Pediatric Cold: Medication and Management Guidelines

‌I. Fever Management Principles‌

1. ‌Fever Classification‌:
   • ‌Low-grade‌: 37.5–38°C (99.5–100.4°F)
   • ‌Moderate‌: 38–39°C (100.4–102.2°F)
   • ‌High-grade‌: ≥39°C (102.2°F)
   • Mild to moderate fever aids immune response against pathogens and supports development.
2. ‌When to Use Antipyretics‌:
   • ‌Avoid medication for low/moderate fever‌ unless the child is uncomfortable.
   • ‌Treat high-grade fever (≥39°C) promptly‌ to prevent complications:
     • Cardiovascular strain, febrile seizures, digestive disorders, or pneumonia.
3. ‌Antipyretic Risks‌:
   • Traditional drugs (e.g., aspirin, APC) may cause gastrointestinal irritation, anemia, liver/kidney damage, or severe allergies.
   • ‌Preferred options‌:
     • ‌Acetaminophen (paracetamol)‌: First-line for children ≥2 months.
     • ‌Ibuprofen or naproxen‌: For children ≥6 months; fewer side effects.
4. ‌Non-Pharmacologic Measures‌:
   • Cool environment (avoid cold drafts).
   • Light clothing and hydration.
   • ‌Avoid outdated methods‌: Cold/water/alcohol sponging (not recommended by WHO).
5. ‌When to Seek Help‌:
   • Persistent high fever, lethargy, refusal to drink, or signs of dehydration.

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‌II. Rational Medication Use‌

‌Antiviral Agents‌ (Avoid unnecessary antibiotics):

1. ‌DNA Virus Inhibitors‌:
   • Acyclovir, Vidarabine, Cytarabine.
   • ‌Penciclovir‌: Broad-spectrum alternative.
2. ‌RNA Virus Inhibitors‌:
   • Ribavirin (for severe respiratory syncytial virus).
3. ‌Others‌:
   • Amantadine, Interferon, Dipyridamole (for viral upper respiratory infections).
4. ‌Herbal Options‌:
   • Andrographis, Isatis root, Honeysuckle, Scutellaria.

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‌III. Antibiotic Indications‌

Use antibiotics ‌only if‌:

1. Fever persists despite antivirals.
2. Secondary bacterial infection is suspected (infants <6 months).
3. Elevated white blood cell count.
4. History of recurrent tonsillitis.
5. Symptoms of bronchitis/pneumonia (productive cough, purulent sputum).

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‌IV. Key Precautions‌

1. ‌Dosage Limits‌: Avoid prolonged or excessive use of medications.
2. ‌Supportive Care‌: Rest, hydration, light meals, and mask-wearing.
3. ‌Age Restrictions‌:
   • ‌Avoid acetaminophen in children <3 years‌ (immature liver/kidney function).
4. ‌Allergy History‌: Contraindicated if family/child has antipyretic allergies.
5. ‌Steroid Avoidance‌:
   • ‌Never use corticosteroids (e.g., prednisone)‌ for fever reduction—risk of immune suppression and infection spread.