Hi

Thanks for posting your query

After going through your description, I am of opinion that you are suffering from either pharyngitis or sinusitis.

Pharyngitis after a bout of upper respiratory infection could be due to the residual inflammation present in the throat because of incomplete resolution of the previous infection. Hence, the presence of congestion in the pharyngeal wall leads to irritation of the throat and thus inducing cough.

Secondly, the incomplete resolution of a previous throat irritation.

Either of the conditions can be treated effectively with the following measures.

1. Drink plenty of warm water.
2. Use saline nasal spray followed by steam inhalation 3-4 times a day.
3. Try taking antibiotics such as a combination of amoxycillin and clavulanic acid or cefuroxime instead of azithromycin.
4. Avoid using levocetrizine, it will worsen your problems as it dries up the secretions in the nose and the throat.
5. A mucolytic such as bromhexine or ambroxol helps in clearing of the thick secretions.
6. Anti-inflammatory medicines such as ibuprofen and diclofenac can be beneficial.
7. Also avoid chilled or hot food and beverages/coffee/smoking.

If the symptoms do not improve with the above measures, please consult a good ENT specialist.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

---

Hi

Thanks for writing back

Q:     Why Azithromycin is not beneficial?
A:     Practically, we Indians have developed resistance for the drug azithromycin, even when you get the culture sensitivity of the throat swab done, it would be showing resistance to the former drug. Secondly, azithromycin is used to cover only mild upper respiratory tract infections, but does not cure sinusitis or resistant cases.
     In your case, antibiotics as well as supportive treatment are required. Supportive treatment reduces most of your symptoms as well as cough.

Q:     Is it a bacterial infection or viral?
A:     It is a bacterial infection; viral infection does not stay so long.

Q:     Should i see a ENT doctor or a lung disease specilaist?     
A:     Yes, you need to see an ENT specialist first to rule out the sinus problmes as well as do a thorough examination of the throat.

Q:     Please suggest a saline nasal spray too.
A:     You can try using Otrivin – S or Nasivion saline nasal spray or Nasocare hypertonic saline nasal spray.

Yes, allergy may be one of the components, but when you are having an upper or lower respiratory tract infection, the entire respiratory tract will be sensitive and inflamed, hence even with trivial exposure to dust or smoke your cough and other problems will be aggravated.

Finally, if you have already taken bromhexine, no problem, you can try doing steam inhalation, which will help in loosening out the thick secretions in the nose and the throat. And also, do steam inhalation which will be very beneficial.

Hope this answers your query; I wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

---