THE COMMON COLD - EFFECTS OF INTRANASAL FLUTICASONE PROPIONATE TREATMENT

Objective: A double-blind, randomized, placebo-controlled trial was co nducted to study the effect of the intranasal corticosteroid, fluticas one propionate (FP), in the naturally occur ring common cold. Methods: One hundred ninety-nine young adults received high-dose FP (200 mu g four times daily) or placebo beginning 23 to 48 hours after onset of t he common cold for 6 days. All symptoms were recorded on diary cards o n days 1 to 20, and clinical examinations were carried out on days 1, 7, and 21, Nasopharyngeal aspirates were collected on days 1 and 7 for detection of rhinoviruses (found in 105 subjects) and Streptococcus p neumoniae, Haemophilus influenzae, or Moraxella catarrhalis (found in 52 subjects) in the nasopharynx. Results: In general, FP treatment had no clinically recognizable effects on the symptoms of the common cold , although it significantly reduced nasal congestion and cough on some study days. After treatment, rhinoviruses were cultured more often in the FP treatment group (37% vs 14%, p < 0.001), but this had no Effec t on the symptoms of common cold. FP treatment produced no changes in the colonization of pathogenic bacteria in the nasopharynx. Some sympt oms of common cold were significantly more severe during days 1 to 10 (p < 0.05) in subjects found to have positive cultures for S. pneumoni ae, H. influenzae, or M. catarrhalis in the nasopharynx on day 1 (n = 33). Conclusion: FP treatment does not have any marked effects on the symptoms of the common cold. FP treatment induced prolonged shedding o f viable rhinoviruses. Some symptoms of the common cold were significa ntly more severe in subjects with pathogenic bacteria in the nasophary nx.