ICS guidelines for cough management

Managing cough in pediatric patients requires careful consideration of both efficacy and safety. According to the Indian Chest Society (ICS) Cough Management Guidelines, fixed-dose combinations (FDCs) of Ambroxol Hydrochloride, Guaifenesin, and Levosalbutamol provide an effective and well-tolerated solution for addressing productive cough in children. This article explores the components, benefits, and ICS-recommended usage of this combination in pediatric cases.

Understanding the Components in Pediatric Care

Ambroxol Hydrochloride

Function: Acts as a mucokinetic agent, reducing mucus viscosity and improving mucociliary clearance.

ICS Recommendation: Ambroxol is safe and effective for children with conditions like wet cough and chronic bronchitis, where thick mucus impairs airway clearance.

Clinical Role: Supports mucus clearance, relieving airway obstruction caused by secretions.

Guaifenesin

Function: An expectorant that hydrates and thins mucus, facilitating expulsion.

ICS Recommendation: Guaifenesin is recommended for managing productive cough in children, helping to prevent mucus accumulation in the airways.

Clinical Role: Effective for wet coughs, reducing the effort required to clear mucus.

Levosalbutamol

Function: A bronchodilator that relieves bronchospasms and facilitates smooth airflow.

ICS Recommendation: The R-enantiomer of Salbutamol, Levosalbutamol, is preferred for younger children due to its lower side effect profile compared to other β2-agonists.

Clinical Role: Especially useful in conditions like asthmatic bronchitis or wheezing, ensuring open airways and better breathing.

Pediatric-Specific Advantages Highlighted by ICS

ICS-Recommended Usage for Pediatric Cough

Dosage for Children:
	Children (6-12 years): 5 mL, 2-3 times daily.
	Young Children (2-6 years): 2.5 mL, 2-3 times daily.
Safety Guidelines: Age-Specific Recommendations:
	Levosalbutamol-based FDCs are preferred for children under 5 years.
Dosage for Children:
	Use with caution in children with pre-existing conditions like cardiovascular disorders or hypersensitivity to bronchodilators.
	Should be avoided in combination with other β2-agonists to minimize side effects like tremors or tachycardia.

Clinical Applications in Pediatrics

This FDC is highly recommended for pediatric cases involving:
	Asthma with productive cough: Relieves mucus buildup and bronchospasms.
	Chronic bronchitis: Clears thick mucus while improving breathing.
	Recurrent wet coughs: Helps prevent mucus stasis and secondary infections.

The ICS highlights that such combinations provide significant relief in bronchospastic conditions and ensure optimal mucus clearance when used alongside physiotherapy in cases like bronchiectasis.

to access the complete Indian Chest Society (ICS) Cough Management Guidelines.

GGI-CO-A1-AQS-300033085-DVC-A25-0279
For the use of a Registered Medical Practitioner, Hospital or Laboratory only.
References: https://www.docvidya.com/ics-guidelines-cough-management.

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ICS guidelines for cough management

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