How to manage respiratory tract infections in children?
Q: I have a 4 year old daughter and the question is related to her. Since the past 8 months she has been suffering from cough followed by breathlessness. In the months of August, September and October the breathing difficulty used to become severe but recently she has improved, after we consulted another doctor. He has told us that she is suffering from Upper Respiratory Tract Infection and has a lot of congestion. She has been prescribed Ventrolin, Steam and Corex Cough Syrup and usually an Antibiotic. The child has shown signs of improvement and we are staying on with the doctor. Three days back she was coughing (though not severely) and when we took her to the doctor he advised Nebulising with Asthalin and the following drugs and dosage. Ventrolin 5ml (8 hourly), Theoped (5ml x 8 hrly) and Piriton CS 2.5ml BD. I administered the drugs to her on Monday afternoon and evening after which she did not sleep too well. By morning she refused to get up and was looking very lethargic. Her pulse rate was also down and she was not responding, I rushed her to the doctor and he advised a blood test and found that the blood sugar was pretty low and started glucose immediately. He also took a chest X ray and though the chest was clear by physical examination. He once again stressed upon the Upper Respiratory Tract Infection. Meanwhile my daughter recovered and by afternoon she was her normal self and active. The IV Glucose continued till today afternoon. He also took a Blood Examination and the following are the results Haemoglobin:11.9; WBC: 15700; Neutrophils: 90%; Lymphocytes: 6%; Monocytes: 0%; Eosinophils: 4%; Basophils: 0%; MP: not seen; Blood Urea: 41; Creatinine: 0.5; Sodium: 140; Potassium: 4.1 He told me that the low sugar could be due to low intake of food and I agreed as she was not taking normal food since the past three days and no milk etc. She has also been given Nosocef Injection and he has advised the same to be continued for 3 more days (5 days in all). Kindly advise me about the blood report (the doctor attributes it to the infection), the treatment and diagnosis, and the reason for her lethargy - could it be drug related?
A:Your daughter probably has an allergic respiratory tract and would probably benefit from the use of a nebuliser, especially since she has been having cough off and on for 8 months. Ventorlin and Theoped are both bronchodilators, used in the management of allergic respiratory disease. However for long term control one has to use inhaled low dose steroids in the form of Seroflo inhaler 125 microgram - two puffs twice a day by inhaler (with the help of Zerostat Spacer and Baby mask made by CIPLA) or Budecort respule 1 mg by nebuliser twice a day and continued for at least a month. Consult your Paediatrician on the details of the ongoing management, but I strongly reccomend this course of action. The use of antibiotics each time she starts coughing is not advisable.