Dr. Shridhar Ganpathy, with Dr. Ravishankar and Dr. Shekhar Biswas share views on two pediatric case studies

In an insightful session moderated by Dr. Shridhar Ganpathy, with Dr. Ravishankar and Dr. Shekhar Biswas as speakers, two pediatric case studies on prolonged cough were discussed. The session emphasized diagnostic reasoning, rational medication use, and tailored treatment strategies.

Case 1: Prolonged Wet Cough in a Preschool Child

Patient Profile:

	Age: 2 years, 11 months
	Symptoms: Productive wet cough lasting 5 weeks, nasal obstruction, snoring, and post-cough vomiting at night.
	History: Cough followed a viral infection; minimal response to amoxicillin-clavulanate.
Clinical Findings:

	Mild adenoidal hypertrophy with throat mucus.
	Earwax blockage and mild inflammation in the nose and throat.
Diagnostic Insights:

	Likely post-viral airway irritation or environmental triggers (e.g., allergens, daycare exposure).
	Bacterial infection ruled out due to absence of fever or weight loss.
Management:

	Earwax removal and nasal saline washes to alleviate congestion.
	A cough mixture and bronchodilator for nighttime relief.
	Symptoms resolved within 14 days, confirming appropriate management.

Case 2: Persistent Wet Cough in a 3-Year-Old Girl

Patient Profile:

	Age: 3 years
	Symptoms: 3–4 weeks of productive wet cough with a history of mild fever.
	History: Multiple short courses of antibiotics and nebulizations with little improvement. Family history of cigarette smoke exposure.
Clinical Findings:

	Bronchoscopy revealed purulent airway secretions, and BAL identified Streptococcus pneumoniae.
	Normal spirometry and chest X-ray results.
Management:

	Targeted antibiotic therapy with amoxicillin-clavulanate (50 mg/kg/day for 4 weeks).
	Supportive care with inhaled corticosteroids (budesonide) and levosalbutamol syrup.

Key Learnings from the Session

Diagnostic Approach to Prolonged Cough:

	Consider viral, bacterial, environmental, and allergic etiologies.
	Avoid unnecessary antibiotics for viral or mild cases.
	Reserve targeted antibiotics for confirmed bacterial infections.
Effective Treatments Discussed:

	Supportive Care: Nasal saline, mucolytics, bronchodilators, and steroids.
	Medication selection tailored to cough type and severity.
Counseling for Parents:

	Educate on environmental triggers (e.g., smoke, allergens).
	Stress the importance of supportive care like nasal washes and natural remedies.
	Reassure parents when antibiotics or tests are unnecessary.
Special Considerations:

	Common repeated infections in daycare-going children.
	Monitor for conditions like GERD or food allergies if symptoms persist.

Best Practices Highlighted

Avoid irrational antibiotic combinations (e.g., cefixime + azithromycin).

Use plain amoxicillin for respiratory infections to minimize resistance.

Turbutaline: Effective for bronchospastic coughs, especially in palatable formulations.

Mucolytics like bromhexine are highly effective for wet cough with proper dosing.

Click here to watch the webinar

GGI-CO-A1-AQS-300033085-APPEMC-L24-0049
For the use of a Registered Medical Practitioner, Hospital or Laboratory only.

Brozedex-LS 1

BroZedex LS: Effective Treatment for Bronchospastic Cough in Children and Adults (6+ Years) with Levosalbutamol, Ambroxol, and Guaiphenesin

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Dr. Shridhar Ganpathy, with Dr. Ravishankar and Dr. Shekhar Biswas share views on two pediatric case studies

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