From the Guidelines
Magic mouthwash containing lidocaine is not recommended for 8-month-old infants with herpangina due to the risk of toxicity and other adverse effects. According to the guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures 1, local anesthetic agents like lidocaine can cause central nervous system excitation or depression, and particular weight-based attention should be paid to cumulative dosage in all children.
For an 8-month-old infant with herpangina, it is recommended to manage symptoms with acetaminophen (Tylenol) liquid at 10-15 mg/kg every 4-6 hours for pain and fever, and ensure adequate hydration with cool liquids and soft foods. Cold foods like popsicles may provide temporary relief. Herpangina, caused by coxsackievirus, typically resolves within 7-10 days without specific treatment.
Key considerations for managing herpangina in infants include:
- Monitoring for signs of dehydration, such as fewer wet diapers or lethargy
- Ensuring adequate hydration and nutrition
- Providing symptomatic relief with acetaminophen and cool liquids
- Seeking immediate medical attention if symptoms worsen or the infant shows signs of distress
It is essential to consult with a healthcare provider before administering any medication to infants, as they can provide guidance on the most appropriate treatment options based on the infant's age, weight, and medical history 1.
From the FDA Drug Label
◆ children under 12 years or younger: ask a doctor The FDA drug label does not answer the question.
From the Research
Dosage of Magic Mouthwash for Herpangina
There is limited research on the specific dosage of magic mouthwash for an 8-month-old infant with herpangina. However, some studies provide information on the ingredients and preparation of magic mouthwash:
- A study published in 2017 2 found that a beyond-use dating of 21 days is appropriate for magic mouthwash formulations containing lidocaine, diphenhydramine, and aluminum hydroxide-magnesium hydroxide-simethicone.
- Another study from 2005 3 surveyed the usage of topical oral solutions, including magic mouthwash, for the treatment of chemotherapy-induced oral mucositis, and found that the top five ingredients used to compound the magic mouthwash are diphenhydramine, viscous lidocaine, magnesium hydroxide/aluminum hydroxide, nystatin, and corticosteroids.
Considerations for Pediatric Patients
When considering the use of magic mouthwash in pediatric patients, especially infants, it is essential to take into account the potential risks and benefits:
- A study from 2015 4 evaluated the effectiveness of topical morphine compared to a routine mouthwash in managing cancer treatment-induced mucositis, but did not provide specific guidance on the use of magic mouthwash in infants.
- There is no direct evidence from the provided studies to support a specific dosage of magic mouthwash for an 8-month-old infant with herpangina.
Recommendations
Based on the available evidence, it is not possible to provide a specific recommendation for the dosage of magic mouthwash for an 8-month-old infant with herpangina. It is crucial to consult with a healthcare professional to determine the best course of treatment for the infant's specific condition.