From the FDA Drug Label
Directions • shake bottle well before use • measure only with dosing cup provided • do not use dosing cup with other products • dose as follows or as directed by doctor adults and children 12 years of age and over 10 mL every 12 hours, not to exceed 20 mL in 24 hours children 6 to under 12 years of age 5 mL every 12 hours, not to exceed 10 mL in 24 hours children 4 to under 6 years of age 2.5 mL every 12 hours, not to exceed 5 mL in 24 hours children under 4 years of age do not use The best antitussive for a pediatric patient is dextromethorphan (PO), with the following dosing guidelines:
- Children 12 years of age and over: 10 mL every 12 hours, not to exceed 20 mL in 24 hours
- Children 6 to under 12 years of age: 5 mL every 12 hours, not to exceed 10 mL in 24 hours
- Children 4 to under 6 years of age: 2.5 mL every 12 hours, not to exceed 5 mL in 24 hours
- Children under 4 years of age: do not use 1
From the Research
Introduction to Antitussives in Pediatrics
Antitussives, or cough suppressants, are commonly used in pediatric patients to alleviate cough symptoms. However, the choice of antitussive can be complex, and healthcare providers must consider the efficacy, safety, and potential risks of each medication.
Overview of Available Antitussives
Several antitussives are available, including over-the-counter (OTC) medications, such as dextromethorphan and diphenhydramine, and prescription medications, like hydrocodone. However, the use of these medications in pediatric patients is often limited by concerns about safety and efficacy.
Honey as a Natural Antitussive
Honey has been shown to be an effective antitussive in pediatric patients, with studies demonstrating its ability to reduce cough frequency and severity 2. Honey is generally considered safe and well-tolerated, making it a popular choice for parents and healthcare providers.
Treatment Options for Pediatric Cough
The following treatment options are available for pediatric cough:
- Honey: 1-2 teaspoons as needed, up to 3 times a day
- Acetylcysteine: dosing varies by age and weight
- Nasal saline irrigation: as needed
- Ipratropium: dosing varies by age and weight
- Topical application of ointment containing camphor, menthol, and eucalyptus oils: as needed
Caveats and Considerations
When using antitussives in pediatric patients, healthcare providers must consider the following:
- OTC medications should not be used in children under 4 years of age
- Hydrocodone and other opioid-containing medications should not be used in children under 18 years of age due to the risk of adverse effects 3
- Honey should not be given to children under 1 year of age due to the risk of botulism
- Parents should be counseled on the importance of good hand hygiene to prevent the transmission of cold viruses
Dosing and Duration
The dosing and duration of antitussive treatment will depend on the specific medication and the individual patient's needs. Healthcare providers should consult the medication's labeling and clinical guidelines for specific recommendations.
Differential Diagnosis
When evaluating a pediatric patient with cough, healthcare providers must consider the differential diagnosis, including:
- Upper respiratory tract infection
- Allergic rhinitis
- Asthma
- Pneumonia
- Bronchiolitis
Conclusion
In conclusion, the best antitussive for a pediatric patient will depend on the individual patient's needs and the specific clinical scenario. Honey is a safe and effective option for pediatric cough, while OTC medications and prescription medications should be used with caution and only under the guidance of a healthcare provider 4, 5.