From the Guidelines
The best treatment for a child with an upper respiratory infection typically involves supportive care and symptom management, with antibiotics only prescribed when a bacterial infection is confirmed or highly suspected. Here's a direct approach:
- Rest and hydration: Ensure the child gets plenty of rest and drinks fluids to stay hydrated.
- Over-the-counter pain relievers: Use acetaminophen or ibuprofen for fever and discomfort, with dosage depending on the child's weight and age, following package instructions carefully 1.
- Nasal saline drops: Use to help clear congestion, especially for infants.
- Humidifier: Run a cool-mist humidifier in the child's room to ease breathing.
- Honey (for children over 1 year): Give 1/2 to 1 teaspoon to soothe sore throat and cough.
- Avoid antibiotics unless prescribed by a doctor, as most upper respiratory infections are viral, and their use can lead to antibiotic resistance and other adverse effects 1. Monitor symptoms and seek medical attention if the child has difficulty breathing, high fever lasting more than three days, or worsening symptoms after 7-10 days.
When considering antibiotic therapy, it's essential to follow guidelines that recommend the use of amoxicillin as the first-line treatment for acute bacterial sinusitis in children, with adjustments based on the severity of symptoms and potential allergies 1. For community-acquired pneumonia, guidelines suggest the use of amoxicillin or other antibiotics based on the child's age, severity of symptoms, and local resistance patterns 1.
In all cases, the decision to prescribe antibiotics should be made judiciously, considering the potential benefits and harms, and always in consultation with a healthcare professional.
From the Research
Treatment Options for Pediatric Upper Respiratory Infections
- Symptom management with over-the-counter drugs is recommended for the common cold, although the Food and Drug Administration advises against use of these drugs in children younger than 6 years 2
- Antibiotics are not recommended for acute rhinosinusitis unless symptoms worsen or do not improve after an additional 7 days 2
- Antibiotics for streptococcal pharyngitis should be prescribed only if test or culture results are positive 2
- Acute otitis media (AOM) can be managed without antibiotics except in certain high-risk patients, such as children younger than 6 months or children with bilateral AOM and otorrhea 2
Antibiotic Therapy
- The choice of antimicrobial drug is based on the evidence of agents and their sensitivity to antimicrobial drugs, age, patient's condition, previous treatment, and possible allergic reactions to the drug 3
- In patients with pharyngitis, a single injection of benzathine penicillin is considered to be first choice, but macrolides may be preferred due to local pain and allergic problems 4
- Amoxicillin is still the drug of choice for AOM in some countries, with a twice-daily regimen demonstrated to be as effective as the traditional thrice-daily schedule 4
Alternative Treatments
- 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 5
- Nutrition may play a role in the treatment of URTIs, although most infections are caused by viruses and do not require specific treatment beyond symptom control 6