1. INTRODUCTION:

Upper Respiratory Tract Infections (URTIs) are infections that affect the entire upper respiratory tract, including the nasal cavity, the pharynx, the larynx, the ear canal and other secondary organs such as the epiglottis and tonsils, and the middle ear tympanic membrane. URTIs are categorized according to the airway or organ that is inflamed, for example, rhinitis, pharyngitis, laryngitis, epiglottitis, tonsilitis, etc. Acute respiratory infections are responsible for a significant number of visits to hospitals. Generally, they cause 20-40% of outpatient visits and 12-35% of inpatient visits. Upper respiratory tract infections are the cause of 87% of all respiratory infection cases. These include tonsillitis, pharyngitis, nasopharyngitis, and otitis media.¹ In 2019, it is estimated that 17.2 billion cases of upper respiratory tract infections occurred globally. This sums for about 42.82% of all diseases and detriments reported in the GBD 2019 research.²People under the age of eighteen are the ones who are most affected by URTIs. The incidence of URTIs declines with age. Adults experience two to four URTIs annually, but young children experience six to eight URTIs on average. There is a discernible seasonal pattern to the incidence of URI. In temperate parts of the northern hemisphere, the autumn and winter months see the highest occurrence rates. The rainy season is when most URTIs originate in tropical nations.³

The vast majority of acute infections in the upper respiratory tract are virus-related. Acute otitis media with effusion, tonsillitis, sinusitis, and lower respiratory tract infections can occasionally exacerbate a common cold, which is primarily caused by viruses. Although most acute respiratory infections are upper respiratory infections, with viruses being the main causative agents, bacterial pathogens play a substantial role in cases of severe lower respiratory tract infections.M. catarrhalis, S. aureus, S. pneumoniae, H. influenzae, and S. pyogenes are the most frequent bacteria that cause sinusitis. In 15% of cases, Group A beta haemolytic streptococcus (GABS) may be the cause of acute pharyngitis, which is common caused by viruses.¹

The prevalence of Upper Respiratory Tract Infection (URTI) pathogens varies by age group. In children younger than 2 years, Enterovirus and Human Rhinovirus are most prevalent. For children between the ages of 2 and 5, Human Adenovirus is prevalent, while Human Rhinovirus is more prevalent in children aged between the ages of 5 and 10 and in adults aged between the ages of 18 and 45 years. Influenza is the dominant pathogen in individuals between the ages of 10 and 18. In the elderly (more than 65 years), Human Rhinovirus re-emerges as a significant pathogen, while the prevalence in those aged 45 to 65 years is somewhat variable.⁴(Table 1.)

Table 1. Enlists the most prevailing pathogens causing URTIs in respective age groups.

Age-related prevalence of common URTI pathogens.
Sl. No.	Age groups	Pathogens
1	Less than 2 years	Enterovirus, Human Rhinovirus
2	More than 2 years and less than 5 years	Human Adenovirus
3	More than 5 years and less than 10 years	Human Rhinovirus
4	More than 10 years and less than 18 years	Influenza
5	More than 18 years and less than 45 years	Human Rhinovirus
6	More than 45 years and less than 65 years	Variable
7	More than 65 years	Human Rhinovirus

CLASSIFICATION:

Classic symptoms of common cold are cough, sore throat, and rhinorrhoea.⁵ Inflammation of the nasal mucosa is the hallmark of 40% of cases of rhinitis globally.⁶ Laryngeal inflammation is associated with hoarse voice, vocal tiredness and dry cough which can be either acute or chronic.⁷ While tonsillitis refers to inflammation of the palatine tonsils and accounts for 1.3% of outpatient visits,⁸ pharyngitis describes inflammation of the mucosa of the pharynx.⁹ Influenza is a viral illness that affects the upper and lower respiratory systems,¹⁰ whereas sinusitis is inflammation of the mucosa of the paranasal sinuses.¹¹ ( Table 2)

Diagnosis of Upper respiratory tract infections:

Primarily, clinicians give a verdict on the provisional diagnosis of URTI based on clinical presentation of the patient which includes patient conditions, signs and symptoms, physical evaluation and patient history taking. When circumstances do not prevail the diagnosis, clinicians turn up for various tests and procedures for the assessment and diagnosis of the URTI-laboratory investigations, microscopic inspection, culture tests, antigen detection assays and nucleic acid amplification tests.¹²

Management of URTIs:

Alleviating symptoms and prevention of disease spread is the aim for managing URTIs.¹³ Adults with cough, congestion, and other symptoms can be clutched with nasal decongestants and combination of antihistamine/decongestant drugs. Probiotics have shown promising results, as an adjuvant therapy of non-infectious rhinitis, in boosting immune response and increasing quality of life.¹⁴ Antibiotics do not alleviate symptoms or lessen the duration of illness, hence evidence-based research does not encourage their use in treating allergic colds,¹⁵but is absolutely essential for treating bacterial URIs. Unnecessary antimicrobial administration without microbiological profile leads to antimicrobial resistance.¹⁶ To improve patient compliance and lower the likelihood of bacterial resistance developing, it is best to administer an antibiotic with regimen of lower days. Treatment with antibiotics, like amoxicillin, lasts 7-10 days. Most common upper respiratory bacterial infections, including S. pneumoniae, H. influenzae, M. catarrhalis, and group A streptococci, are well inhibited by azithromycin, which also has an excellent safety profile with a regimen of minimum 1-5 days.¹⁷Method of producing vaccines using reverse genetics of Zebrafish infected by Human Pathogenic Avian Influenza have shown tremendous results.¹⁸ The best defence against influenza is vaccination. Antiviral chemoprophylaxis is also useful in preventing influenza (70% to 90% effective), when treated with antivirals early on, hospital stays are shortened, complications are less likely, and the duration of influenza symptoms is shortened.¹⁶Balloon sinuplasty is a novel method for the correction of sinusitis with almost negligible surgical intervention.¹⁹Honey is a safe and affordable option for youngsters older than one year. It is easily accessible and may be a useful demulcent for treating a child's cough.²⁰Cinnamon and Cardamum has good expectoration abilities, thus can be utilised as a substitute to synthetic expectorants.²¹Zinc supplements are also proven to be very effective in outcomes of an acute respiratory infections in paediatric population.²²

2. AIM AND OBJECTIVES:

Aim:

A retro-prospective study of patients with a condition to URTI.

OBJECTIVES:

General Objectives:

i. Evaluation of the prevalence of common cold as per the different age groups in the community.

ii. Identification of the causative agent or the pathogenic strain causing the major havoc in different age groups.

iii. Discovering the treatment guidelines or the medications currently used in treating URTIs and their ADRs.

Specific Objectives:

i. Diagnosing: To identify if the infection is caused by environmental changes (cold climate) or any pathogens.

ii. Prevention: To prevent any further epidemics of Influenza or some like COVID-19 by spreading awareness about the disease and necessity of OP visits for the accurate diagnosis of any pathogenic URTI.

iii. Quality of Life: To enhance Quality of Life (QOL), as URTI is quite a notorious lifestyle hindrance.

3. METHODOLOGY:

STUDY DESIGN:

A retro-prospective cross-sectional observational population survey design conducted in Parul Sevashram Hospital, Waghodia, Vadodara.

ETHICAL CONSIDERATION:

The study proposal is obtained from Institutional Ethical Committee of Parul Sevashram Hospital, Vadodara and the ethical approval number is PUIECHR/PIMSR/ 00/081734/6505. After peer interviewing and reviewing, the study was approved by the ethics committee.

STUDY DURATION:

For a duration of 6 months, we collected the data of patients, which included a Google form, which was filled by the population of the study sample themselves.

STUDY SITE:

Parul Sevashram Hospital. P.O. Limda. Tal. Waghodia, Vadodara, Gujarat, 391760.

NO. OF SAMPLE COLLECTED:

150 patients.

SOURCE OF DATA:

Data was obtained by collection of information through Google forms distributed to the population.

STUDY CRITERIA:

INCLUSION CRITERIA:

i. Patients who suffered from URTI at least once in their lifetime.

ii. People who are willing to participate in the study and provided with their informed consent

EXCLUSION CRITERIA:

i. People who did not provide with their consent.

DATA COLLECTION:

A specially designed Google form was prepared and validated. It was distributed among the people who filled in the data as per the information they had. It included demographics details of the patients - Gender, age group which they fall in; disease which they suffered from; symptoms which they faced; blood tests undergone; medicines which were taken and for how long were they taken; non-pharmacological therapy utilised; side effects of the medicines, if any; and the recurrency of the ailment.

DATA ANALYSIS:

Data were collected through Google forms. The collected data were tabulated and statistically analysed. Different types of graphs, figures, and tables are used to summarize the data visually using Microsoft Excel sheet.

STATISTICAL ANALYSIS:

Counts and percentages were used to summarize categorical variables. Graphical data displays were used to summarize data.

4. RESULTS:

The analysis of patient data reveals significant trends across various parameters. The majority of patients were male (54%) and predominantly aged between 18 and 30 years (85.3%). Awareness of their ailments was high, with 84% of patients being informed about their condition. Common cold was the most prevalent ailment, affecting 86.5% of patients, followed by tonsillitis and flu. Symptoms such as cough, fever, and runny nose were the most frequently reported. Despite 41.33% of patients undergoing blood tests, the most common test conducted was CBC. Azithromycin and paracetamol were the most commonly prescribed medications. Regarding treatment duration, most patients took medications for three days (44%). Home remedies were popular, with hot water and salt gargle being used by 82% of patients. Adverse drug reactions were noted in some patients, with weakness and dizziness being the most common.

STATISTICAL ANALYSES:

1. Chi-square test of independence (Sex vs Disease):

Null Hypothesis (H₀): The occurrence of common cold is independent of sex. (i.e., the distribution of common cold cases is the same for males and females).

Alternative Hypothesis (H₁): The occurrence of common cold is not independent of sex (i.e., the distribution of common cold cases differs between males and females).

Table 3. Table of accumulated data

Sex	Affected	Not Affected	Total
Male	72	9	81
Female	50	17	67
Preferred not to say	0	2	2
Total	122	28	150

Prevalence test for determining the prevalence of common cold in different age groups.

Table 4. Prevalence of common cold in different age groups

Age groups	Total patients (N)	Patients with Common cold (n)	Prevalence (%)
< 2 yrs	2	1	50 %
>= 2 yrs < 10 yrs	0	0	Nil
>= 10 yrs < 18 yrs	17	10	58.82 %
>= 18 yrs < 30 yrs	128	110	85.94 %
>= 30 yrs < 45 yrs	1	0	Nil
>= 45 yrs < 65 yrs	2	1	50 %
>= 65 yrs	0	0	Nil

Outcome:

As per the data gathered, we evaluated the prevalence of common cold in different age groups. Common cold was most prevalent in the outgoing age group of >= 18 < 30 years of age.

5. DISCUSSION:

We have collected retrospective data from 150 patients and conducted study and assessment, keeping the study objectives in mind.

While assessing the gender specificity of URTI, our study indicates a higher incidence of URTIs in males i.e., 54% (n= 81) compared to females i.e., 44.70% (n= 67) which aligns with an existing literature by Susan Isaac et al.²³ It is evident that males suffer more from URTIs (p value than females characterizing URTI as a clinical burden for males. This finding underscores the clinical burden of URTIs on males and aligns with existing literature by Falagas et al²⁴ and Jin X et al².

Common cold emerges as the most prevalent URTI in our study sample, with a high proportion of individuals reporting previous infections. This highlights the need for effective strategies for managing and preventing common cold episodes. Rhinovirus thus can be considered the most prevalent causative organism of URTIs. Tonsilitis, Flu and Sinusitis were the other most common URTI affecting the sample size, which is also highlighted in an existing literature by Susan Isaac et al.²³

Age group-wise prevalence of common cold is taken into consideration for discovering the most affected group of population. Our study reveals that lives of people who are >18 years and < 30 years of age are the most impacted by the incidences of common cold. (prevalence of 85.94%).

Patient education on transmission, management and prevention of communicable diseases are a necessity to stop epidemics from arising. As per our study we collected data from patients regarding their knowledge and awareness of URTIs and we discovered that 84% of people in our sample are aware of the group of diseases certainly known as Upper Respiratory Tract Infections. Thus, we must conduct teaching programmes like one conducted by T. Merlinshiba et al²⁵, it will benefit the mass unaware about transmission, tackling and prevention of URTIs.

While taking infection history from study sample, we found that 78% people have already been infected with URTI before. On further investigating we discovered that the majority of the study sample have suffered from a common cold before. We estimated that 86.5% people had been diagnosed with a common cold making it the most prevalent disease under the category of URTIs.

Symptoms are likely to be associated with the etiologic pathogen and the inflamed organ or part of the respiratory tract. Earlier we discovered that Common cold is the most prevalent URTI diagnosed in the study sample, thus it can be correlated with the most prevalent symptoms faced by the patients of the study area. Thus, the most prevalent set of symptoms were found to be the general symptoms of URTIs – ‘Cough’, ‘Fever’, ‘Sore throat’ and ‘rhinorrhoea’. Cough was the most frequent symptom with an occurrence rate of 76.70%.

While assessing the blood tests which were conducted, we found that the majority of patients i.e., 66 % patients had their Complete Blood Count tested.

The collected data was studied for the use of drug intake, and we found that majority of the patients (99 patients) were prescribed with Azithromycin. This outcome aligns with the study by Donde S et al.¹⁷who conducted a study to assess the efficacy of Azithromycin in URTI patients. The trend was followed by drugs like Paracetamol (at par with the study conducted by Anaghya V Naik et al.²⁶), Levocetirizine and Cheston Cold. ADRs were also checked, and we found that the majority of the ADRs were weakness, dizziness, dry mouth, gastric acidity and diarrhoea. Inappropriate dose and utilisation of antimicrobials can be the reason for instances of ADRs, which is also confirmed by a study conducted by Dhananjay Sangale et al.²⁷

When peeking into the options of non-pharmacotherapeutic management of URTIs, we discovered that – Hot water and salt gargle, consumption of ‘Kadha’ (a typical household hot fuming heterogenous solution of black pepper, ginger, clove and various other stuffs), consumption of honey and Tulsi (was also revealed to be utilitarian by a study conducted by Anibasa FO et al.²⁰) were preferred by 123 patients and 89 patients and 59 patients respectively.

86 % of the sample had no recurrent infections while 14% faced issues of recurrency. This can be misinformation as URTI patients generally do not visit Healthcare centres and thus, this is completely a public opinion-based answer. Thus, misreporting of disease occurrence is probable. Steps should be taken to promote reporting of URTIs, as irrational use of antimicrobials in URTIs caused by threatening microorganisms may result into generation of more antimicrobial resistant species which complicates the situation and thus can be tough to be managed with pre-existing empirical antimicrobials.

In conclusion, our study provides valuable insights into epidemiology, clinical presentation, treatment patterns, and patient preferences related to URTIs. These findings can inform healthcare strategies aimed at reducing the burden of URTIs and improving patient outcomes. Additionally, efforts to enhance public awareness, promote preventive measures, and optimize treatment approaches are crucial for mitigating the impact of URTIs on individual and population health.

6. CONCLUSION:

Our study confirms previous research indicating a higher incidence of URTIs in males (p value = 0.029) compared to females. Individuals aged >18 years and < 30 years are the most impacted by URTIs especially common cold (prevalence of 85.94%). The majority of individuals in our sample are aware of URTIs, emphasizing the importance of patient education on transmission, management, and prevention of communicable diseases. Strengthening public awareness campaigns can contribute to reducing the incidence and impact of URTIs. Common cold emerges as the most prevalent URTI in our study sample, with a high proportion of individuals reporting previous infections. Cough, fever, sore throat, and rhinorrhea are the most prevalent symptoms associated with URTIs, mirroring the clinical presentation commonly observed in patients with URTIs. Azithromycin emerges as the most prescribed drug for URTIs in our study sample, consistent with its efficacy demonstrated in previous research. However, attention should be paid to adverse drug reactions (ADRs) associated with treatment, such as weakness, dizziness, and gastrointestinal symptoms. Patients in our study commonly utilized home remedies such as hot water and salt gargle, 'Kadha' consumption, and honey ‘Tulsi’ (basil) reflecting a preference for natural remedies in managing URTIs. Integrating these complementary therapies with conventional treatment approaches may enhance patient outcomes. There is a notable discrepancy in reporting recurrence of URTIs, indicating potential misinformation or public opinion-based responses. Further investigation is warranted to accurately assess the recurrence rate of URTIs and address any misreporting biases.

7. LIMITATIONS:

i. The sample size of the study may restrict its applicability to broader populations.

ii. Retrospective data collection might introduce selection bias.

iii. The data collected was provided by people and thus can be opinion-based.

iv. The data was collected majorly by communing the Google forms.

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Received on 09.09.2024 Revised on 11.02.2025

Accepted on 20.04.2025 Published on 05.09.2025

Available online from September 08, 2025

Research J. Pharmacy and Technology. 2025;18(9):4323-4328.

DOI: 10.52711/0974-360X.2025.00620

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