From the Guidelines
For a 12-year-old with a cough due to an Upper Respiratory Tract Infection (URTI), the recommended treatment is primarily supportive care, as most URTIs are viral and self-limiting, and according to 1, peripheral cough suppressants have limited efficacy and are not recommended for this use. The treatment should focus on relieving symptoms and supporting the child's immune system.
- Rest and adequate hydration are essential to help the body recover from the infection.
- Honey (5-10 ml as needed) can help soothe the throat and reduce cough frequency, as it has natural anti-inflammatory properties.
- Over-the-counter medications like acetaminophen (10-15 mg/kg every 4-6 hours, not exceeding 5 doses in 24 hours) or ibuprofen (10 mg/kg every 6-8 hours with food) can be used for fever or pain relief, but it's crucial to follow the recommended dosage and avoid giving aspirin to children due to the risk of Reye's syndrome.
- Saline nasal sprays and humidifiers can help relieve congestion by adding moisture to the air and loosening mucus, making it easier for the child to breathe.
- As stated in 1, in patients with cough due to URI, central cough suppressants have limited efficacy for symptomatic relief and are not recommended for this use, which supports the approach of focusing on supportive care rather than cough suppression. Most URTIs resolve within 7-10 days without antibiotics, and parents should seek medical attention if the child develops difficulty breathing, persistent high fever, severe headache, unusual drowsiness, or if symptoms worsen after 7 days. These supportive measures work by addressing symptoms while the child's immune system fights the viral infection, making the recovery period more comfortable.
From the Research
Treatment Options for Cough due to URTI in a 12-Year-Old
- The treatment for a 12-year-old with a cough due to Upper Respiratory Tract Infection (URTI) may involve the use of expectorants such as guaifenesin 2, which acts by loosening mucus in the airways and making coughs more productive.
- Guaifenesin has a well-established and favorable safety and tolerability profile in adult and pediatric populations, and its dosing range allows for flexible dose titration 2.
- Early intervention with mucoadhesive gel nasal sprays may also be effective in alleviating symptoms and preventing the transmission of URTI viruses 3.
- Nasal irrigation with saline solution may reduce symptom severity in children with URTIs, with a level of evidence of 2 and a recommendation strength of B 4.
- Saline nasal irrigation possibly has benefits for relieving the symptoms of acute URTIs, although the evidence is not conclusive due to the small size and high risk of bias of the included trials 5.
Considerations for Antitussive Medications
- Over-the-counter (OTC) antitussive medications should not be routinely used in children under 2 years of age, but may be recommended for older children with cough after informed counseling 6.
- Antitussives with minimal adverse profile and some evidence of benefit may be considered for use in children with cough, although the effectiveness of these medications is not well established 6.