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Suggest Treatment For Sneezing, Cough, Fever And Ear Pain
Question: Hi,
My daughter who is 2 years and 3 months old has been suffering from fever and ear ache from the last two days. What started as mild sneezing and cough 4 days back turned into mild fever and ear ache a couple of days back. The fever was coming upto 101 degrees F and I administered Calpol and the fever would go for 6 hours. But the main problem was my daughter complianing about pain in her ears. We took her to her doctor who tried to check her ears but couldnt confirm ear infection as her ears had ear wax. But since my daughter kept on complaining and crying about ear pain, he prescribed her Azythromycin 200 mg, 3.5 ml a day for the ear infection. For cold he prescribed Relent which Cetrizine Hydrochloride and Ambroxyl Hydrochloride 3ml twice day.
Since then we had given two doses of Azythromycin and 3 doses of Relent. It seems that the pain her ears might have receeded because my daughter has not been crying or complaining about pain in her ears for the last 10 hours. But the fever has gone worse. She now has fever of around 102 every 4 hours. Giving her Calpol 250 mg, 5mL reduces her fever slowly (in about 40 mins) but the fever comes back in 4 hours. At the beginning the fever stayed away for 6 hours with Calpol. What steps should we follow next.
FYI...my daughter had fever like this without ear pain a month back, and it came down after 8 days, with combining Cefropox and Azythromycin anti-biotics.
My daughter who is 2 years and 3 months old has been suffering from fever and ear ache from the last two days. What started as mild sneezing and cough 4 days back turned into mild fever and ear ache a couple of days back. The fever was coming upto 101 degrees F and I administered Calpol and the fever would go for 6 hours. But the main problem was my daughter complianing about pain in her ears. We took her to her doctor who tried to check her ears but couldnt confirm ear infection as her ears had ear wax. But since my daughter kept on complaining and crying about ear pain, he prescribed her Azythromycin 200 mg, 3.5 ml a day for the ear infection. For cold he prescribed Relent which Cetrizine Hydrochloride and Ambroxyl Hydrochloride 3ml twice day.
Since then we had given two doses of Azythromycin and 3 doses of Relent. It seems that the pain her ears might have receeded because my daughter has not been crying or complaining about pain in her ears for the last 10 hours. But the fever has gone worse. She now has fever of around 102 every 4 hours. Giving her Calpol 250 mg, 5mL reduces her fever slowly (in about 40 mins) but the fever comes back in 4 hours. At the beginning the fever stayed away for 6 hours with Calpol. What steps should we follow next.
FYI...my daughter had fever like this without ear pain a month back, and it came down after 8 days, with combining Cefropox and Azythromycin anti-biotics.
Brief Answer:
She may need drug changes....
Detailed Answer:
Hi,
I had gone through your question and understand her fever has worsened despite 2 days of azithromycin. Clinically, at this age group ear pain, fever, cough and sneezing points towards possibility of ASOM that is acute suppurative otitis media - inflammation and infection of middle ear.
As an ENT surgeon , I see many cases in my practice. I recommend the following.
1) I usually recommend amoxicillin with clavulinic acid syrup for this condition. As she continues to have fever despite two doses of azithromycin, it would be better to switch over to amox + clavulinic acid combination. Discuss with her doctor.
2) In addition Mefenamic acid may be added as it has a better and longer fever control than paracetamol.
3) For cold I recommend loratadine , its more effective than cetrizine.
Please discuss about these options with her treating doctor. In the meanwhile you can use XXXXXXX warm sponging to bring down fever. Continue calpol in the right doses every 4-6 hourly.
Hope I have answered your question. If you have any further questions, I am happy to help.
Wish her a speedy recovery.
Regards,
Dr Paparaja S MBBS MS
Consultant ENT Surgeon.
She may need drug changes....
Detailed Answer:
Hi,
I had gone through your question and understand her fever has worsened despite 2 days of azithromycin. Clinically, at this age group ear pain, fever, cough and sneezing points towards possibility of ASOM that is acute suppurative otitis media - inflammation and infection of middle ear.
As an ENT surgeon , I see many cases in my practice. I recommend the following.
1) I usually recommend amoxicillin with clavulinic acid syrup for this condition. As she continues to have fever despite two doses of azithromycin, it would be better to switch over to amox + clavulinic acid combination. Discuss with her doctor.
2) In addition Mefenamic acid may be added as it has a better and longer fever control than paracetamol.
3) For cold I recommend loratadine , its more effective than cetrizine.
Please discuss about these options with her treating doctor. In the meanwhile you can use XXXXXXX warm sponging to bring down fever. Continue calpol in the right doses every 4-6 hourly.
Hope I have answered your question. If you have any further questions, I am happy to help.
Wish her a speedy recovery.
Regards,
Dr Paparaja S MBBS MS
Consultant ENT Surgeon.
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Above answer was peer-reviewed by :
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