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Suggest Remedy For Fever And Cough In A Child Caused By Bronchitis
Question: Dear Doctor,
My son is currently 13 months old, he is 10kg, he is growing normally.
3 days ago, he developed slight fever and slight coughing, on the second day and night the fever got higher about 38 degree celsius, i gave him paracetamol to calm him down. The time i was giving the medicine was almost once or twice in 24 hours since the fever wasn't coming back strongly and it mostly stayed between 37.2 to 37.8.. I only gave him the fever medicine when his temperature was 38.. his cough also got a bit stronger.
Today the third day he got fever again which reached to 38 and then gradually got lower by it self without medicine (remittent fever), it just comes and goes, and the cough became more loud and stronger it's more in the morning till afternoon compared to evening and night
I took him to doctor today and he did auscultation for him as well as X-ray, he said it seems like he has bronchitis, he also said he is teething (canine teeth( which could indicate the reason for fever. he also said that this bronchitis could be due to either virus or bacteria so he suggested to give him amoxicillin to be on the safe side.
following is the medicines the doctor prescribed.
1.profinal 135ml... dosage 5ml/4 times a day
2.mucolyte- bromhexine hydrochloride syrup 100ml bottle... dosage 2.5ml/3times a day
3.augmentin culavulanic acid amoxicillin powder 70ml .... dosage 2.5ml/twice daily
4.Zyrtec drops oral 10ml .... Dosage 10 drops/once per day
5.tonimer I baby , Sea water.... Dosage 1 puff/ 4 times a day
My questions .
1.what do you think my son has?
2. i took him to the doctor about 4 hours ago, however i thought he prescribed him a lot of medicines and most are unnecessary since the fever is not that strong and it goes up and down by it self, so i decided to only give him Mucolyte for now and avoid other medicines till tomorrow to see if he is getting any better. do you think that's a good idea?
3.do you think the dosages he gave for the medicines are good? i read in the Augmentic inside paper that if the infection is not severe then the dosage should just be 1.25ml while the doctor wrote him 2.5ml. ? which dosage do you suggest if i have to give him the medicine?
4.finally what is your conclusion and suggestions for my sons case?
My son is currently 13 months old, he is 10kg, he is growing normally.
3 days ago, he developed slight fever and slight coughing, on the second day and night the fever got higher about 38 degree celsius, i gave him paracetamol to calm him down. The time i was giving the medicine was almost once or twice in 24 hours since the fever wasn't coming back strongly and it mostly stayed between 37.2 to 37.8.. I only gave him the fever medicine when his temperature was 38.. his cough also got a bit stronger.
Today the third day he got fever again which reached to 38 and then gradually got lower by it self without medicine (remittent fever), it just comes and goes, and the cough became more loud and stronger it's more in the morning till afternoon compared to evening and night
I took him to doctor today and he did auscultation for him as well as X-ray, he said it seems like he has bronchitis, he also said he is teething (canine teeth( which could indicate the reason for fever. he also said that this bronchitis could be due to either virus or bacteria so he suggested to give him amoxicillin to be on the safe side.
following is the medicines the doctor prescribed.
1.profinal 135ml... dosage 5ml/4 times a day
2.mucolyte- bromhexine hydrochloride syrup 100ml bottle... dosage 2.5ml/3times a day
3.augmentin culavulanic acid amoxicillin powder 70ml .... dosage 2.5ml/twice daily
4.Zyrtec drops oral 10ml .... Dosage 10 drops/once per day
5.tonimer I baby , Sea water.... Dosage 1 puff/ 4 times a day
My questions .
1.what do you think my son has?
2. i took him to the doctor about 4 hours ago, however i thought he prescribed him a lot of medicines and most are unnecessary since the fever is not that strong and it goes up and down by it self, so i decided to only give him Mucolyte for now and avoid other medicines till tomorrow to see if he is getting any better. do you think that's a good idea?
3.do you think the dosages he gave for the medicines are good? i read in the Augmentic inside paper that if the infection is not severe then the dosage should just be 1.25ml while the doctor wrote him 2.5ml. ? which dosage do you suggest if i have to give him the medicine?
4.finally what is your conclusion and suggestions for my sons case?
Brief Answer:
Your child is suffering from bronchiolitis
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone very carefully through the entire details provided. Most often cough and cold (sometimes also associated with fever) is due to viral cause. In children between 6 months and 3 years of age, such viral infection results in a condition called bronchiolitis (not bronchitis) which is characterized by wheezing and stridor. It seems that your son has this condition and your doctor probably thinks the same. Sometimes there is a superadded bacterial infection and your doctor has decided to play safe by giving antibiotics. For your child 2.5 ml twice daily is fine to be given. If you decide to give it, start now and complete the 5 day course. Else, skip the antibiotic entirely. The choice is yours.
Profinal contains ibuprofen which needs to be given only if there is fever.
Zyrtec contains an antiallergic and I think that you should give it for next 3-5 days.
Tonimer Nasal Spray contains saline water and should be helpful in clearing nasal block, if present, not otherwise.
Alongside all these, be sure to give steam inhalation. Just sit with the child in your lap and place the source of steam before you. Water vapor will be in the air and automatically the child will breathe it in. It will help in diluting the cough and would provide relief.
Let me know if you have any further queries and I would be glad to help.
Regards
Your child is suffering from bronchiolitis
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone very carefully through the entire details provided. Most often cough and cold (sometimes also associated with fever) is due to viral cause. In children between 6 months and 3 years of age, such viral infection results in a condition called bronchiolitis (not bronchitis) which is characterized by wheezing and stridor. It seems that your son has this condition and your doctor probably thinks the same. Sometimes there is a superadded bacterial infection and your doctor has decided to play safe by giving antibiotics. For your child 2.5 ml twice daily is fine to be given. If you decide to give it, start now and complete the 5 day course. Else, skip the antibiotic entirely. The choice is yours.
Profinal contains ibuprofen which needs to be given only if there is fever.
Zyrtec contains an antiallergic and I think that you should give it for next 3-5 days.
Tonimer Nasal Spray contains saline water and should be helpful in clearing nasal block, if present, not otherwise.
Alongside all these, be sure to give steam inhalation. Just sit with the child in your lap and place the source of steam before you. Water vapor will be in the air and automatically the child will breathe it in. It will help in diluting the cough and would provide relief.
Let me know if you have any further queries and I would be glad to help.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor for the quick response and the well detailed answer.
I will start giving him the antibiotic tomorrow morning as soon as he wakes up to be on the safe side.
he is sleeping now, 3 hours ago he had a fever of 37.8 and now reduced to 37.2 without medication, his fever seems to be fluctuating in that range..
1.at what temperature do you suggest i should give him the fever medicine. i usually give him when the fever reaches 38 or above..
2.I was using Paracetamol as an antipyretic, now the doctor gave me profinal. which one do you suggest i should give? continue with Paracetamol syrup or profinal?
3. in Child Bronchiolits how many days should the symptoms such as fever and cough subside? if the symptoms are still there, does fever subside before cough ? do i need to take him back to doctor for another check up ?
Thanks a lot ...
I will start giving him the antibiotic tomorrow morning as soon as he wakes up to be on the safe side.
he is sleeping now, 3 hours ago he had a fever of 37.8 and now reduced to 37.2 without medication, his fever seems to be fluctuating in that range..
1.at what temperature do you suggest i should give him the fever medicine. i usually give him when the fever reaches 38 or above..
2.I was using Paracetamol as an antipyretic, now the doctor gave me profinal. which one do you suggest i should give? continue with Paracetamol syrup or profinal?
3. in Child Bronchiolits how many days should the symptoms such as fever and cough subside? if the symptoms are still there, does fever subside before cough ? do i need to take him back to doctor for another check up ?
Thanks a lot ...
Brief Answer:
Another check up does not seem necessary
Detailed Answer:
Thanks for writing back.
Give paracetamol for fever above 37.8ºC. I prefer it to ibuprofen. Give ibuprofen only if fever is not controlled with paracetamol.
Both the fever and cough should be gone in a week. Most often fever subsides first.
You need to take him to the doctor only if he becomes lethargic or has respiratory distress. Else you may wait.
Regards
Another check up does not seem necessary
Detailed Answer:
Thanks for writing back.
Give paracetamol for fever above 37.8ºC. I prefer it to ibuprofen. Give ibuprofen only if fever is not controlled with paracetamol.
Both the fever and cough should be gone in a week. Most often fever subsides first.
You need to take him to the doctor only if he becomes lethargic or has respiratory distress. Else you may wait.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor.
I forgot about a question. It's most important for me..
When my son was 4 month old he showed to be allergic to penicillin. They did allergy test before they gave him medicine and he was allergic (skin rash) when they tested for penicillin..
1. Since amoxicilin is in same group with penicillin can it cause severe allergic reaction to him?
2. He had upper respiratory infection before and he was treated with erythromycin, I asked the doctor to give him erythromycin since it worked well for him before.. But he said it's better to give him amoxicilin to avoid bacterial resistance... What do you suggest?
I forgot about a question. It's most important for me..
When my son was 4 month old he showed to be allergic to penicillin. They did allergy test before they gave him medicine and he was allergic (skin rash) when they tested for penicillin..
1. Since amoxicilin is in same group with penicillin can it cause severe allergic reaction to him?
2. He had upper respiratory infection before and he was treated with erythromycin, I asked the doctor to give him erythromycin since it worked well for him before.. But he said it's better to give him amoxicilin to avoid bacterial resistance... What do you suggest?
Brief Answer:
Avoid the antibiotic altogether. Continue the others.
Detailed Answer:
Thanks for writing back again.
I would need to know whether other than the resultant rash from allergy test, were there any other pointers present that could indicate penicillin allergy? I need to ask this because over 80% cases of the so called penicillin allergy are overdiagnosed.
In any case, it would perhaps be worth avoiding amoxycillin as if the penicillin allergy is actual, amoxycillin would also cause problems. Be sure to mention about the penicillin allergy to ALL doctors whom you visit subsequently.
Amoxicillin is likely to be more effective and so your doctor had preferred it. The choice would perhaps have been different. Anyway, as of now, I would insist you to avoid the antibiotic altogether. Look out for increased rate of breathing. Unless the rate of breathing is greater than 60 per minute, or unless there is associated respiratory distress, your child does not need to be treated with antibiotics.
Regards
Avoid the antibiotic altogether. Continue the others.
Detailed Answer:
Thanks for writing back again.
I would need to know whether other than the resultant rash from allergy test, were there any other pointers present that could indicate penicillin allergy? I need to ask this because over 80% cases of the so called penicillin allergy are overdiagnosed.
In any case, it would perhaps be worth avoiding amoxycillin as if the penicillin allergy is actual, amoxycillin would also cause problems. Be sure to mention about the penicillin allergy to ALL doctors whom you visit subsequently.
Amoxicillin is likely to be more effective and so your doctor had preferred it. The choice would perhaps have been different. Anyway, as of now, I would insist you to avoid the antibiotic altogether. Look out for increased rate of breathing. Unless the rate of breathing is greater than 60 per minute, or unless there is associated respiratory distress, your child does not need to be treated with antibiotics.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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