How to manage a cough that persists despite medicine?

Question

Hello doctor,

My daughter is 4 years old and weighs around 35.27 pounds. She has been having a cough and cold for the past seven days, and can not sleep well at night. I have been giving her Ambroxol syrup for the past four days, and I gave her Allerkid last night. What medication can I give her?

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern.

Does the patient have a fever? Is the patient a known asthmatic, or have food and drug allergies? How was the response to Ambroxol and Allerkid?

The cough and cold may be due to an infection (viral or bacterial), an allergy, or an asthma attack, among other possible diagnoses. If it is due to an infection, it is usually associated with fever, but it can also present without any fever. If the cause is viral, it will resolve on its own. However, COVID-19 (an infectious disease caused by the SARS-CoV-2 virus) is also considered. If it is a bacterial infection, then an antibiotic is needed. If the cause is an allergy, the Allerkid (Cetirizine) may help. If it is an asthma attack, then adding Salbutamol (bronchodilator) via a nebulizer may help.

However, because of her age and the duration of the symptoms, I would really suggest bringing the patient to a doctor, so they may be properly examined and the right medicine may be given. It is quite hard to evaluate children because they can not verbalize how they feel.

As of now, continue the Allerkid (Cetirizine), and you may nebulize with Salbutamol when she coughs, but again.

I hope that was helpful.

Thank you and regards.

Answer 2

Hello,

Welcome back to icliniq.com.

The dose for Salbutamol (Ventolin nebule) is 2.5 mg, one nebule every four to six hours. You can try tonight to nebulize the child before sleeping.

If the frequent coughing is more at night, it might be due to bronchial asthma (a condition in which a person's airways become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe). You may add Montelukast 5 mg, one tablet after dinner, but, as I suggested earlier, it is really best if the child is seen by a doctor so a proper examination may be done.

To be on the cautious side, since she has not yet been seen by a doctor, nebulize only if needed, or every six to eight hours intervals. Try to give one dose only tonight before she sleeps. We only recommend giving it every four hours after proper examination of the patient. Consult a doctor and give the medicines accordingly.

In your case, a diagnosis is really needed, so an actual consultation with a physical examination is really necessary before maintaining her on nebulization.

Please reach out for any further queries.

Thank you.