I was browsing some articles the other day and came across a gem that I thought changed my understanding of disease and one that you might be interested in. The topic was a scientific estimates of the length, in time, of respiratory symptoms in children.
Why is this important you ask? Well, doctors use these estimates to guide treatment… we are taught that if a cold last more than 10 days that means the child likely has a bacterial secondary nasal infection and a needs antibiotics? Think again. In this study, they estimated that 90% of the children with colds took 15 days to resolve their symptoms rather than the accepted 10 days. That means that 10% lasted even longer! What did they find for the nagging cough of bronchitis? Pediatricians usually consider treating this infection when symptoms last more than 10 days? Think again. 90% actually take 25 days to go away. And how about the all important otitis media that is untreated? How long does the pain last without treatment? We are taught 2-3 days. Try 7-8 days.
So what does all this mean? First, let’s remember that generalizing about human infections is dangerous business since there are so many factors that are at play:
Age of the child
Time of year
Whether the child has a tendency to allergy
Whether the child has other, co-infections with other viruses that is so common of children in group care.
Whether a child has exposure to cigarette smoke
Structural issues about their ears, nose, sinuses, and lungs
Given all that, I think with this new information, it is safe to say that being a little slower about calling colds sinus infections, bronchitis being prolonged and in need of antibiotics, or ear infections complicated and requiring intervention is probably a good idea.
I agree, it’s hard to watch your child suffer with an earache, struggle with a bad cough, or have nasal congestion and poor sleep for weeks on end. I know, that is the world that I live in but I think this study tells us we need to stretch our comfort zone before we reach for the antibiotics. Have faith that with a little tincture of time and your child’s own strong immune system, most of the time your little Johnny or Janie will make a full recovery, without meds. Remember this Doc Smo Pearl; “Trust your child’s body; it has been practicing medicine longer than any doctor alive.”
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Thanks for joining me today. I hope you found that discussion both informative and entertaining. If you listen regularly to my posts, I guarantee you will know more about pediatrics than 99.9% of parents. Portable, practical pediatrics is what we promise and try and deliver every week. Your comments are welcome at www;docsmo.com or on Facebook. I would love it if you would write a review of my blog on iTunes and even subscribe while you are there. You can also subscribe on my website, www.docsmo.com. This is Doc Smo, broadcasting from studio 1E, reminding you that the next time your child is sick, it wouldn’t be a crime to give it a little more time. Until next time.
Duration of symptoms of respiratory tract infections in children: systematic reviewBMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7027 (Published 11 December 2013)Cite this as: BMJ 2013;347:f7027