Patient's question:
My baby is ten and a half months old. On the morning of December 6th, he received the Japanese encephalitis vaccine, and by that evening, he had a fever. First, he felt cold and his face turned purple for about half an hour, then he had a high fever. After taking traditional Chinese medicine for four days, it was not effective. A follow-up examination revealed bronchitis, so we switched to intravenous drip with Ribavirin and Lixianxin. After three days of medication, there was slight improvement, but he still had a runny nose, coughed two or 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, he has been taking traditional Chinese medicine and Cefixime 0.125g once. Could you please ask the expert what to do?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 medicine, and general symptomatic treatment alone.
2. For more severe symptoms, including fever, which are secondary to upper respiratory tract 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 first choice. Avoid unnecessary combination of two antibiotics.
3. For patients with thick, sticky sputum, it is particularly important to ensure adequate fluid intake. Avoid using cough suppressants alone. The following medications are commonly used:
(a) Infant Cough Mixture (MT) 1 ml/kg/dose Tid
(b) Brown Mixture 1 ml/year/dose Tid
(c) Cetyl 1/2–1 cap Bid or Tid
Cetyl contains diphenhydramine, so it should not be used concurrently with promethazine or other sedatives.
(d) Bisolvon 4–8 mg Tid
4. For weak infants, pay attention to preventing sputum blockage. Change positions frequently and reduce unnecessary intravenous fluid administration. For patients with excessive sputum and shortness of breath, perform percussion and sputum 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 once after 30 minutes if necessary.