Treating The Common Cold: An Expert Panel Consensus Recommendation for Primary Care Clinicians

Example Rx Form

Name:__________________________________________________________ Date: _____/_____/_____

Diagnosis: ___ Cold ___ Flu ___ Cough ___ Sore Throat ___ Middle Ear Fluid ___ Other: __________________________________________

You have been diagnosed with a viral illness. Antibiotics do not cure viral infections or lessen the symptoms associated with the illness. If given when not needed, antibiotics can be harmful. The treatments indicated below will help you to feel better while your body's own defenses are fighting the infection.

General Instructions: ___ Drink extra fluids (eg, water, juice, tea, chicken soup). ___ Use a cool-mist room air humidifier and/or saline nasal spray to relieve congestion. ___ Use ice chips, sprays, or lozenges to relieve sore throat pain.

Over-the-Counter Medicines: ___ Nasal congestion: _________________________________ ___ Fever or aches: ___________________________________ ___ Cough: _________________________________________ ___ Sore throat: ______________________________________ ___ Facial pain: ______________________________________ ___ Ear pain: ________________________________________ ___ Other: __________________________________________

Use nonprescription medicines strictly according to package instructions or as directed by your healthcare professional. Stop taking the medication(s) when symptoms resolve.

Follow-Up: ___ If your symptoms have not improved in ___days or have worsened within ___days, if new symptoms occur, or if you have other concerns, please call or return for a recheck. ___ Other: ________________________________________________

Adapted from www.cdc.gov/drugresistance/community.