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Suggest Treatment For Chest Infection In Child

Posted on Mon, 14 Sep 2015

Question: Hi, my four year old son has got a chest infection. He's got augmentin duo 400/57 syrup to take for it and doctor had also given some nuelin syrup 133.5mg/25mL. He was prescribed 6mL three times a day but the pharmacist said that is too low and he should be taking 15mL three times a day. Can't contact the doctor till tomorrow and unsure what if I can give him an extra to top up to 15mL if the 6mL doesn't work??

Answered by Dr. Sumanth Amperayani (33 minutes later)

Brief Answer:
Please get back to me with the weight of the kid

Detailed Answer:
Hi... Nuelin syrup is Theophyllin Elixir (133.3mg/25ml). The dose is 8mg/kg every 8th hourly - that is thrice a day.

I request you to get back to me with the weight of the kid and I will be glad to guide you further regarding the dosage. All the pediatric drugs are dosed based on body weight and not on the age.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (3 hours later)

hes 18-19kg

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
According tp weight it comes to 15ml 8th hourly

Detailed Answer:
Hi...
According to his weight you need to use 15ml every 8th hourly.

But rather than Theophyllin, at this age group I would prefer to use, Levosalbutamol for wheezing and lower respiratory infection like this.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (30 minutes later)

Thanks. The pharmacist who filled the prescription had called the doctor two times to confirm dosage and suggest 15mL but he was adamant on going with 6ml as he said that's what he always does and he had calculated the dosage.. I'm not sure what to do cos I don't want to go against my GP /.. would there be any certain reason for him using a lower dose ? Would 6mL be enough. He doesn't even have asthma as of yet.. its just the non stop coughing he gets with the infection

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
Might be wheezing - please answer the questions below

Detailed Answer:
Hi...By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -
Questions:
1. How many days per month does the kid cough or feel breathless?
2. How many nights per month does the kid's sleep get disturbed due to above symptoms?
3. Does the kid feel breathless when runs around or plays with other kids?
4. Are the symptoms when there are seasonal changes?
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
6. Is the cough always associated with fever?

Please get back with answers so that I can guide you better.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (6 hours later)

He doesn't really ger breathless but coughs persistently
Only really gets it when he is sick and this is the first time he got nuelin syrup

Answered by Dr. Sumanth Amperayani (5 hours later)

Brief Answer:
This might be 1st episode of wheezing then

Detailed Answer:
Hi...then this should be his 1st episode of wheezing as Nuelin is given only for wheezing. In this age group persistent cough might be the only manifestation of wheezing.

I suggest you go ahead with the prescription of your gp as sometimes Theophylline can cause increased heart rate in kids. This might be the reason why your gp has prescribed a lower dose.

Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar