Hi, Note the history about your daughter having severe coughing , was given Azithromycin and steroids, started nose bleed. Steroid and Azithromycin are not really known to cause this problem. The commonest causes are: Rupture of the superficial small blood vessel in the front part of the nasal septum called Little s are and strain of coughing or over blowing of nose can cause nosebleed what we call as epistaxis. Hypertension. Nasal infection. I would advise you to take her to ER as you have suggested. Proper examination may find the cause and thus get treated. IF the bleeding is more her nose will be packed from pressure control of bleeding. Further management as the the cause found by an ENT Surgeon. Medications as would be advised. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T. Chandrakant, ENT and General Surgeon