REQUEST
Is honey effective in reducing acute cough symptoms due to upper respiratory tract infections in children? RESPONSE
Background
Upper respiratory tract infections are one of the most common illnesses in children, with acute cough as a primary complaint. This can become quite cumbersome for parents to manage, considering young children may have up to eight respiratory infections with a cough per year, each lasting approximately ten days.1 Despite the frequency of this ailment, there are not many effective therapeutic options for children. Antitussives and expectorants are over-the-counter medications mainly utilized for acute cough. However, they lack sufficient evidence to justify its use in children.2,3 Therefore; studies have been
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The study was a randomized, placebo-controlled clinical trial including 139 children ages 24-60 months suffering from cough due to URTI from December 2008 to May 2009. A standard questionnaire was completed by the mother before and after a one night intervention. Four groups were arranged; with group 1-3 receiving 2.5 mL of natural honey, dextromethorphan (DM), and diphenhydramine (DPH), respectively, before sleep. Group 4 was only given supportive treatments that included saline nose drops, water vapor, and cleaning a blocked nose. The results yielded honey as having a significantly effective curing impact on cough frequency (1.93+/- 0.65 honey, 2.47 +/- 0.72 DM, 2.50 +/- 0.70 DPH, 3.11 +/- 0.57; p < 0.001), cough severity (1.51 +/- 0.61 honey, 2.16 +/- 0.69 DM, 2.11 +/- 0.68 DPH, 2.69 +/- 0.66; p < 0.001), and sleep quality of children and their parents (1.42 +/- 0.56 and 1.54 +/- 0.56 honey, 1.91 +/- 0.69 and 1.94 +/- 0.53 DM, 1.97 +/- 0.62 and 2.02 +/- 0.52 DPH, 2.50 +/- 0.65 and 2.44 +/- 0.69; p < 0.001). There were no difference between dextromethorphan and diphenhydramine
As such, the diagnosis and management of AOM has a significant impact on the health of children, cost of providing care, and overall use of antibacterial agents (AAFP, 2004). Watchful waiting can have many benefits for the children and the provider if used properly. Diagnosing AOM can be tricky. The signs and symptoms can also be related to other illnesses such as an upper respiratory virus. Throwing antibiotics at any illness use to be the course of action. However, now that there is evidence that bacteria have become resistant to some antibiotics, clinicians are testing out other means of treating illnesses. If the child presenting with symptoms of AOM has no underlying conditions and has means to follow up with the doctor if the symptoms progress, watchful waiting is an appropriate approach for treating the child. According to the research, placebo controlled trials have shown that children have responded well without antibacterial intervention. Giving the opportunity for the illness to resolve without antibacterial intervention not only benefits the child but, the caregivers and the clinician. It benefits the child by not being exposed to antibiotics that are not needed, therefore creating a potential resistance to that antibiotic. It benefits the caregiver by not spending money on a medication their child does not need. Last, it benefits the clinician by preventing resistance to an antibiotic that may be useful in the near future.
Physical examination discloses nasal congestion, discharge, nasal mucosal bogginess, mucous in the oropharynx, or a cobblestone look of the oropharyngeal mucosa..12 Since UACS it is very common and may be clinically unclear, it is judicious to utilize a brief trial of empirical action in the approach to diagnosis. Being that UACS is a syndrome lacking a solid description, is best confirmed by a response to therapy. As the optional treatment (older generation antihistaminics) can suppress the cough reflex centrally and peripherally, response to therapy may not necessarily confirm that the diagnosis is
Bartle, J. and J. Emberlin, Understanding the main causes of hayfever. Practice Nursing, 2011. 22(5): p. 231-235.
Features of asthma include increased airway response to stimuli (internal or external to body), airway obstruction via bronchospasms, inflammation of airways, and is treatable but not curable. Asthma is caused by a combination of genetic and environmental factors (immune response, allergens, exercise, air pollutants, occupational factors, respiratory tract infections, nose and sinus problems, drugs and food additives, gastro-oesophageal reflux disease and psychological factors). Symptoms include recurring bouts of wheezing, breathlessness, coughing, tightness in the chest; symptoms being most common at nights or early morning. The rate of Australians suffering from asthma is one of the highest in the world (8-12% of population or 2 million people) and this rate is increasing. (Kaufman 2015)
Acute tonsillitis is inflammation of the tonsils secondary to an infectious process causing painful swallowing and is more commonly attributed to a viral cause rather than bacterial (Shepherd, 2013). A physical assessment of the tonsils may reveal an increase in size with edema and erythema. This is often associated with upper respiratory symptoms like, headache and cough (Shepherd, 2013). Another diagnosis is pharyngitis. Pharyngitis is also a sore throat which is secondary to inflammation noted at the back of the throat and associated with complaints of pain when swallowing (Shepherd, 2013). Viral pharyngitis is the most common and can be contributed to the rhino or coronavirus which lasts between 5-7 days and presents with associated symptoms like cough, headache, fatigue and mild fever (Ruppert & Fay, 2015). Finally, GABHS or more commonly noted as strep throat is a potential diagnosis. This bacterial infection is most common in children and adolescents. Often individuals present with symptoms including throat pain, fever, chills, headache, cervical lymphadenopathy and exudate noted to tonsils or in the pharyngeal (Ruppert & Fay, 2015). This infectious process in younger children may also present with gastrointestinal symptoms like nausea, vomiting and abdominal pain but is not accompanied by cough or nasal
Pratter MR, Brightling CE, Boulet LP, and Irwin RS. An Empiric Integrative Approach to the Management of Cough: ACCP Evidence-Based Clinical Practice Guidelines. Chest 2006, 129(1_suppl):222S-231S. http://journal.publications.chestnet.org/data/Journals/CHEST/22039/222S.pdf
A health-issue known to be documented in the pre-school setting is pertussis, or better known as whooping cough (Kid Source Online, n.d.). Whooping cough, as it’s name implies, is a very communicable, infectious disease of the respiratory tract, which causes the child to make a “whooping” sound when trying to draw breath after a prolonged cough spell (Kid Source Online, n.d.). Nonetheless, not all children are known to make this said “whooping” sound while having this disease; thus, one must be aware of the general symptoms indicating whooping cough, which include, however aren't limited to, a runny nose and an extreme cough, both which gradually seem to only get worse, and perhaps can even end with the child profusely vomiting (Kid Source Online, n.d.). It is important to catch any symptoms of abnormal cold indications as soon as possible, as once the whooping stage begins, antibiotics can no longer help (Kid Source Online,
Infants with acute bronchiolitis may present with a wide range of clinical symptoms and severity, from mild upper respiratory infections to impending respiratory failure. Typically, these symptoms include tachypnea, wheezing, cough, crackles, use of accessory muscles, and/or nasal flaring. An infant with bronchiolitis will often present as having a “seasonal viral illness characterized by fever, nasal discharge and a dry, wheezy cough” (Conquest, Cremonesini, & Neill, 2013). During the first seventy-two hours of illness, the infant typically becomes worse before the symptoms begin to improve. An infant with bronchiolitis will present with 2-3 days of symptoms similar to that of the
Allergic rhinitis” is very comnon disease affects about 5-22% from world population with about 9% of all visits to physicians” for the allergic diseases [1].
I was contemplating on the possibility of a foreign bodies inside the infant which could be an effect of the substance triggering the cough reflex. Inhalation of foreign body is a serious condition in childhood and may result in an acute respiratory distress. However, since the mother states the 7-month old cough mostly at night and when she cries makes me put a question mark on the differential diagnosis of ingested foreign bodies. According to Dias (2013), the initial symptoms of airway blockage include choking, coughing, wheezing, shortness of breath, the face turn blue; but if the object was easily swallowed by the infant, it could results into abdominal pain, fever, loss of appetite, drooling, vomiting and gagging. I decided to eliminate
Murk, W., Risnes, K. R., & Bracken, M. B. (2011). Prenatal or early-life exposure to antibiotics and risk of childhood asthma: A systematic review. Pediatrics, 127(6), 1125-1138
Allergic rhinitis (AR) is a common disease characterised by nasal itch, sneezing, blockage and rhinorrhoea.1 The prevalence of AR has steadily increased during the past three decades, and has been estimated over 20% of the UK population.1, 2
Acute bronchitis is one of the five top reasons to seek medical care in the United States. The incidence of acute bronchitis is typically higher in fall and winter season, accounting for 82% of the cases (Fayyaz, 2014). It affects full spectrum of population including any age group, gender and demographics. The incidence of acute bronchitis accounts for 36 million office visits annually (Blush, 2013). Although it can be seen in variety of patients, children tend to get acute bronchitis as many 6 times a year where as adults acquire about two to four on average every year (Blush, 2013). These
URI, or Upper Respiratory Infections, are very common infections. To the average person, it is known as the common cold. Unlike colds, tuberculosis cases are somewhat rare. Cough medications or drugs like expectorants are used in treating colds. Expectorants are drugs that help a person cough up mucus. Examples of expectorants include Robitussin, Mucinex, and guaifenesin. Antitussive drugs
a bacterial infection has occurred(Carson-DeWitt). Fever and discomfort can be helped by taking acetaminophen (Carson-DeWitt). A cool mist vaporizer may help with the cough (Carson-DeWitt). Fever leads to dehydration, therefore patients must be given lots of fluids and liquids to stay hydrated(Carson-DeWitt).