children: NO DECONGESTANTS. Vaporub can be helpful on the chest or feet, nasal saline (Little Noses) and suctioning with a bulb suction or “Nosefrida” is best for infants, especially before each feeding

• Cough

  • Honey reduces both cough and sore throat. It is also helpful in warm drinks like tea. For kids over 1 year of age: 1 tsp of honey before bed-time or a honey-containing cough medication like Zarbees or Chestal Honey works well

  • Dextromethorphan (20 mg every 6 hours) contained in Delsym or Robitussin is the most effective cough syrup and is as beneficial as codeine containing syrups with less side effects

  • Tessalon Perles (200 mg every 8 hours) reduces the cough reflex by anesthetizing the lung and trachea

  • Mucinex (1200 mg twice daily). Helps to thin out the mucous. You can also use Mucinex DM which combines Mucinex with dextromethorphan.

• Pain/Aches/Chills – ask about children’s dosing

  • Anti-inflammatories: Ibuprofen (600-800 mg every 8 hours) You can take this as long as you are not on any other anti-inflammatory medications and don’t have kidney disease

  • Acetaminophen: Tylenol (1000 mg every 6-8 hours). You can take this as long as you are not taking combination medications that contain Tylenol and don’t have liver disease.

  • Advil Cold and Sinus (1-2 tablets every 4-6 hours) – this combines ibuprofen with Sudafed

  • Tylenol Cold and Flu (2 capsules every 4 hours) – this combines Tylenol with dextromethorphan, Sudafed, and Mucinex

  • Take care not to take these combinations with other medications unless you check with Dr. Town first

• Sore Throat

  • Chloraseptic spray or cepacol lozenges numb the back of the throat

  • Warm Salt Water gargles: mix one teaspoon of table salt in warm water and gargle for 30 seconds 3 times per day

  • Vaporub on the neck, covered loosely with a bandana or scarf overnight

Most importantly, GET PLENTY OF SLEEP, wash your hands frequently and use hand sanitizer to prevent spreading the virus and give it some time. If not getting better, let me know. Other treatments may be recommended or restricted based on your personal medical history and medications.