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doc4kids, Pediatrician
Category: Pediatrics
Satisfied Customers: 455
Experience:  General Pediatrics and Pediatric Emergency Medicine
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My son 3 and a half years old, has been given Aspelone a couple

of months back for flu/cold... Show More
of months back for flu/cold. Now he is sick again. I am currently giving him Otrivin nose spray, Betnesol-N drops, ACC200 and Brochoped. His cough is “slimy”and his nose is runny – green. He has no fever.
Can I give him the Aspelone again? Is there something I should avoid giving in conjunction with Aspelone. Can I add something?
I have in the house Rinex…
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It sounds like your child has a secondary bacterial infection that requires antibiotics

I would see the doctor again for this

A positive rating is the only way I am credited for my time. Please don't click "bad" or "poor" service as this leaves me negative feedback. If you aren't 100% satisfied, just click "reply."

I agree with DrPhilMD in that its not a bad idea for you to discuss these symptoms with your doctor. I am, though, not confident we have yet enough information to determine etiology: viral vs. bacterial vs. allergic. It is ill advised to base a decision to start antibiotics based on color or consistency of mucous. Sinusitis, the infection to which DrPhilMD is likely referring, is much more common in adults thank children; viral processes in kids predominate. In 2001, the American Academy of Pediatrics in conjunction with experts in Family Practice, Ear Nose and Throat, Radiology, Infectious Disease put together a practice guideline to help with both the diagnosis and management of this disease process. It can be found here In summary, the guideline suggests this diagnosis should be considered in a child with progressive worsening of symptoms beyond 10-14 days. Certainly, if fever were to develop late in the course, face pain/pressure, progressive cough, headache etc would indicate a worsening or severe symptom set. This guideline also touches on the use of steroids, which is where I could address your question more directly. While I believe your description of his symptoms fall short of the diagnosis, there is little evidence to support the use of steroids in rhinitis (runny nose) or sinusitis (sinus infection). While intranasal or inhaled steroids are more studied in allergies and discussed in this guideline, we try to generally avoid systemic (oral) steroids, given the potential long term complications with their frequent use. You also state you are using Otrivin nasal spray/drops. While safe and very effective for short term use, they are quite problematic if used beyond about 3 days. Your nose becomes accustomed to its use and symptoms come back much worse when stopping following more prolonged use. Please use these with caution. So I would hold on steroids unless he has asthma and is requiring frequent inhaler use (and even then I would agree with DrPhilMD that he should see his doctor). And as far as what to add, I would consider saline rinse of his nose for symptom control. I hope this helps. If you have other concerns, please feel free to respond to either my, or DrPhilMd's post. Thanks

Customer reply replied 3 years ago.
Hi. What is the difference between viral and bacterial? How is it identified?
This could be an involved answer but basically bacterial infections are treated with antibiotics and viral infections are treated by addressing the symptoms. With viral infections, you might hear, "give lots of fluids, rest and treat fever." Bacterial infections can be tested for by sampling fluid in the space around it, pus out of a wound, throat swab, urine or blood collection. In many cases bacterial infections can be presumed when an area on exam is red, hot, swollen, tender. Skin abscesses (pus pockets), infected hip or knee joints, belly, throat ear infections can either be diagnosed or presumed on physical exam. In the case of a sinus infection, we don't usually sample the fluid (although it can be done). We do, as I described before diagnose this when symptoms are severe or are getting progressively worse. I hope this is helpful.