What is the treatment for a child with fever, sore throat, and body aches?

Treatment of a Child with Fever, Sore Throat, and Body Aches

For a child with fever, sore throat, and body aches, ibuprofen or paracetamol (acetaminophen) should be given as first-line treatment for symptom relief, with ibuprofen showing slightly better efficacy for pain relief. 1, 2

First-Line Symptomatic Treatment

• Ibuprofen appears to have slightly better efficacy than paracetamol for pain relief, particularly after 2 hours of administration 1, 2
• For children, the appropriate dosing is:
  • Ibuprofen: 10 mg/kg every 6-8 hours 3
  • Paracetamol: 10-15 mg/kg every 4-6 hours, not exceeding 60 mg/kg/day 4
• Both medications are considered safe when used according to directions for short-term treatment of sore throat pain and fever 1, 5
• Aspirin is contraindicated in children under 16 years due to risk of Reye syndrome 1

Supportive Care Measures

• Ensure adequate fluid intake to maintain hydration 1, 6
• Rest is recommended to reduce metabolic and oxygen requirements 1
• Minimal handling of the child may help reduce metabolic and oxygen requirements in more severely ill children 1
• Avoid unnecessary bundling of the child; appropriate clothing can help manage fever 6

Assessment of Severity

• Assess for signs of severe illness requiring medical attention:
  • Respiratory distress (tachypnea, retractions) 1
  • Altered mental status 1
  • Inability to take oral fluids 1
  • Fever for 4-5 days without improvement 1
  • Initial improvement followed by worsening symptoms 1

Age-Specific Considerations

• Children under one year of age should be seen by a healthcare provider 1
• Children aged 1-7 years may be seen by a nurse or physician 1
• Children aged 7 years and above may be seen by any member of the community health team 1

Antiviral Considerations

• Consider oseltamivir if the child presents within 48 hours of symptom onset during influenza season and has fever >38.5°C 1, 7
• Oseltamivir dosing is weight-based:
  • <15 kg: 30 mg twice daily
  • 15-23 kg: 45 mg twice daily

  • 24 kg: 75 mg twice daily 1

Antibiotic Considerations

• Antibiotics are not recommended for most cases of sore throat as most are viral in origin 8
• Consider antibiotics only if high suspicion for streptococcal infection (3-4 Centor criteria) with positive testing 8
• If antibiotics are indicated, penicillin V is the first-line treatment 8

Common Pitfalls to Avoid

• Do not focus solely on normalizing body temperature; the goal should be improving the child's overall comfort 5
• Avoid tepid sponging as it causes discomfort and has only short-term effects on fever 6
• Do not use antibiotics to prevent complications in low-risk patients 8
• Do not use zinc gluconate lozenges as they have inconsistent efficacy results and increased adverse effects 2
• Avoid herbal remedies or alternative treatments due to lack of reliable efficacy data 2, 8

When to Seek Further Medical Attention

• If the child develops shortness of breath or difficult breathing 1
• If the child becomes drowsy, disoriented or confused 1
• If fever persists for 4-5 days without improvement 1
• If the child initially improves but then develops high fever and feels unwell again 1