Patient's question:
My baby is ten and a half months old. On the morning of December 6th, she received the Japanese encephalitis vaccine, and by that evening, she developed a fever. She first experienced chills and her face turned purple for about half an hour, followed by high fever. After taking traditional Chinese medicine for four days without improvement, a follow-up examination revealed bronchitis. She was then given intravenous drips, including Ribavirin and Lixianxin. After three days of medication, there was slight improvement, but she still had a runny nose, coughed two to three times in the morning and evening, and still had a sore throat. It has been 17 days since then. In the past two days, she has been taking traditional Chinese medicine and Cefixime 0.125g once daily. Could you please ask the expert what should be done?Doctor's answer:
Hello: Key Points of Treatment1. In early-stage cases of dry cough without fever in older children, the principle is to use traditional Chinese medicine, Chinese patent medicines, and general symptomatic treatment alone.
2. For more severe symptoms, including fever, which are secondary to upper respiratory infections, the first-line treatment is SMZc0 or penicillin, erythromycin, and macrolides. Aminopenicillin or cephalosporins are used as alternatives. For children over 5 years old, erythromycin is the preferred choice. Avoid unnecessary combination of two antibiotics.
3. For patients with excessive, thick mucus, it is particularly important to ensure adequate fluid intake. Avoid using cough suppressants alone. The following medications are commonly used:
(1) Infant Cough Mixture (MT) 1 ml/kg/dose TID
(2) Brown Mixture 1 ml/year/dose TID
(3) Cetyl 1/2–1 cap BID or TID
Cetyl contains diphenhydramine, so it should not be used concurrently with promethazine or other sedatives.
(4) Bisolvon 4–8 mg TID
4. For weak infants, pay attention to preventing mucus blockage. Change positions frequently and reduce unnecessary intravenous fluid administration. For patients with excessive mucus and shortness of breath, perform percussion and suction after ultrasonic nebulization.
5. For recurrent bronchitis with wheezing and prominent lung wheezing sounds, try 0.1% theophylline 0.1 ml/kg/dose subcutaneous injection. If symptoms and signs improve significantly or disappear within 5–10 minutes, it may indicate possible bronchial asthma. If the effect is not obvious, repeat the dose after 30 minutes if necessary.