ARVI Without Complications: The Role of the Pharmacist in the First 48 Hours of Illness

Many patients with the first symptoms of ARVI go not to the doctor but to the pharmacy.

It is the pharmacist who becomes the first point of triage: assessing the condition, identifying “red flags,” explaining the principles of symptomatic therapy, and warning about the uselessness of antibiotics for viral infections.

This article offers a practical algorithm for the pharmacist’s actions during the first 48 hours of ARVI. You can also read about the causes of ARVI and existing methods of cold prevention in the article “Winter immunity: do we really get sick more often and what can we do about it?”.

And you can choose products that are usually recommended for colds in the online store medizine.ua.

Why the first 48 hours are so important

• The severity of the course is determined: whether it will be a mild form or complications are possible.

• The patient chooses a “trajectory” — self-treatment, doctor consultation, or “an antibiotic just in case.”

• Timely triage helps reduce the risk of pneumonia and decompensation of chronic diseases, and prevents antibiotic misuse.

Table title: The goal of pharmacist consultation at the first symptoms of ARVI

Survey Algorithm: What to Ask First

1. Body temperature and duration of symptoms.

2. Warning symptoms: shortness of breath, chest pain, difficulty breathing, confusion.

3. Chronic conditions: cardiovascular diseases, COPD, diabetes, cancer, immunodeficiency.

4. Patient age: children under 5, adults 60+ — high-risk groups.

5. Pregnancy, breastfeeding.

6. What medications the patient is already taking (including “home stock” antibiotics).

Table title: “Red Flags” in ARVI — Immediate Referral to a Doctor / emergency medical service

What a Pharmacist Can Recommend for Uncomplicated ARVI

• Regimen: rest, adequate hydration, light meals, humidified air.

• Antipyretics (paracetamol, ibuprofen) — according to age, contraindications, and instructions.

• Throat, nasal, and cough remedies — considering age, comorbidities, and symptom duration.

• Explain: antibiotics do not work against viruses; only a doctor can prescribe antibiotics.

Questions and Answers

Patient: “Give me something strong so I can go to work tomorrow.”
The pharmacist can explain that symptomatic remedies relieve symptoms, but they do not eliminate the need for rest; going to work with a fever increases the risk of complications and infecting colleagues.

“This antibiotic always helped me. Why can’t I take it now?”
Explain the difference between bacterial and viral infections, the risks of resistance and side effects. Recommend symptomatic treatment and advise contacting a doctor if symptoms worsen.

“Can I combine several cold medicines?”
Emphasize the risk of doubling paracetamol/ibuprofen doses when using combination medicines. Help create a safe schedule to avoid overlap.

“When should I see a doctor if I’m treating myself at home?”
If fever lasts >3 days, or if shortness of breath, chest pain, severe headache, rash, or pronounced weakness appear — a doctor’s examination is needed.

Conclusions

• The pharmacist is a key first-contact figure in ARVI.

• A clear survey algorithm and knowledge of “red flags” help ensure timely referral to a doctor and prevent complications.

• Effective communication helps reduce unnecessary antibiotic demand and strengthens trust in the pharmacist.

References

1. WHO. Clinical management of respiratory infections at primary care. 2023.

2. CDC. Antibiotic Use and Viral Respiratory Infections. 2024.

3. NICE Guideline: Respiratory tract infections (self-limiting). 2023.