What is the best approach for treating Febrile Respiratory Illness (FRI) in children, considering their age and potential underlying conditions such as asthma?

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Treatment of Frequently Relapsing Nephrotic Syndrome (FRNS) in Children

I notice there appears to be a mismatch between your question about "FRNS in children" and the provided evidence, which focuses entirely on respiratory illnesses, asthma, and influenza rather than Frequently Relapsing Nephrotic Syndrome.

Critical Issue with Available Evidence

The evidence provided does not address nephrotic syndrome, steroid-responsive nephrotic syndrome, or FRNS management. Instead, the evidence covers:

  • Influenza treatment and antiviral therapy 1
  • Asthma diagnosis and management in children 1, 2, 3, 4
  • Respiratory syncytial virus infections 5
  • General febrile illness management 6, 7, 8

If You Intended to Ask About Respiratory Illness

For febrile respiratory illness in children, particularly those with underlying asthma, early antiviral treatment with neuraminidase inhibitors should be initiated within 48 hours of symptom onset for high-risk patients, while maintaining asthma controller medications. 1

High-Risk Children Requiring Antiviral Treatment

  • Children aged <2 years are at highest risk for influenza complications 1
  • Children with chronic pulmonary conditions including asthma require prompt antiviral therapy 1
  • Hospitalized children or those with severe, complicated, or progressive illness need immediate treatment regardless of symptom duration 1

Asthma-Specific Considerations

  • Continue inhaled corticosteroids (ICS) as the preferred controller medication during respiratory illness 3
  • For children under 5 years with asthma, budesonide nebulizer solution (FDA-approved from age 1 year) or fluticasone DPI (age 4+) should be maintained 3
  • Viral respiratory infections are the predominant trigger for asthma exacerbations in children 4

Treatment Should NOT Be Delayed

  • Do not wait for diagnostic test confirmation before starting antivirals in high-risk children 1
  • Empiric treatment is appropriate when influenza is suspected clinically 1

If You Actually Need FRNS Information

Please confirm whether you need information about Frequently Relapsing Nephrotic Syndrome (a kidney disorder requiring immunosuppressive therapy) or clarify the specific respiratory condition you're asking about, as the current evidence does not match nephrotic syndrome management.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Evaluation and Management of Suspected Asthma in Young Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Asthma Management in Children 5 Years and Younger

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Asthma Pathophysiology and Clinical Implications

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Respiratory syncytial virus infection in children.

American family physician, 2011

Research

Childhood fever.

Singapore medical journal, 1996

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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