Monday morning Veda woke up with a horrible cough, which sounded like a lot of mucus was in her chest. I never thought psuedoephedrine would be the prescribed cure.
She had no other symptoms besides this bad cough, but by night and Tuesday morning it was much worse so I brought her to a local doctor here in South Africa. She was great with Veda, and I basically walked there, asked for an appointment, and was seen within five minutes as a new patient. She was very patient and took her time checking Veda over.
The doctor diagnosed Veda with bronchitis, which isn’t serious but needs to be addressed so it doesn’t turn into something worse (like pnuemonia). Since we’re flying from South Africa back to Chicago on Saturday, I want to make sure she’s healthy for the flights and long trip! The doctor sent me to the pharmacy with five prescriptions for Veda, and a referral to a physiotherapist to work on loosening the mucus.
Wait…five prescriptions? I went straight to the pharmacy and filled the prescriptions, but when I got home and started looking at them closely, and tried to figure out what in the world all these syrups were for, I started questioning whether I should actually give them to Veda. This is what she was prescribed:
1) Antibiotic. Dosage: 5 ml syrup by mouth twice daily/ every 12 hours
2) Mucospect- for respiratory tract disorders with excessive mucus in the absence of an infection. Dosage: 5mL of syrup by mouth every six hours
3) Coryx Paediatric syrup (which contains 25mg of pseudoephedrine per 5ml dose as well as Triprolidine)- for symptoms of cold and influenza including nasal congestion. Dosage: 3mL of syrup by mouth every six hours
4) ACC tablets: for loosening of mucus. Dosage: 1 tablet dissolved in water and given twice daily
5) Probiotics Junior (primarily acidophilus)- for strengthening immune system, improves intestinal strength, promotes healthy digestion. Dosage: 3 chewable tablets daily with antibiotics
Doesn’t that seem like over-kill? Three different things for mucus? I mean, she has a bad cough, but really? And wait- Pseudoephedrine ? Isn’t that stuff– bad? I try to approach my child’s health with practicality and reason, erring on the side of organic and natural as much as possible. I started googling all these things. Several of the drugs aren’t even recommended for children under age two. Veda is only 16 months old. But both the doctor and pharmacist found these to be appropriate?
CORYX PAEDIATRIC SYRUP SIDE-EFFECTS AND SPECIAL PRECAUTIONS:
Central effects of pseudoephedrine include fear, anxiety, restlessness, tremor, insomnia, confusion, irritability, weakness and psychotic states. Appetite may be reduced and nausea and vomiting may occur. Anginal pains may be precipitated in patients with angina pectoris. Pseudoephedrine causes vasoconstriction which may lead to a resultant rise in blood pressure and possibly to cerebral haemorrhage or pulmonary oedema.
Pseudoephedrine may also produce tachycardia, cardiac arrhythmias, anginal pain, palpitations, cardiac arrest, hypotension with dizziness and fainting and blushing.
Triprolidine: is an antihistamine and may cause sedation, varying from slight drowsiness to deep sleep, and including lassitude, dizziness and inco-ordination. Blurred vision, dysuria, dryness of the mouth and tightness of the chest may occur. Gastrointestinal disturbances such as nausea, vomiting, diarrhoea or constipation, epigastric pain, anorexia or appetite increase may occur. Other central effects may include hypotension, muscular weakness, tinnitus, euphoria and headache. Paradoxical central nervous system stimulation may occur particularly in children, with insomnia, nervousness, tachycardia, tremors and convulsions.
Whoa! Psychotic states? Cerebral haemorrhage? Cardiac arryhthmias? This is serious stuff! She just has a cough!
And, wait, Mucospect is to treat mucus in the respiratory tract when an infection is not present? Isn’t she taking antibiotics because the doctor believes there is an infection?
MUCOSPECT SIDE-EFFECTS AND SPECIAL PRECAUTIONS:
Nausea, diarrhoea, headache, dizziness, palpitations and heartburn may occur.
So, I did what I should have done before I even went to the pharmacy and blew $75 on prescriptions and called my regular pediatrician back in the states. The lovely nurse who promptly left a detailed message for me on my US voice mail started by saying that although they can’t comment on what another physician has prescribed for treatment, this is how bronchitis is treated in the U.S. for little ones:
* Antibiotics are normal to treat bronchitis if a bacterial infection is suspected
* Probiotics are normal as they help replace the good bacteria when taking the antibiotics
* The other three are absolutely not recommended, particularly the Coryx with the Pseudoephedrine, which is considered dangerous for children due to the very bad side effects. In the U.S. no cough or cold syrups are recommended for children or babies.
* Keep the mucus loose- push lots of fluids, hot liquids, keep her in a steamed bathroom for 15 minutes at a time, and have her sleep with her head elevated.
So, I ended up tossing the two syrups and the tablets and am giving Veda the antibiotics and probiotics and following the recommendations of my pediatrician in the U.S. to treat Veda more naturally. However, I’m not entirely sure antibiotics are really appropriate, either. I’m finishing the course since we started it, but I think I could have just tried the home remedies and lots of liquids first, and then antibiotics if it wasn’t clearing up. I don’t think the doctor could actually tell if it was bacterial-related or viral.
Regardless, it’s another reminder of how important it is to know how to reach your regular pediatrician when traveling with babies. The doctor in South Africa is no way negligent or bad- they just do things differently and have different standards for treatment throughout the world. Prescribing cough and cold syrups with psuedoephedrine for babies and toddlers is quite common throughout the world outside of the U.S., as are many other treatments that aren’t considered in the U.S. to be safe for little ones. If you find yourself taking your baby or child to see a doctor on your travels, it’s always best to double-check with your regular care provider, especially when treatment including medication or prescriptions have been recommended. It’s always best to be on the safe-side and know what you’re giving your child, even if a doctor has told you to give it to him or her.
- Why Doctors Uselessly Prescribe Antibiotics for a Common Cold (ideas.time.com)