Cough, Colds & Congestion

This information is intended only for patients with an established relationship with Dr. Cahill. Patient should always use their best judgement to seek medical attention directly with a physician for worrisome ongoing symptoms. This information is not intended to replace direct consultation or care.

Congestion, ear pressure, cough, sore throat, Laryngitis, Bronchitis

The first 7-10+ days of cold, sinus, bronchitis and laryngitis symptoms are nearly always viral. Symptoms usually peak around 5 days. Thicker yellow/green mucus is common. Antibiotics do not improve viral infections, and may cause troublesome side effects such as diarrhea and bacterial resistance that can lead to later dangerous bacterial infections that will not respond to antibiotics.

A mild cough can linger after a viral infection for several weeks, as residual inflammation heals. If beyond the 10 day mark, you note a cough that is worsening, new fever >100.4, new wheezing, shortness of breath or focal chest or facial pain: please contact your doctor. However, in the absence of these, it’s generally still a “supportive cares” plan as below.

Infant & Child Symptom Care

1. STEAMY SHOWERS to moisturize and thin mucus.

2. NASAL SALINE: Mist or 1-2 drops 2-3 times daily until symptoms improve to moisturize passages and keep mucus thin. May use bulb suction a minute or so after saline use to pull mucus out and clear the nose.

3. NASAL SPRAYS: kids that are preschool aged and older may tolerate OTC fluticasone (Flonase) or other OTC nasal steroid: 1 spray each nostril daily; May continue the steroid spray as long as needed. These help keep nasal and sinus passages open so that mucus can drain (preventing bacterial sinus infection), and inner ear pressure/pain is relieved. It can be drying: ok to use a little vaseline just inside the nose if noting nose bleeds.

4. ACETAMINOPHEN (Tylenol) every 4-6 hours and/or IBUPROFEN (Motrin) every 6-8 hours as needed for sore throat, ear pain, fever or body aches. You can give whichever allows your child the HIGHER dose: 1) age based – or – 2) weight based

IBUPROFEN (Motrin) DOSAGE BY WEIGHT/AGE

ACETAMINOPHEN (Tylenol) DOSAGE BY WEIGHT/AGE

5. HONEY (**ONLY for kids >12 months) is also proven to help lessen cough and soothe the throat. A spoonful 2-3x/day.

OLDER TEEN & ADULT SYMPTOM CARE

1. STEAMY SHOWERS to moisturize and thin mucus.

2. NASAL SPRAYS: Afrin nasal spray: 2-3 sprays/nostril, twice daily for up to 4 days for nasal congestion. OTC fluticasone (Flonase) or other OTC nasal steroid spray about 5min after the Afrin: 1-2 sprays each nostril daily; May continue the steroid spray as long as needed. These help keep nasal and sinus passages open so that mucus can drain (preventing bacterial sinus infection), and inner ear pressure/pain is relieved. Vaseline via qtip just inside the nose to swab the septum to can lessen bloody noses from any over-drying if this occurs.

3. NASAL SALINE: Spray, drops, Neti-pot or SinuCleanse twice daily until symptoms improve to moisturize passages and keep mucus thin.

If using Neti-pot or SinuCleanse, use lukewarm water, and 1/2 salt packet at first to avoid burning sensation in nose. Do *not use standard table salt.

4. SUDAFED (pseudoephedrine) by mouth, as directed on box for nasal congestion. If you are treated for high blood pressure, you may need to avoid over the counter oral decongestants which can raise blood pressure. You’ll need to ask the pharmacist for this, but it is still OTC.

5. ACETAMINOPHEN (Tylenol) 1000mg 4x/day or IBUPROFEN 400-600mg 4x/day for sore throat, facial pain, fever or body aches for older teens and adults. For kids 12yo and under: dose can be the greater of the age or weight based as per OTC box instructions.

6. CEPACOL lozenges or throat spray and salt water gargles for sore throat.

7. MUCINEX DM (guaifenesin/dextromethorphan) as needed for cough

8. HONEY is also proven to help lessen cough and soothe the throat. A spoonful 2-3x/day.