Question

The child has elevated neutrophils and lymphocytes with no obvious symptoms. After taking antipyretics, the body temperature drops but soon rises again. The child is also taking ceftriaxone, Xinfulin, and Jian’er Qingjie Liquid. The question is whether to administer intravenous fluids and seek a better treatment plan.

Answer

Hello: Key points for the treatment of upper respiratory infections in children include;

  1. During the fever period, maintain bed rest, pay attention to keeping warm, and drink plenty of fluids.
  2. Avoid excessive use of antibiotics. Generally, symptomatic treatment is preferred in the early stages for those in good general condition, with the first choice being herbal preparations, antiviral oral liquids, Yinjiao Antipyretic Decoction, or Strong Yinjiao Tablets.
  3. Indications for antibiotic use: (1) If the course of illness is over 3 days and symptoms worsen, or there is a clear bacterial infection. (2) For infants and young children with poor constitution or nutrition. (3) For children under 2 years old with a body temperature above 39°C, WBC > 10.5×10^9/L, neutrophils > 70% with nuclear left shift. It is advisable to send blood culture examination before using antibiotics to discover possible bacteremia early. The first choice of antimicrobial agents is SMZCO, penicillin or ceftriaxone. For those suspected of having hemolytic streptococcal infection based on throat swab culture, penicillin is the first choice. Once confirmed, the treatment course should be maintained for 10 days. Alternatively, oral ceftriaxone or a single intramuscular injection of long-acting penicillin 600,000 to 1.2 million units can be administered after the fever subsides and symptoms improve.
  4. Antiviral medications, in addition to the aforementioned herbal preparations, can be used locally or systemically with Virazole. (1) 0.5% solution nasal drops – administered once every hour on the first day for a total of 4-6 times. From the second day onwards, administer 3-4 times a day.