Respiratory infections in children

Emma Best and Stephen Howie talk with Dr Diana North, Goodfellow Unit GP Advisor about the management of respiratory illness in children. Emma is a paediatric infectious disease specialist at Starship Hospital and a senior lecturer in the Department of Paediatrics at the University of Auckland. Dr Stephen Howie is a Paediatrician Waitemata DHB Paediatric and Newborn Services.

Topics covered include:

  • antibiotic stewardship
  • duration of course of treatment
  • satrategies to manage respiratory infections 
  • the use of paracetamol in fever and infection
  • recommendations re dosages
  • the management of upper and lower respiratory tract infections: ear infections, common cold, sinusitis, laryngitis/croup, whooping cough
  • use of steroids
  • when to treat with antibiotics
  • when to refer to hospital.

    

Resources

Peer group discussion points

  1. What are some of the aspects of dealing with respiratory infections in children that you find particularly challenging? How do others manage these challenging aspects?
  2. We are encouraged to use good antibiotic ‘stewardship’. This involves using antibiotics only when indicated and in appropriately short courses.
  • Have you had any particularly bad experiences with either prescribing or not prescribing antibiotics?
  • How has this changed your prescribing practice (if at all)?
  • Are there any aspects to not prescribing antibiotics in the child with a viral respiratory infection that you find particularly challenging?
  • What are some strategies that might help you manage these challenges more effectively?

3.  When prescription of antibiotics is not indicated for the respiratory illness the child has presented with, giving parents are caregivers advice about how they can care for their child at home is important (along with appropriate safety-netting).

  • For those who are not offered antibiotics for their child’s illness, what supportive options do you usually suggest for relief of sore throat, cough, congested or runny nose etc?
  • Does anyone routinely suggest Vapour rubs, vitamin C or echinacea in children? Do you think this would be helpful or unhelpful in your patient population?
  • Are there any ‘over the counter’ or alternative treatments parents are using in your practices? What do you think about these? What advice do you usually give parents regarding over the counter and alternative treatments?

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Date Published: 
Friday, March 10, 2017