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Pediatric Cough

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Anoop Verma    15 January 2018

  1. It is important to differentiate viral infection from bacterial infection.
  2. An antibiotic should not be prescribed without reasonable evidence of bacterial infection.
  3. Antibiotics in RTI:
ConditionAntibioticDuration
Otitis mediaAmoxycillin (80-90 mg/kg/d), Amoxyclav, Cefpodoxime, Cefdinir, Azithromycin10 days
Bacterial sinusitisAmoxycillin (80-90 mg/kg/d), Amoxyclav, Cefpodoxime, Cefdinir, Azithromycin10 days
PharyngitisPenicillin V, Penicillin G, Benzathine, Amoxycillin, Clindamycin, Macrolides7-10 days
BronchitisMacrolides7-10 days
BronchiolitisNone 

 

4. Cough in children persists for 10-14 days. Cough for >14 days needs evaluation.

5. Choosing cough syrup – Mucolytics and expectorants have no role in infants and children; oral phenylephrine and antihistamine can be used; don’t use xylometazoline and oxymetazoline.

6. Chest X-ray visualizes lung parenchyma, pleura or mediastinum and not the airways. Severe cough denotes airway disease. X-ray is thus not helpful in severe cough.

7. Behavioral therapy – Teach the patient to delay the cough each second; instruct the patient to focus entirely on holding back the urge to cough for an initially brief period; increase the patient’s confi dence; change the mindset; autosuggestion helps.

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