CHILDHOOD ILLNESSES
> the eardrum may perforate to discharge fluid and relieve the
pressure pain, although it heals within a month.
many ear infections are due to viruses and are self-limiting, however some circumstances do require antibiotic treatment due to a bacterial origin, commonly indicated by the presence of discharge exuding from the ear.
childhood vaccinations help prevent some ear infections caused by certain bacteria. middle and outer ear infections typically affect children between six months to five years of age, and are usually seen after a child has a bad cough or cold.
While generally self-limiting, referral for medical advice may be necessary if the child is in severe pain, or if their temperature is particularly high. Some children may also be prone to recurrent middle ear infections, which may be associated with glue ear, and therefore further investigation would be warranted if the child has reduced hearing as a result.
children tend to suffer from conditions of the upper respiratory tract more commonly than adults, with many exhibiting symptoms of the common cold (acute viral rhinopharyngitis) or flu, making it difficult to distinguish the exact severity of the underlying cause.
children can expect about four to five bouts of the cold a year, characterised by the typical symptoms of mild fever, congestion, coughing and sore throat. flu, on the other hand, tends to be a bit more serious as children and adults display headache, severe aches and pains and, in more intense cases, exhaustion.
Standard treatment is fluids, bed rest and analgesics, if appropriate, as most cases last five to seven days. many conditions of the upper respiratory tract will display the same symptoms and then differentiate as they progress into the lower airways.
respiratory syncytial virus (rSv) is an infection of the airways which has seen a rise in incidence in recent years, and is now the most common viral respiratory viral infection that causes hospitalisation in infants. generally, the condition isn’t serious.
36 - PharmacY In focUS
however, if the child is under two, has a heart or lung disease, or is immunocompromised, it can cause inflammation of the lungs and lead to development of pneumonia or bronchiolitis. Symptoms typically present as that of influenza, such as a runny nose, nasal congestion and cough, however the child may also appear irritable and display difficulty in breathing. Wheezing would also be indicative of rSv.
croup (laryngotracheobronchitis) - a condition which targets the windpipe or larynx, typically affects infants under two. It may display the standard runny nose and fever of other respiratory tract infections, however it can be differentiated based on certain distinctive features.
the symptoms, for example, are typically sudden in onset and the cough, which tends to worsen at night, can be likened to that of a barking seal. another characteristic feature is inspiratory stridor: a loud high-pitched harsh noise when breathing in.
the most common causes of croup are viral in origin and last no longer than a week, therefore referral is not generally not necessary, and it can be treated by seating the child in a steamed up bathroom for ten minutes. While these conditions are viral in origin, whooping cough (pertussis) is caused by bacteria, and therefore referral for antibiotics is generally required.
Whooping cough classically affects young children, however vaccination has reduced its incidence in that age group, and now more commonly affects those aged between five and ten years of age. again, it starts with cold-like symptoms and progresses to coughing spasms. It also exhibits a characteristic ‘whoop’ when the child tries to inhale between coughs, hence its name.
Sore throats are normally rare in young children compared to other conditions and more commonly due to tonsillitis. caused by either a bacterial or viral infection of the tonsils, it is characteristically defined by a sore red throat, with swollen tonsils, pain on swallowing, fever, coughing and in some cases headache.
glands at the back of the neck are often swollen and pus may be present on the tonsils, which may indicate
bacterial origin. antibiotics may also be advised. recurrent tonsillitis may require removal of the tonsils by surgery, however most cases are acute and self-limiting. While swollen glands are a common feature of tonsillitis, they may also be present in other conditions that may not be as innocuous, such as mumps or glandular fever.
mumps typically affect the salivary glands, causing swelling on one or both sides of the face (parotitis) accompanied by associated muscle aches, weakness and fatigue. glandular fever on the other hand causes chills and sweating, but both of these conditions are better to be clinically diagnosed due to the risk of complications - (mumps can spread to the brain (meningitis), the testicles (orchitis), the ovaries (oophoritis), or the pancreas (pancreatitis)) and to rule out more serious causes such as cytomegalovirus, rubella or toxoplasmosis that may be mistaken for glandular fever.
as pharmacists, we are not only positioned to identify symptoms of childhood illnesses, but also determine those which we can treat otc, and those which require further investigation. We are placed as health advocates, and as such must offer preventative advice and educate parents about the symptoms of commonly-encountered conditions, and where to turn to if they arise.
Provision of preventative advice, education and recognition of serious symptoms to parents of infants and young children is imperative to the treatment of infections. children will get sick regardless of what we say, and there is little we can do to control this.
Preventative advice is mainly the same for all infections and is associated with basic hygiene measures, as the infections are typically passed through sneezing, coughing or hand to hand contact. these measures are rudimentary and include: use of tissues for coughs and sneezes, avoidance of sharing towels or flannels, avoidance of scratching skin conditions etc.
many immunisations are now available - such as mmr, meningitis or influenza - to prevent the illnesses from occurring, and parents should be recommended to ensure their children are vaccinated. It is often necessary to reassure parents about the self-limiting nature of many childhood illnesses, and to tell them that the use of antibiotics is not usually required.
however, a knowledge of when to recognise symptoms and investigate further is a crucial part of our role, and passing this information on to parents of young children is imperative in maintaining the best quality of care for our youngest and most vulnerable patients. •
thE goLdEn EYE rangE of EYE-carE ProdUctS offErS a comPrEhEnSIvE trEatmEnt choIcE for mInor EYE InfEctIonS PrESEntEd to and trEatabLE bY thE PharmacISt
golden Eye drops and golden Eye ointment are indicated for the treatment of minor eye and eyelid infections. both contain antibacterial agents, effective against bacteria that cause common eye infections such as conjunctivitis, providing symptomatic relief. golden Eye antibiotic ointment contains chloramphenicol for the treatment of acute bacterial conjunctivitis (children over 2 years). the range of golden Eye products ensures pharmacists have a selection of treatments available otc for most minor eye infections likely to be presented by their customers. golden Eye has a well-known and trusted reputation in otc eye care.
golden Eye drops – PIP code: 092-5248 golden Eye ointment – PIP code: 092-5230 golden Eye antibiotic ointment – PIP code: 333-8563
further information can be found at
www.goldeneyecare.co.uk or by telephone on 01953 607856
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