From the Research
Introduction to Pediatric Influenza and Upper Respiratory Tract Infections (URTIs) Management
The management of pediatric patients with influenza (flu) and upper respiratory tract infections (URTIs) is crucial to prevent complications and reduce the risk of transmission. According to 1, influenza is one of the commonest causes of acute respiratory illness in children, and its management includes prompt institution of infection control measures, early identification of children at higher risk, supportive care, and antiviral drugs.
Supportive Care for Pediatric Patients
Supportive care for pediatric patients with influenza and URTIs includes the use of over-the-counter (OTC) analgesics such as paracetamol and ibuprofen to relieve fever and pain symptoms. As stated in 2 and 3, these medications are safe and effective in treating fever and pain in children. The dose of paracetamol is 15 mg/kg per dose, and the dose of ibuprofen is 10 mg/kg per dose, with a maximum of four doses of paracetamol and three doses of ibuprofen in 24 hours.
Antiviral Treatment for Pediatric Patients
Antiviral treatment for pediatric patients with influenza includes the use of oseltamivir and baloxavir. According to 4, baloxavir is a cap-dependent endonuclease inhibitor that has been approved for the treatment of influenza in pediatric patients in Japan. The recommended dose of baloxavir is weight-based, with a dose of 10 mg for patients weighing 10-20 kg, 20 mg for patients weighing 20-40 kg, and 40 mg for patients weighing 40 kg or more.
Prevention of Influenza in Pediatric Patients
Prevention of influenza in pediatric patients includes the use of inactivated influenza vaccine (IIV) and live attenuated influenza vaccine (LAIV). As stated in 1, these vaccines have good efficacy in preventing influenza. Additionally, cough etiquette, use of face masks, and hand hygiene are important measures to reduce the risk of infection transmission from person to person.
Differential Diagnosis and Caveats
It is essential to consider the differential diagnosis of influenza and URTIs in pediatric patients, including other respiratory illnesses such as pneumonia and bronchiolitis. According to 2, young children who are unwell with fever should be treated with ibuprofen first, but the relative risks and benefits of using paracetamol plus ibuprofen over 24 hours should be considered. Additionally, the use of Echinacea has been shown to be safe and effective in treating acute cold episodes in children, as stated in 5.
Treatment Duration and Monitoring
The treatment duration for pediatric patients with influenza and URTIs depends on the severity of the illness and the response to treatment. According to 4, the primary clinical endpoint is the time to illness alleviation of influenza, from administration of baloxavir or oseltamivir until the following criteria are met and sustained for at least 21.5 hours. Monitoring of pediatric patients with influenza and URTIs includes regular assessment of symptoms, temperature, and respiratory status.
Key Points for Healthcare Providers
- Use of OTC analgesics such as paracetamol and ibuprofen to relieve fever and pain symptoms
- Antiviral treatment with oseltamivir and baloxavir for pediatric patients with influenza
- Prevention of influenza with IIV and LAIV
- Importance of cough etiquette, use of face masks, and hand hygiene to reduce the risk of infection transmission
- Consideration of differential diagnosis and caveats, including other respiratory illnesses and the use of Echinacea
- Monitoring of pediatric patients with influenza and URTIs, including regular assessment of symptoms, temperature, and respiratory status.