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Suggest treatment for severe cough and fever in a child

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Posted on Mon, 23 Nov 2015
Question: My 1.6 months baby was he has a too much cough in chest & slight brithing problem. Fever not came down even after giving paracetamol & below mentioned medicine. Please guide me.
doctor
Answered by Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
The dosage are not seems to be correct for the age

Detailed Answer:
Hello

Thanks for asking on this platform

I can understand your concern.The most common cause of cough/cold with fever in this age is some viral infection but there are high chances of secondary bacterial infection in this age group.
The dosage of all the medications does not seems to be correct for this age.
First of all I would like to know the weight of your baby.The dosage in children are adjusted to body weight and not to the age.
The average weight of 1.6 month old baby is 4 kgs.The pyrakem contains paracetamol an antipyratic(to bring down the temperature).Each ml(20 drops) of pyrakem contains 100 mg of paracetamol.The dosage of paracetamol is 10-15 mg/kg/dose that is 8-12 drops (0.4-0.6 ml)of pyrakem.It can be given at an interval of 4-6 hours(total 60 mg/kg/day).
Asthalin contains salbutamol(a bronchodilator) 2 mg/5ml.The dose of salbutamol is 0.15-0.25 ml/kg/dose that is about 2.5 ml.
Phenargan should not be advised in small children due to the side effect of respiratory depression.
Oflamac forte contains 100 mg of ofloxacin per 5 ml.The dose of ofloxacin is 10-15 mg/kg/day.Your baby is getting 200 mg/day that is too high.
Ofloxacin is also not a good antibiotic for respiratory infection.
It appears that you have consulted a general physician not a child specialist.
I would like to give paracetamol 10/mg/kg/dose at interval of 4 hours.If fever is not responding to paracetamol adding mefenemic acid would help.
Asthalin should be given 2.5 ml three times a day.
Apart from this antihistaminic and decongestent combination would help in cold and relieving the congestion.
Cefpodoxim or cefixime a good antibiotic for respiratory infection.
All these are prescription medication so please get it prescribed by a pediatrician in proper dosing.
If baby is lethargic or excessive irritable,not accepting orally well or breathing difficulty is remarkable consult a pediatrician for evaluation and management accordingly.

Please let me know if you have any more query.
Wishing for your baby's speedy recovery.
Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Pradeep Kumar Jain (2 hours later)
Thank you Doctor for Your answer.
First I let you know that that my baby's age is 1.6 years means 1 year 6 months & her weight is 10.00 kg.
secondly just i consult with a second ped.
He told that the reson of fever is viral infection along with cold.
He has given the following medicine.
1. Cefpodoxime proxetil oral suspension 5 ml x 2 times
2. Phenylephrine Hydrochloride & chlopheniramine meleate syrup - 5 ml x 3 times
3. Bromhexine,Terbutaline & Guaiphenesin xpectorant - 5 ml x 3 times
4. Ibugesic Plus - 5 ml 6 hours interval.

Is it correct medication for her
doctor
Answered by Dr. Pradeep Kumar Jain (13 minutes later)
Brief Answer:
This is the right prescription

Detailed Answer:
Thanks for follow up

Cefpodoxime is a good antibiotic for respiratory infection.
Phenylephrine is a decongestant and chlorpheniramine is an antiallergic.It would provide relief in nasal blockage and cough too.
The terbutaline combination relieves airway spasm and soothens the throat.
Ibugesic plus contains paracetamol with ibuprofen and is appropriate for your baby as her fever is not responding to paracetamol alone.
The dosage are also appropriate for her weight.
I would suggest you to continue with the same.

Thanks and regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Pradeep Kumar Jain (34 minutes later)
Thank you very much.
doctor
Answered by Dr. Pradeep Kumar Jain (21 minutes later)
Brief Answer:
Happy to help

Detailed Answer:
It's my pleasure that you found my suggestions helpful.
I shall be glad to answer if you have any more doubt.

Thanks and regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Pradeep Kumar Jain (48 hours later)
Hello Doctor,

My Baby was much beter than before. Her problem is now heavy cough & expectoration of mucus by coughing. To day i again consult with my Paed. He gve her nebulisation. He added two med with the previous.
Omnacortil solution (prednisolonesodium phophete solution) - 5 ml x 3 times
Junior Lanzol 15 - one in a day.

Is omnacortil safe for her?
doctor
Answered by Dr. Pradeep Kumar Jain (9 hours later)
Brief Answer:
short course steroid decreases airway's inflammation

Detailed Answer:
In case of involvement of lower respiratory tract which is mainly suspected to be due to hyper reactive airway disease, short course of steroid helps.
Short course (less than 7 days ) of steroid (omnacortil)doesn't have significant side effect.It may cause some gastric irritation which can be counteracted by acid reducing agent like junior lanzole.
I hope this helps.

I shall be glad to answer if you have any more doubt.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2028 Questions

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Suggest treatment for severe cough and fever in a child

Brief Answer: The dosage are not seems to be correct for the age Detailed Answer: Hello Thanks for asking on this platform I can understand your concern.The most common cause of cough/cold with fever in this age is some viral infection but there are high chances of secondary bacterial infection in this age group. The dosage of all the medications does not seems to be correct for this age. First of all I would like to know the weight of your baby.The dosage in children are adjusted to body weight and not to the age. The average weight of 1.6 month old baby is 4 kgs.The pyrakem contains paracetamol an antipyratic(to bring down the temperature).Each ml(20 drops) of pyrakem contains 100 mg of paracetamol.The dosage of paracetamol is 10-15 mg/kg/dose that is 8-12 drops (0.4-0.6 ml)of pyrakem.It can be given at an interval of 4-6 hours(total 60 mg/kg/day). Asthalin contains salbutamol(a bronchodilator) 2 mg/5ml.The dose of salbutamol is 0.15-0.25 ml/kg/dose that is about 2.5 ml. Phenargan should not be advised in small children due to the side effect of respiratory depression. Oflamac forte contains 100 mg of ofloxacin per 5 ml.The dose of ofloxacin is 10-15 mg/kg/day.Your baby is getting 200 mg/day that is too high. Ofloxacin is also not a good antibiotic for respiratory infection. It appears that you have consulted a general physician not a child specialist. I would like to give paracetamol 10/mg/kg/dose at interval of 4 hours.If fever is not responding to paracetamol adding mefenemic acid would help. Asthalin should be given 2.5 ml three times a day. Apart from this antihistaminic and decongestent combination would help in cold and relieving the congestion. Cefpodoxim or cefixime a good antibiotic for respiratory infection. All these are prescription medication so please get it prescribed by a pediatrician in proper dosing. If baby is lethargic or excessive irritable,not accepting orally well or breathing difficulty is remarkable consult a pediatrician for evaluation and management accordingly. Please let me know if you have any more query. Wishing for your baby's speedy recovery. Regards