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Bronchodilators, Antibiotics, and Oral Corticosteroids Use in Primary Care for Children With Cough
Sankaran Krishnan1, Vicki Ianotti1, John Welter1
1New York Medical College, Valhalla, NY, USA.
Insights
Real-world acute cough management in children involves varied treatments. Key factors influencing decisions for therapies like antibiotics, corticosteroids, and bronchodilators include patient history and cough type.
Area of Science:
- Pediatric Medicine
- Respiratory Medicine
- Clinical Practice Research
Background:
- Acute cough is a common pediatric primary care concern.
- Real-world management strategies for pediatric acute cough are not well-defined.
- Understanding treatment variations is crucial for optimizing care.
Purpose of the Study:
- To analyze real-world management decisions for acute cough in children.
- To identify factors influencing the prescription of common therapies.
- To describe patient characteristics associated with specific treatment choices.
Main Methods:
- Retrospective analysis of 560 pediatric encounters for acute cough.
- Data collected from a suburban academic pediatric practice over one year.
- Evaluation of patient history, cough characteristics, and prescribed treatments.
Main Results:
- Treatment decisions were significantly influenced by past medical history, cough duration, and cough characteristics.
- Commonly prescribed therapies included bronchodilators, antibiotics, and oral corticosteroids.
- Specific patient factors (age, cough type, medical history) were associated with the choice of antibiotic, corticosteroid, or bronchodilator therapy.
Conclusions:
- Pediatric acute cough management is multifactorial, influenced by patient history and cough presentation.
- Distinct clinical profiles correlate with the use of antibiotics, oral corticosteroids, and bronchodilators.
- Further research can refine evidence-based guidelines for pediatric acute cough.
Abstract:
Real-world management decisions for acute cough in children in primary care practice are not well understood. This study is an analysis of 560 encounters for children with cough, 19 days to 18 years of age, seen in a predominantly suburban academic pediatric practice, over 1 year. Past history, cough duration, and cough characteristics significantly affected treatment decisions. Children with cough frequently had a history of preterm birth, allergies, asthma, and neurological conditions. Most common therapies were bronchodilators, antibiotics, and oral corticosteroids. Children prescribed antibiotics were older, more likely to have a wet or productive cough, history of sinusitis, pneumonia or dysphagia, and longer cough duration. Children prescribed oral corticosteroids were younger, less likely to be wet or productive and more likely to have history of asthma or dysphagia. Children prescribed bronchodilators were more likely to have fever, nasal congestion, and wheezing and history of previous asthma, pneumonia, or dysphagia.
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