Common cold
Also called: cold, head cold, acute nasopharyngitis, viral upper respiratory tract infection, zukam / nazla (Urdu)
The common cold is a mild virus infection of the nose and throat. It causes a runny or blocked nose, sneezing, sore throat and cough, and gets better on its own in about a week or two. Antibiotics do not help; rest, fluids and simple medicines ease the symptoms.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
The common cold is a mild infection of the upper airways (the nose and throat). It is caused by viruses. More than 200 different viruses can cause a cold, and rhinoviruses are the most common. It is the most common short-term illness in many countries, and it is the most common reason children miss school.
Cold viruses pass from person to person in tiny droplets when someone coughs, sneezes or blows their nose. You can also pick up the virus by touching a surface that has the virus on it and then touching your nose, eyes or mouth. Symptoms usually start two to three days after catching the virus. People spread the infection most easily in the first two to three days of being ill. Colds are more common in winter and in the rainy season.
Most colds are worst in the first two to three days and then slowly get better. Most symptoms settle within about 7 to 10 days, but a runny nose and cough can last up to two weeks, and a cough can sometimes linger for three to four weeks. There is no cure. The body clears the virus by itself. Antibiotics do not work against viruses, so they do not help a cold and can cause harm. Treatment aims to ease the symptoms while the body recovers.
In Pakistan: what studies show
In one Quetta hospital clinic, 69.80% of prescriptions for upper respiratory tract infections (a group that includes colds) had an antibiotic. In public surveys, 62.5% of adults in Islamabad and 47.5% in Punjab wrongly believed antibiotics work against colds and flu.
- In one military hospital outpatient department in Quetta in 2021, 69.80% of prescriptions for upper respiratory tract infections (URTI, a group that included the common cold) contained an antibiotic, which the authors said did not follow guidelines.[1] (cross-sectional prescription review, data 1 Mar 2021 - 31 May 2021)
- In a 2017 study of children in five public hospitals in Lahore who were given antibiotics for airway and chest infections, only 13.1% of the antibiotics went to children with upper respiratory tract infections (URTI); most went to children with lower (chest) infections.[5] (multicentre cross-sectional, data 1 Jan 2017 - 30 Jun 2017)
- In one hospital study of 314 otherwise healthy children with URTI (fever, cough or runny nose for 5 days or less) seen in a children's clinic and emergency department, only 6.7% were given an antibiotic at the first visit under an antibiotic stewardship approach.[6] (hospital-based outcome study, data not stated)
- When researchers posing as parents asked drugstores in Lahore for help with a child's upper respiratory infection (URI) in 2019-2020, antibiotics were handed over without a prescription in 197 visits, which was 50.9% of those visits.[4] (cross-sectional simulated client study, data 1 Nov 2019 - 31 Jan 2020)
- In a 2020 survey of 480 adults in Islamabad, 32.5% had taken antibiotics without a prescription (self-medication); the study lists illnesses such as cough or cold, runny nose, flu, sore throat, diarrhoea and fever (this figure covers all illnesses, not only colds).[2] (cross-sectional interview survey, data Feb 2020 - Jul 2020)
- In the same 2020 Islamabad survey, 62.5% of adults wrongly believed that antibiotics are useful to treat colds and the flu.[2] (cross-sectional interview survey, data Feb 2020 - Jul 2020)
- In a survey of 2,106 members of the public in Punjab, 47.5% believed antibiotics work against cold and flu.[3] (cross-sectional survey, data not stated)
- In the same Punjab survey, nearly 60% of people said they had taken antibiotics without a prescription (for any illness, not only colds).[3] (cross-sectional survey, data not stated)
What we do not know yet: No national survey or official data were found on how often adults or children in Pakistan get colds or URTI; the studies here are from single cities or hospitals, and most group colds with other URTIs. Self-medication estimates differ between surveys (32.5% in Islamabad vs nearly 60% in Punjab), and no Pakistan guideline for colds was found.
Pakistan studies cited
- Hashmi H, Sasoli NA, Sadiq A, et al. Prescribing Patterns for Upper Respiratory Tract Infections: A Prescription-Review of Primary Care Practice in Quetta, Pakistan and the Implications. Frontiers in Public Health 2021;9:787933. doi:10.3389/fpubh.2021.787933. PMID 34869195. Open source
- Aslam A, Zin CS, Jamshed S, et al. Self-Medication with Antibiotics: Prevalence, Practices and Related Factors among the Pakistani Public. Antibiotics (Basel) 2022;11(6):795. doi:10.3390/antibiotics11060795. PMID 35740201. Open source
- Gillani AH, Chang J, Aslam F, et al. Public knowledge, attitude, and practice regarding antibiotics use in Punjab, Pakistan: a cross-sectional study. Expert Review of Anti-Infective Therapy 2021;19(3):399-411. Open source
- Malik UR, Chang J, Hashmi F, et al. A Simulated Client Exploration of Nonprescription Dispensing of Antibiotics at Drugstores for Pediatric Acute Diarrhea and Upper Respiratory Infection in Lahore, Pakistan. Infection and Drug Resistance 2021;14:1129-1140. Open source
- Iftikhar S, Sarwar MR, Saqib A, et al. Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan. Medicina (Kaunas) 2019;55(2):44. doi:10.3390/medicina55020044. Open source
- Khan EA, Raja MH, Chaudhry S, et al. Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections. Pakistan Journal of Medical Sciences 2020;36(4):642-646. doi:10.12669/pjms.36.4.1420. Open source
Symptoms
- Runny nose or blocked (stuffy) nose
- Sneezing
- Sore or scratchy throat
- Cough
- Mucus from the nose that starts clear and may turn thick, yellow or green after two to three days; this is normal
- Mucus dripping down the back of the throat (postnasal drip)
- Mild fever or no fever in adults; young children more often have a fever
- Headache, body aches and feeling tired or generally unwell
- Less appetite than usual
Causes and risk factors
Causes
- Viruses: more than 200 types can cause a cold, and rhinoviruses are the most common
- Breathing in tiny droplets released when an infected person coughs, sneezes or blows their nose
- Touching a surface or object that has the virus on it, then touching your nose, eyes or mouth
- Close personal contact with someone who has a cold, especially in the first two to three days of their illness
What makes it more likely
- Being a young child, especially one in a nursery, day care or school with many other children
- Close contact with people who have a cold at home, school or work
- Winter and the rainy season, when colds are more common
- Not washing hands often, and touching the face with unwashed hands
- Breathing in other people's cigarette smoke (second-hand smoke)
- Asthma or other long-term lung disease, which a cold can make worse
- Long-term heart, kidney, liver or lung disease, a weak immune system, or older age, which raise the risk of complications
Complications
Most colds get better without any problems. A cold is the most common trigger for wheezing in children with asthma, and it can make other long-term lung or heart conditions worse for a while. Sometimes the infection spreads or another infection follows, such as a middle ear infection (otitis media), a sinus infection (sinusitis), a chest infection (bronchitis) or, less often, pneumonia (infection of the lungs). A cough can last for three to four weeks after the cold itself has gone. Taking antibiotics that are not needed is itself a risk: they can cause side effects such as diarrhoea, allergic reactions and a serious bowel infection called C. difficile, and they help germs become resistant to antibiotics.
When to see a doctor
- Trouble breathing, breathing fast, wheezing or chest pain: get medical help urgently
- A baby under three months old with a fever of 38°C or higher: contact a doctor straight away
- Signs of dehydration, such as passing very little urine, a very dry mouth or unusual sleepiness
- Fever that lasts more than four days, or a high fever
- Symptoms that last more than 10 days without getting better, or that get better and then come back worse
- Severe headache or pain in the face, or a cough that lasts more than three to four weeks
- A long-term illness such as asthma, heart or lung disease getting worse during the cold
Diagnosis
A cold is diagnosed from the symptoms. A doctor, pharmacist or health worker asks how the illness started and how long it has lasted. In most cases no tests are needed. Yellow or green mucus is normal in a cold and does not mean a bacterial infection needs antibiotics.
The doctor also thinks about other conditions that look like a cold, such as allergic rhinitis (hay fever), influenza (flu), COVID-19, a throat infection (pharyngitis), a bacterial sinus infection or whooping cough (pertussis). Flu and colds can be hard to tell apart from symptoms alone. If flu or COVID-19 is possible, especially in someone at higher risk, a test may be done because there are antiviral medicines for those infections. If you still feel unwell after 7 to 10 days, the doctor may look for a sinus infection, an allergy or another problem.
Treatment
- Rest and drink plenty of fluids. Most colds get better on their own within one to two weeks.
- Ease aches, sore throat and fever with paracetamol or ibuprofen if needed. Read the label or ask a pharmacist; your doctor or pharmacist decides the dose, especially for children.
- For a blocked nose, use salt water (saline) nose drops or spray. Adults and older children may use a decongestant nose spray for a few days only, because longer use can make the blockage come back worse.
- Adults and older children may get modest, short-term relief from combined cold medicines (an antihistamine with a decongestant and/or a painkiller). Check the label so you do not take the same medicine, such as paracetamol, twice.
- Do not give over-the-counter cough and cold medicines to young children. CDC advises against them under 6 years because of serious, sometimes life-threatening side effects; from 6 years, ask a doctor or pharmacist first. In the UK, cough medicines containing codeine or dextromethorphan are not used under 12.
- Do not use antibiotics for a cold. They do not kill viruses, do not speed recovery and can cause side effects. A doctor may give an antibiotic only if a bacterial complication, such as pneumonia, is found, or for some very unwell or high-risk people.
- If flu or COVID-19 is confirmed, ask a doctor whether antiviral treatment is right for you.
Medicines in Pakistan
Medicines a doctor may use, by group. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Pain relievers and fever reducers | ease fever, headache, sore throat and body aches; they do not shorten the cold or help cough; ibuprofen may work slightly better for fever discomfort; doctor or pharmacist decides the dose, and babies under 3 months should only have them on medical advice | Paracetamol (350 brands), Ibuprofen (378 brands) |
| Nasal decongestants | relieve a blocked nose in adults and older children; use for a few days only (about three), because longer use can cause rebound stuffiness; they do not help cough | Xylometazoline (6 brands) |
| Combination cold medicines (antihistamine, decongestant and/or painkiller) | may give modest relief in adults and older children, mostly in the first days; more side effects such as dizziness; no proven benefit in young children and not for children under 6 years unless a doctor advises | Ibuprofen + Pseudoephedrine (6 brands), Paracetamol + Pseudoephedrine + Chlorpheniramine (4 brands) |
Also used (not yet in our price list): Ipratropium nasal spray: may reduce a runny nose; a doctor decides if it is suitable (not for children under 5), Zinc lozenges: one review found they may shorten a cold in adults if started early, but the evidence is mixed; ask a pharmacist, Antihistamines on their own and cough suppressants (such as dextromethorphan or codeine) have little or no proven benefit for a cold
Self-care and prevention
Self-care
- Rest and get enough sleep
- Drink plenty of fluids such as water, warm drinks and soups
- Use salt water (saline) nose drops or spray to loosen a blocked nose; this is safe for children
- Breathe moist air from a clean humidifier or a hot shower; keep children away from bowls of hot water because of the risk of burns
- Suck throat lozenges for a sore throat, but do not give them to children under 4 years
- Honey can ease a cough in anyone aged 1 year or older; never give honey to a baby under 1 year
- For children aged 2 years and older, a menthol chest rub at bedtime may ease a blocked nose and night-time cough
- Always read medicine labels and tell your pharmacist about other medicines you take
Prevention
- Wash hands often with soap and water, especially after blowing your nose or changing nappies and before eating or cooking; an alcohol hand rub with at least 60% alcohol also works
- Avoid touching your eyes, nose and mouth with unwashed hands
- Cover coughs and sneezes with a tissue, throw it away straight away, then wash your hands
- Clean surfaces that are touched often, such as door handles, phones and toys
- Avoid second-hand smoke, breastfeed babies if you can, and avoid antibiotics that are not needed
- Keep up to date with recommended vaccines, such as flu and COVID-19 vaccines; there is no vaccine for the common cold itself
Common questions
Do I need antibiotics for a cold?
No. Colds are caused by viruses, and antibiotics only work against bacteria. Antibiotics do not make a cold better or shorter, and they can cause diarrhoea, allergic reactions and antibiotic resistance. See a doctor if you have warning signs such as trouble breathing or symptoms lasting more than 10 days.
My mucus is green. Does that mean I need antibiotics?
No. It is normal for nasal mucus to become thick, yellow or green after two to three days of a cold. This colour change is part of the body fighting the virus and is not, on its own, a sign of a bacterial infection.
How long does a cold last and when is it contagious?
Symptoms are usually worst in the first two to three days. Most people feel better within 7 to 10 days, although a runny nose and cough can last up to two weeks, and a cough sometimes lasts three to four weeks. You spread the virus most easily during the first two to three days.
Can I give cough and cold syrup to my young child?
Health agencies advise against over-the-counter cough and cold medicines for young children. CDC says not to give them under 6 years, because they can cause serious side effects and have not been shown to help. Saline nose drops, fluids, rest and honey (only from age 1) are safer choices. Ask a doctor or pharmacist before giving any medicine to a child.
Is it a cold or flu?
Colds and flu share many symptoms, and it can be hard to tell them apart. A cold usually comes on slowly and mainly affects the nose and throat, while flu often makes people feel much more unwell with fever and body aches. If you are at higher risk or very unwell, see a doctor, as flu and COVID-19 can be tested for and treated.
Sources
- CDC. Preventing and Managing the Common Cold (2026).
- NICE. Cough (acute): antimicrobial prescribing (NG120) (2019).
- American Family Physician (AAFP). Treatment of the Common Cold (2019).
- Cochrane for Clinicians, American Family Physician. Oral Antihistamine/Analgesic/Decongestant Combinations for the Common Cold (2022).
- MedlinePlus. Common cold: MedlinePlus Medical Encyclopedia (2025).
- Frontiers in Public Health. Prescribing Patterns for Upper Respiratory Tract Infections: A Prescription-Review of Primary Care Practice in Quetta, Pakistan and the Implications (2021).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.
Related conditions
Influenza (flu)Acute bronchitisSinusitisMiddle ear infection (otitis media)Allergic rhinitis (hay fever)Pneumonia