Upper Respiratory Tract Infections in Children Flashcards
where do URTI affect?
Do the benefits from antibiotics justify the harm?
- Diarrhoea
- Oral thrush
- Nappy rash
- Allergic reaction
- Multi resistance
There’s no doubt that the overall burden of harm from antibiotics given to the population is greater than the overall benefit
Putting URTI into context - how common are they?
very very common
URTIs - what are the mian features of them?
- They’re common!!
- Fever (Often associated with fever):
- Antibiotics or not?
- Prodrome to serious illness?
Natural history - is it important
yes
what is rhinitis?
Rhinitis is inflammation and swelling of the mucous membrane of the nose, characterized by a runny nose and stuffiness and usually caused by the common cold or a seasonal allergy
- Very common, 5-10 per year
- Winter months
- Self-limiting condition
The dilemma here is..… - Prodrome to other illnesses - Pneumonia, bronchiolitis, Meningitis, Septicaemia
•Review if not sure
how long does a runny nose last normally?
Days from onset of symptoms
Some individuals, symptoms last longer
what is Otitis media?
- Common, self-limiting
- Not “a bit pink” - its red
- Primary viral infection
- Secondary infection with Pneumococcus/H’flu
- Spontaneous rupture of drum
- Antibiotic treatment usually doesn’t help……
what is the duraiton of ear ache?
20% of individuals can last upto 7 days
how do you treat otitis media?
- Analgesia works for sure (Prominent symptoms in otitis media is pain)
- The jury is out for antibiotics
- Antibiotics may work >24 hours (Antibiotics don’t do any good in first 24 hours)
- First do no harm? - The end point is the same (End point is same for 99.999% of individuals so don’t use antibiotics)
Tonsillitis/pharyngitis - what is it, how common and how do you manage it?
•Common
The dilemma is….
- Viral or bacterial?
- Throat swab
- Either nothing or 10 days penicillin
- Don’t give amoxycillin
Croup/epiglottitis: what are they, what causes them, how common are they, how do patient present
Take home messages:
- URTIs are very common in children
- >99% URTIs are self-limiting (don’t say “viral”)
- Antibiotics do not usually help
- Understand what is normal
- If in doubt, review