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Suggest Dosage For Azithral

Posted on Fri, 10 Jun 2016

Question: Hi,

my daugther is 4.5 yrs old. has been diagonised with grade 4 adenoids (based on xray and telescopic view), bilateral conductive hearing loss(based on hearing test) and middle ear fluid in both ears by the ent. For the past one n half month treating her with nasonax nasal spray(1 - 0 1) and relent syrup.

Meanwhile our pediatrician advised us to treat her with the following medicine:
zyrtec syrup 0 - 0 - 4ml (2 weeks. dose completed)
maxclav ds syrup 5ml - 0 - 5ml (9 days) dose got completed on april 10th sunday 2016
and to start azithrol 250 mg for 6 weeks/2 tablets per week (1st week april 12th and april 13th and to continue till 6th week)

we went back to the ent yesterday for review. she advised us to stop the azithrol 250 mg dose immediatly (just completed one week).
the adenoids is still enlarged though she has regained her hearing mostly.
we could also see improvement with respect to mouth breathing snoring and cough.

As per the review hearing test, she has normal hearing in right ears but still hearing loss persist in left ear. middle ear fluid present in both the ears. The ent has suggested we go opt for surgical procedure.

Plz clarify if its advisable to continue the azithrol 250mg 6wks dosage along with nazonax spray to see improvement?

her wt is 23kg

Thanks for the patience.

Answered by Dr. Sumit Bhatti (37 minutes later)

Brief Answer:
Continue the medication. Do not rush into surgery.

Detailed Answer:
Hi,

Thank you for your query.

1. Continue the medication. Add an anti allergic, mucolytic and supervised steam inhalation.

2. You should wait for 6 to 8 weeks before deciding surgical intervention.

3. Most children will recover.

4. You can get an Impedance Audiometry ( Tympanometry ) done. Repeat this test and the adenoid X-ray after 6 to 8 weeks.

5. If these tesrs are normal and her symptoms improve, there is no need for surgery.

6. However, trapped middle ear fluid tends to thicken to lead to a glue ear, and hence should be treated.

7. The adenoids usually regress after the age of 7 to 8 years.

9. This medication, excluding short term antibiotics and cough syrups, can safely be given for several months.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Sumit Bhatti (2 hours later)

Thanks for the response dr. Kind of you.

I m summing up my understanding for clarity:
#I can continue with the azithrol 250mg (2 tablets per week for 6 weeks)
#To continue with nasonax nasal spray
#To include steam inhalation
#Start giving anti allrgic medicine mucolytic.
Please confirm if this is right.

Is this mucolytic medicine syrup? dosage please? for how many days/weeks?

And regarding the treatment for trapped middle ear fluid, does that need a surgical procedure? or is it curable with medicines? How long can we wait to see improvement with respect to middle ear fluid?

PS:We have already done the- Impedance Audiometry ( Tympanometry ) test and got confirmed with middle ear fluid in both ears.As per your advise will again do it after 6 weeks to know the progress

Kind Regards,
Priya.R

Answered by Dr. Sumit Bhatti (2 hours later)

Brief Answer:
Yes, your summary is correct.

Detailed Answer:
Hi,

Thank you for writing back.

1. Syrup Relent contains an anti-allergic and a mucolytic.

2. This should be given twice a day for a two to four weeks.

3. Continue the rest of the medication.

4. The fluid build-up in the ears is common and usually responds to medical treatment. Only a few cases require surgery (myringotomy with grommet insertion).

5. Upload the follow up tests here or directly at bit.ly/Dr-Sumit-Bhatti

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Sumit Bhatti (5 hours later)

Thank u dr.

Relent syrup dosage 4ml - 0 - 4ml.
Is it right for her wt? She is 4.5yrs. 23kg

Will surely upload the follow up results.

Answered by Dr. Sumit Bhatti (4 hours later)

Brief Answer:
Yes, 4-5 ml of Syrup Relent twice a day is fine.

Detailed Answer:
Hi,

Thank you for writing back.

1. Syrup Relent 5 ml twice a day is also fine.

2. Do follow up in due course.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Prasad