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Had Wet Productive Cough, Fever And Febrile Seizure. Took Mortin And Tylenol. Antibiotics?

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Posted on Wed, 5 Jun 2013
Question: My 2 year old has had a wet productive cough for 8 days. She is now getting fevers that spike to 101 at night (2 nights). She had a febrile seizure a few months ago so I am trying to keep the fever in control. I give her a bath and dose of Motrin when it spikes. Last night I had to give her Tylenol as well because it spiked only 4 hours after I gave Motrin. I gave her another dose of Motrin at 2am and the fever has not spiked again during the day. Is it OK to rotate Tylenol and Motrin? Do you think she needs antibiotics? Please provide dosage and type of antibiotics, she weighs 27lbs.
doctor
Answered by Dr. Satyadeo Choubey (1 hour later)
Hi,

Thanks for your query.

Fever with wet productive cough lasting eight days strongly favors lower chest x-ray, complete blood count, and sputum culture and sensitivity done.

Since she has history of febrile seizures, Keeping away with fever spikes with antipyretics should be done and you are right here. But treating the cause of the fever ( as lower respiratory tract infection here) is more important.

Definitive antibiotic therapy should follow the culture report but empirical antibiotics need to be started at this juncture like amoxycillin and gentamicin. She may be needing hospitalization, Kindly consult your doctor.

Best wishes.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Satyadeo Choubey (17 hours later)
Is there a chance this could be a virus? Her fevers have not come back since yesterday. Is gentamicin safe? I thought it had XXXXXXX side effects and needed to be monitored by peek and trough levels. You would give both amox and gentamicin? or only amox is enough?
doctor
Answered by Dr. Satyadeo Choubey (20 minutes later)
Thanks for follow up.

Usually to start with, respiratory tract infection in children are viral. But there are chances of super-added bacterial infection once it is prolonged.

If she has not fever since yesterday, you may wait before starting antibiotics.
Both amox and gentamicin are safe and can be given simultaneously to increase the coverage.
Supportive treatments like plenty of fluids, regular feeding etc are of utmost importance.

Best wishes
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Satyadeo Choubey (22 hours later)
Is there a safer alternative to gentamicin?
doctor
Answered by Dr. Satyadeo Choubey (1 hour later)
Thanks for follow up.

As I have said earlier, gentamicin is relatively a safer drug. If you have any concerns, can try plain amoxycillin also. But you said she is not having fever since 48 hrs. So if it is the case you can wait.

Thanks
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Answered by
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Dr. Satyadeo Choubey

Pulmonologist

Practicing since :2006

Answered : 554 Questions

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Had Wet Productive Cough, Fever And Febrile Seizure. Took Mortin And Tylenol. Antibiotics?

Hi,

Thanks for your query.

Fever with wet productive cough lasting eight days strongly favors lower chest x-ray, complete blood count, and sputum culture and sensitivity done.

Since she has history of febrile seizures, Keeping away with fever spikes with antipyretics should be done and you are right here. But treating the cause of the fever ( as lower respiratory tract infection here) is more important.

Definitive antibiotic therapy should follow the culture report but empirical antibiotics need to be started at this juncture like amoxycillin and gentamicin. She may be needing hospitalization, Kindly consult your doctor.

Best wishes.