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Cough - acute with chest signs in children - Management
Overview of management
For all children with a cough and signs in the chest on examination:
- Assess the cause of the cough associated with chest signs, the level of risk, and the ability of the carers to cope.
- Refer all children at high risk, and those children at intermediate risk when the carers are unable to cope, or where there is uncertainty about the diagnosis, or the child deteriorates on treatment or does not respond to treatment as expected.
- Advise on self-care measures to control fever and maintain hydration.
Bronchiolitis:
Respiratory tract infection associated with wheeze:
- For children with a confirmed diagnosis of asthma, see the CKS topic on Asthma.
- For children less than 5 years of age presenting with respiratory tract infection and wheeze, arrange a trial of therapy with bronchodilators to determine their responsiveness to treatment. Continue treatment for those who are responsive.
- Advise carers on monitoring their child's condition, and when to reconsult if the child deteriorates.
Community-acquired pneumonia:
- Specific management of a child with community-acquired pneumonia:
- For a child less than 5 years of age prescribe:
- Amoxicillin.
- A macrolide if the child is allergic to penicillin.
- For a child more than 5 years of age prescribe:
- Amoxicillin or a macrolide.
- A macrolide if the child is allergic to penicillin, or during times of known Mycoplasma outbreak.
- Advise carers on monitoring their child's condition and when to reconsult if the child deteriorates.
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