Monthly Topics
Current Interim guidance by the CDC:
On September 8, 2009 the CDC updated its recommendations on the treatment
of the current H1N1 influenza A virus. The CDC states that treatment with
antiviral medications such as Tamiflu or Relenza is only recommended for
persons with suspected or confirmed influenza who are at high risk of
complications. These are specifically children younger than 5 years of age
(especially those younger than 2 years), adults 65 and older, pregnant women,
persons with certain chronic medical conditions such as asthma, metabolic
disorders (such as diabetes or mitochondrial disease) or immunosuppressive
conditions ( such as being on chemotherapy or a transplant recipient),
neurodevelopmental conditions (such as Cerebral Palsy, Down Syndrome), and
persons less than 19 years of age on chronic aspirin therapy.
Otherwise
healthy persons with suspected 2009 H1N1 influenza or seasonal influenza who
present with an uncomplicated febrile illness do not require treatment
according to the CDC. The signs & symptoms of 2009 H1N1 flu virus include:
- Fever
- Cough
- Sore throat
- Runny or stuffy nose
- Body aches, headaches, chills, fatigue
- And some people report diarrhea and vomiting
Unless patients are in a high-risk group, this influenza
has been a self-limiting viral infection and will resolve on its own.
Therefore, it is not necessary for every child who has fever and flu symptoms
to be tested for influenza. If your child has fever and flu-like symptoms,
treat symptomatically with acetaminophen (Tylenol) or ibuprofen (Motrin or
Advil) for fever, plenty of fluids, and rest. They should be kept out of public
environments such as school or daycare until they are fever free for 24 hours
without the aid of fever-reducing medications. If they have fever for longer
than 5 days, sudden change in the severity of symptoms, neck pain or stiffness,
wheezing, complaints such as persistent ear pain, fever over 104°, or if
they meet the category of any of the high risk groups mentioned above, they
need to be seen in the office.
The warning signs of the need for urgent
medical attention are;
- Fast or trouble breathing
- Bluish or grayish skin color
- Not drinking enough fluids
- Severe or persistent vomiting
- Being so irritable that the child does not want to be
held or touched
- The flu-like symptoms improve but then return with fever
and worsening cough.
For these children, you should call immediately to speak
with their healthcare provider for further instructions.
ANTIBIOTIC
USE
There are two main types of infections in the pediatric
population: viral and bacterial. Viral infections are responsible for most
colds, vomiting, diarrhea, and sore throats. There are no cures for most viral
infections. They must run their course, which lasts 5 to 10 days. Since
antibiotics are not effective against viral infections, treatment is aimed at
comfort and symptomatic relief.
Antibiotics are the mainstay of
treatment for bacterial infections and are among the most prescribed pediatric
drugs. As antibiotic use has increased over the years, so has the resistance of
pathogens. This makes it more difficult to treat true infections.
In an effort to decrease the risk of bacterial resistance, the American Academy
of Pediatrics has emphasized judicious use of antibiotics. Antibiotics, as with
any medicine, come with potential for side effects varying from mild to severe
reactions. Our Doctors take a conservative approach to treating illness, using
antibiotics only when appropriate, looking out for the best interest of your
child.
Friday, October 12th
Doctors say recall will affect parents
For years, Dr.
Deborah Greenhouse at Palmetto Pediatrics in Columbia has been telling
parents not to use over-the-counter cough and cold medicines on children
younger than 2 years old.
So have many other pediatricians, worried
about serious side effects when strong medicine is put in tiny bodies.
Despite the years of warnings from physicians, the withdrawal of those
products from store shelves will have a huge impact, Greenhouse said.
“Parents who have an infant that has a bad cold will do anything
to get them to sleep through the night,” Greenhouse said.
Those
desperate parents often turned to products such as Dimetapp Decongestant Plus
Cough Infant Drops and Tylenol Concentrated Cold Drops, either instead of
seeing a physician or before seeing one.
When parents tell
Greenhouse they are using cold products on their infants, she recommends
they stop and explains about the mounting evidence the drugs aren’t
effective and can cause serious problems. She suggests the safe alternatives
— saline nose drops and cool mist humidifiers.
Jody Yates, the
pharmacist at Long’s Drugstores on Kilbourne Road, said the infant cold
products Long’s carried either already were kept behind the counter or
were moved there Thursday.
The concern is not so much that the
medicines are not safe but that dosages are not administered correctly, Yates
said. This is why he recommends parents purchasing over-the-counter medicine
for young children consult a pharmacist to make sure they understand how much
medicine to administer.
The medicine in tiny bottles is concentrated,
so the recommended dosage could be very small, Yates said.
“Parents might see two little drops and not think it’s
enough,” Yates said.
— Joey Holleman and Ben Werner |
