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What Do These Following X-ray Findings Indicate?

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Posted on Mon, 8 May 2017
Question: Hello Doctor,
I am writing to get your opinion on a 2 year old girl who is currently on vacation in South XXXXXXX She has a 2 day history of fever, cough, and difficulty breathing. She was taken to a doctor in South XXXXXXX who diagnosed her with bronchopneumonia.
The X-rays and medication list is attached.
The X-rays confirm bronchial congestion however it is the prescription in particular that is concerning as it seems to be excessive. There is a lot of overlap in the medication and I'm not too sure about the necessity of using a medication such as Stilpane for this purpose. I would appreciate it if you could take a look at the attachments and provide your input on the treatment. Also, is there anything else you would recommend?
She has no significant medical for surgical history. Mother is allergic to penicillin so Klacid was prescribed instead of Augmentin.
Thanks in advance.
doctor
Answered by Dr. Diptanshu Das (2 hours later)
Brief Answer:
Significance of medicines mentioned

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your query and understand your concerns. The X Rays indeed show congestion.
* Benylin dry cough - contains dextromethorphan, a cough suppressant. I would strongly insist you not to give this medicine. Rather, give steam inhalation. Water in form of vapor will reach deep inside and will help in diluting the thickened mucus and would thereby provide relief.
* Klacid (Clarithromycin) - antibiotic not related to penicillin, can be given.
* Empaped (paracetamol) - essential to bring down the fever, to be given when needed rather than twice daily.
* Sinumax (paracetamol and pseudoephedrine) - Do not give this composition. Rather give cetirizine syrup once daily.
* St. Ipene Syr. - Not sure of its contents but I doubt if that is required.

Feel free to write back. Please be patient as irrespective of treatment it may take a week to recover.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Diptanshu Das (5 hours later)
Dear Dr. XXXXXXX

Thanks very much for your quick response.
I have a few follow up questions:

1) It is not known whether the infection is viral or bacterial - should antibiotics still be continued in this case? Only 1 dose has been given so far.
2) Stilpane syrup: the contents are Paracetamol 120 mg, Promethazine HCl 6.5 mg, Codeine Phosphate 5 mg, Camphorated Opium Tincture 0.3 mL, Alcohol (100%)     16,7% v/v. It is for this reason why this medication concerned me the most - so you agree that it should not be given?
3) What is the concern with Benylin? I was under the impression that it had a relatively safe profile and is even available over the counter in Canada. Is it specifically Benylin DRY cough or Benylin in general?

Thanks again and look forward to hearing from you.

Regards,
XXXX
doctor
Answered by Dr. Diptanshu Das (1 hour later)
Brief Answer:
Questions answered one by one.

Detailed Answer:
Thanks for writing back.

1. There are chances of it being due to a viral cause. However traveller's are given antibiotics as they are new to the environment and they do not stay longer to adapt to environs. Alternatively blood for complete blood count and C-Reactive protein levels can confirm whether it is due to bacterial cause.
2. Given the composition I would suggest to avoid this syrup too.
3. Benylin Dry Cough is a cough suppressant with Dextromethorphan. If it is bronchopneumonia what you need is an expectorant. If I were the doctor I would opt to give Benylin Mucous Cough or any other which does not have dry in the name.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (24 minutes later)
It's all clear now. Thank you so much!
doctor
Answered by Dr. Diptanshu Das (2 hours later)
Brief Answer:
Glad to be of service

Detailed Answer:
Feel free to write back in case you have any further queries, now or in the future. Please close and rate our discussion.

Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3875 Questions

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What Do These Following X-ray Findings Indicate?

Brief Answer: Significance of medicines mentioned Detailed Answer: Thanks for asking on HealthcareMagic. I have gone through your query and understand your concerns. The X Rays indeed show congestion. * Benylin dry cough - contains dextromethorphan, a cough suppressant. I would strongly insist you not to give this medicine. Rather, give steam inhalation. Water in form of vapor will reach deep inside and will help in diluting the thickened mucus and would thereby provide relief. * Klacid (Clarithromycin) - antibiotic not related to penicillin, can be given. * Empaped (paracetamol) - essential to bring down the fever, to be given when needed rather than twice daily. * Sinumax (paracetamol and pseudoephedrine) - Do not give this composition. Rather give cetirizine syrup once daily. * St. Ipene Syr. - Not sure of its contents but I doubt if that is required. Feel free to write back. Please be patient as irrespective of treatment it may take a week to recover. Regards