Patient's question:
Detailed medical condition and consultation purpose: Suffering from a cold for three days, with high neutrophil and lymphocyte counts, no runny nose or cough symptoms. The fever drops when taking fever-reducing medication, but it returns to 38.5°C after four hours. Currently taking Cefixime and Xinhua Lin, Jian'er Qingjie Liquid. Please ask: Should IV infusion be used in this case? Please provide a better treatment and medication plan. Thank you very much!!!!!!!!!Doctor's answer:
Hello: The key points for treating upper respiratory tract infections in children are as follows;1. During the fever phase, adhere to bed rest, pay attention to keeping warm, and drink plenty of fluids.
2. Avoid the indiscriminate use of antibiotics. In principle, symptomatic treatment is preferred for early cases with good general condition, with the first choice being traditional Chinese medicine preparations, antiviral oral liquid, Yinqiao heat-reducing granules, or strong Yinqiao tablets, etc.
3. Indications for antibiotic use
(a) The course of the disease exceeds 3 days, symptoms worsen, or there is a relatively clear basis for bacterial infection.
(b) Infants and young children with poor constitution or nutrition.
(c) For children under 2 years old with a temperature above 39°C, WBC above 10.5×10^9/L, neutrophils above 70% with left shift of the nucleus, strive to send blood culture tests before using antibiotics to early detect possible bacteremia.
The first choice of antibacterial drugs is SMZCO, penicillin, or erythromycin group. Before medication, throat swab culture is sent for suspected hemolytic streptococcal infection, and penicillin is preferred. Once confirmed, the course of treatment should be strictly 10 days. Alternatively, after the fever subsides and symptoms and signs improve, oral erythromycin can be switched, or a single intramuscular injection of long-acting penicillin 600,000–1,200,000 U can be given.
4. Antiviral drugs, in addition to the aforementioned traditional Chinese medicine, ribavirin can be used locally or systemically.
(a) 0.5% solution for nose drops: once every hour on the first day, for a total of 4–6 times; starting from the next day, 3–4 times daily.
(b) 5–10 mg/kg/day, administered in two divided intramuscular injections or added to an appropriate amount of glucose solution for intravenous drip.
5. Symptomatic treatment
(a) Antipyretic and sedation