How to treat a cold in a child?

Treatment of a cold in a child is determined by the age of the child and the severity of the course of the disease itself.

Non-pharmacological treatment of a cold in a child

At a condition of average gravity and a heavy current of disease the bed mode which proceeds from 3-4 till 5-7 days is shown. Diet is normal. Widely used warming procedures: a bandage on the throat, warming foot baths, etc.

Drug treatment for a cold in a child

Treatment of a runny nose in a child should start in the first 2 days of the disease, the most effective therapy started in the first hours of the disease. The scope and program of treatment are determined by the severity of the disease, the health and age of the child, the development of complications or the risk of their development. Therapy may be limited to the appointment of vasoconstrictor intranasal drops. Frequently ill children, or with a severe course of the disease, or with the development of complications, therapy can be quite extensive. With the appointment of therapy in the first 2 days of the disease, these measures have a therapeutic effect proven in placebo-controlled studies.

Therapy of acute rhinitis and rhinopharyngitis in children

Features of the disease	Possible causative agent	Treatment
Uncomplicated, uncomplicated rhinopharyngitis	Rhinovirus Coronavirus Parainfluenza viruses PC viruses	Vasoconstrictive intranasal drops Antipyretics (according to indications) Anti-inflammatory drugs (according to indications) Antitussives (according to indications)
Uncomplicated, uncomplicated rhinopharyngitis in children with frequent pain, in children with chronic tonsillitis, adenoiditis, sinusitis Severe rhinopharyngitis (with hyperthermia and intoxication)	Rhinovirus Coronavirus Parainfluenza viruses PC viruses Influenza viruses	Vasoconstrictive intranasal preparations Local antibiotic therapy Anti-inflammatory drugs Antiviral: Interferons intranasally, rectally Inductors of interferonogenesis "Rimantadine" Antipyretic drugs Antitussives (according to indications)
Rhinopharyngitis with persistent flow and persistent cough	Mycoplasma pneumonia Chlamydia pneumonia	Local antibiotic therapy or systemic therapy with macrolides Antitussives Antipyretics (according to indications)

Characteristics of intranasal decongestants and features of their use in pediatrics

Preparations	Duration of action, h	Approved age of application	Number of instillations in the nose per day
Naphazoline	4-6	From 2 years in a concentration of 0.025%	4-6
Tetrisolin	4-6	Since 5 years in a concentration of 0.05%	4
Xylometazoline	8 10	From 2 years old	3-4
Oxymetazoline	10-12	From birth 0,01% solution From 1 year 0,025% solution From 5 years 0,05% solution	2

• Oxymetazoline is administered intranasally:
  • a newborn with 1 drop of 0.01% solution in each nasal passage 2 times a day;
  • children older than 5 months - 1-2 drops in each nasal passage 2 times a day:
  • children older than 1 year - 1-2 drops of 0.025% solution 2 times a day;
  • children older than 5 years - 1-2 drops of 0.05% solution 2 times a day.
• Naphazoline and tetrisolin are administered intranasally:
  • children older than 2 years - 1-2 drops of 0.025% solution in each nasal passage 4-6 times a day; about children from 5 years - 2 drops of 0.05% solution in each nasal passage 4-6 times a day.
• Xylometazoline is administered intranasally to children older than 2 years 1-2 drops in each nasal passage 3-4 times a day.

Anti-inflammatory therapy is indicated for severe inflammatory manifestations of ARI. In these cases, appoint fenspiride (erespal):

• Children under 12 years of age in oral solution at a rate of 4 mg / kg per day or
• newborn by 1/2 teaspoon 2-3 times a day:
• children from 1 to 3 months - 1 teaspoonful 2 times a day:
• children from 3 to 6 months - 1 teaspoonful 3 times a day:
• children from 6 months to 2 years - 1 teaspoon 3-4 times a day:
• children 2-4 years - 1 tablespoon 2 times a day;
• children 4-7 years - 1 tablespoon 3 times a day;
• children 7-12 years - 2 tablespoons 3 times a day:
• children and adolescents - 1 tablet 3 times a day.

Antitussive treatment in the common cold is mainly represented by preparations of expectorant and enveloping action. Drugs prescribed with a pronounced cough for 7-10 days.

Antitussive drugs expectorant and combined (expectorant and enveloping) action

A drug	Composition
Bronchipret drops, syrup and tablets	Drops and syrup - from 3 months; contain thyme and ivy, tablets - thyme and primrose
Bronchicum elixir	Thyme, quebracho, primrose
Glyceram	Licorice
Breast gathering number 1	Althaeus, oregano, mother-and-stepmother
Breast gathering number 2	Mother-and-stepmother, plantain, licorice
Breast gathering number 3	Sage, anise, pine buds, marshmallow, licorice, fennel
Thoracic Elixir	Licorice, aniseed oil, ammonia
Doctor Mom	Extracts of licorice, basil, elecampane, aloe, etc.
Lycorine	Licorice
Mukaltin	Altein root
Pectusin	Mint, eucalyptus
Pertussin	Thyme or thyme herb extract

Antipyretic therapy with a mild and uncomplicated rhinitis is rarely shown. However, in severe cases, especially in young children. Often in the first days of the disease, hyperthermia of the body is noted up to 39.5 ° C. Then prescribe antipyretics (paracetamol or ibuprofen) or a combination of antipyretics with antihistamine drugs of the 1st generation.

• Paracetamol is administered orally or rectally from the calculation of 10-15 mg / kg per day in 3-4 doses.
• Ibuprofen is also prescribed internally from the calculation of 5-10 mg / kg per day in 3-4 doses.
• Prometazine (pipolphen) is administered orally 3 times a day:
  • children under 3 years of 0,005 g;
  • children under 5 years of 0.01 g;
  • children over 5 years of age at 0,03-0,05 g.
• Chloropyramine (suprastin) is administered orally 3 times a day:
  • children under 3 years of 0,005 g;
  • children under 5 years of age to 0.01 g;
  • children over 5 years of 0.03-0.05 p.

At a temperature above 40 ° C, a lytic mixture is used, into which chlorpromazine (aminazine) enters a 2.5% solution of 0.5-1.0 ml, promethazine (pipolphene) in a solution of 0.5-1.0 ml. The lytic mixture is administered intramuscularly or intravenously, once. In severe cases, the mixture includes metamizole sodium (analgin) in the form of 10% solution from the calculation of 0.2 ml per 10 kg.

Medicinal preparations of antiviral action should be included in therapy along with the above drugs in case of severe disease with severe intoxication. Hyperthermia (above 39.5 ° C), a violation of the general condition, as well as often sick children. To this end, in the first 2-3 days of the disease, native leukocyte interferon alfa and / or, more effectively, can be used. Recombinant interferon alfa-2 (viferon).

Interferon leukocyte human intranasal injected 1 to 3 drops in each half of the nose every 2 hours for 2-3 days. Interferon alfa-2 (viferon) is administered rectally in suppositories of 150,000 IU (viferon 1) for children under 5 years and 500,000 IU (viferon 2) for children 5 years and older 2 times a day for 5 days. After 2-3 days, if necessary, take viferon repeat 1 suppository 2 times a day 1 day and spend 4-6 such courses.

Since 2.5 years, the inducer of the synthesis of endogenous interferon arbidol can be used, which is prescribed to 0,05 g (arbidol children) 2 times a day for children under 7 years, 0.25 g 2 times a day for children over 7 years old. Arbidol is also used in the first 2-3 days of acute rhinopharyngitis for 2 days, then a 3-day break and treatment is repeated for 1 day; do 2-3 such repetitions.

In addition, homeopathic preparations are used. In acute rhinopharyngitis, viburkol, aflubin, anaferon children, agri child (antigrippin homeopathic for children), and infusions are shown. Homeopathic medicines are prescribed for children starting from 6 months, except for the children's agri, appointed from the age of 3, and the infusiocide prescribed with 6 years. Children under 3 years are given 1/2 tablet 2-3 times a day. Children older than 3 years - on a tablet 3-4 times a day. The exception is viburkol, which is prescribed in candles. Children of the first 3 years of life - 1 suppository rectally. Children older than 3 years - 2 suppositories rectally per day. The duration of the course of homeopathic therapy is 3-5 days.

Antiviral drugs, such as rimantadine and rimantadine / alginate (algirem), have activity against influenza A virus. Indications for prescribing rimantadine are established or highly probable influenza aetiology of the disease (corresponding epidemiological situation, severe, progressive symptoms, "delay" of catarrhal symptoms ORZ for several hours or 1-2 days).

• Rimantadine is prescribed to children over the age of 5 mg per kg per day (but not more than 15 mg / kg) in 2 divided doses for 5 days.
• Rimantadine / alginate Syrup 2% is prescribed orally for children older than the year:
  • in the 1st day - 10 mg 3 times a day;
  • in the second and third days - 10 mg 2 times a day;
  • on the 4th and 5th day - 10 mg once a day.

Inclusion of local antibiotic therapy with fusafungin (bioparox) in the treatment regimen is recommended for severe acute rhinopharyngitis, as well as for frequently ill children and children with chronic tonsillitis, adenoiditis, sinusitis over 2.5 years. Bioparox along with the local antibacterial also has a pronounced anti-inflammatory effect. Bioparox is recommended for children older than 2.5 years due to the fact that it is prescribed by inhalation. Do 2-4 inhalations in each nasal passage and oral cavity every 6 hours, i.e. 3-4 times a day. The duration of therapy is 5-7-10 days.

Systemic antibiotics macrolides are used in the inefficiency of local antibiotic therapy with fusafungin in acute rhinopharyngitis mycoplasmal or chlamydial etiology. Macrolide antibiotics are characterized by almost identical antibacterial activity against Chlamydofila pneumoniae and M. Pneumoniae, so their choice is determined by the individual tolerability and convenience of the dosage form used.

Doses, route and multiplicity of administration of macrolide antibiotics

Antibiotic	Doses	Routes of administration	Multiplicity of the introduction
Erythromycin	Children under 12 years 40 mg / kg Children over 12 years of age 0.25-0.5 g every 6 hours	Orally	4 times a day
Spiramycin	Children under 12 years 15 000 U / kg Children over 12 years of age 500 000 units every 12 hours	Orally	2 times a day
Roxithromycin	Children under 12 years of age 5-8 mg / kg Children over 12 years of age 0.25-0.5 g every 12 hours	Orally	2 times a day
Azithromycin	Children under 12 years 10 mg / kg per day, then 5 mg / kg per day for 3-5 days Children over 12 years of age 0.5 g once a day every day for 3-5 days	Orally	1 time per day
Clarithromycin	Children under 12 years of age 7.5-15 mg / kg Children over 12 years of age 0.5 g every 12 hours -	Orally	2 times a day

[1], [2], [3], [4], [5]

Surgical treatment of a cold in a child

Do not spend.

Indications for consultation of other specialists

In case of complications (acute otitis media, acute sinusitis, etc.), as well as a prolonged or severe course, consultation of the otolaryngologist,

Indications for hospitalization

Hospitalization is carried out in the following cases:

• body temperature 40 ° C and above;
• severe respiratory and pulmonary heart failure;
• impaired consciousness;
• convulsive syndrome;
• development of purulent complications.

Hospitalization is best done in the boxed ward of the hospital, in cases of seizures - in the intensive care unit or resuscitation department, with the development of complications (otitis, sinusitis, etc.) - in a specialized ENT department. Particular attention should be paid to the children of the first half of life, who should be hospitalized whenever possible, and better in the box office.

Prognosis of a cold in children is favorable.