What are the recommended management strategies for a patient presenting with symptoms of a common cold?

Recommended management strategies for a patient presenting with symptoms of a common cold include:

• Offer self-care advice: Advise the patient that symptoms can usually be managed at home, explain the likely duration of illness, and inform them when and how to seek further medical help if symptoms worsen rapidly, do not improve, or they become systemically very unwell.
• Assess for severity and risk factors: Evaluate if symptoms suggest a more serious illness (e.g., pneumonia) or if the patient has comorbidities or is immunosuppressed, which may require face-to-face assessment.
• Avoid routine antibiotic prescribing: Do not routinely prescribe antimicrobials for common cold symptoms as these are usually viral infections and antibiotics are not indicated.
• Use clinical judgement and CRP testing if lower respiratory tract infection is suspected: If it is unclear whether antibiotics are needed, consider a point-of-care C-reactive protein (CRP) test to guide prescribing decisions.
• Remote assessment considerations: If assessment is remote, ensure the patient understands when to seek further help and only prescribe antibiotics remotely if there is a sound clinical reason and the risk of alternative diagnoses is low.

These strategies aim to manage symptoms effectively while minimizing unnecessary antibiotic use and ensuring patient safety through appropriate assessment and follow-up advice.

All recommendations are based on NICE guideline NG237: Suspected acute respiratory infection in over 16s: assessment at first presentation and initial management.

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