Medications and non-pharmacological measures to alleviate the symptoms of respiratory tract infections in the pediatric population

In the pediatric population, acute respiratory tract infections (RTIs) are the most common reason for seeking professional help from a physician or a pharmacist. Alleviation of symptoms is the only therapeutic measure in viral RTIs and is an adjunct to antibiotic therapy in bacterial RTIs. This article discusses pharmacologic and non- pharmacologic options for treating nasal congestion, cough, fever and sore throat in RTIs and clinical evidence on their efficacy and safety in the pediatric population. In general, clinical studies conducted in children for most of these drug groups are few or nonexistent, making it difficult to create evidence-based recommendations. Nasal decongestants, cough suppressants, mucolytics, expectorants, antipyretics/analgesics and sore throat local preparations are available in suitable pharmaceutical forms and strengths for the certain age. As many of them are over-the-counter (OTC) preparations, it is necessary to strictly take into account the age of the child in whom they may be used and dose properly. Multicomponent preparations carry the risk of taking unnecessary medications and of their side effects. The use of multiple OTC medicines is associated with the risk of an overdose of a component that may be present in different preparations. Appropriate non-pharmacological measures (e.g. oral hydration, nasal saline application or irrigation, honey) may be helpful and should be used whenever possible due to their safety. U pedijatrijskoj populaciji, akutne infekcije respiratornog trakta (IRT) su najčešći razlog traženja stručne pomoći od lekara ili farmaceuta. Ublažavanje simptoma je jedina terapijska mera kod virusnih i dodatak je antibiotskoj terapiji kod bakterijskih IRT. Ovaj članak govori o farmakološkim i nefarmakološkim opcijama za lečenje nazalne kongestije, kašlja, povišene telesne temperature i upale grla kod IRT i kliničkim dokazima o njihovoj efikasnosti i bezbednosti u pedijatrijskoj populaciji. Uopšteno govoreći, kliničke studije sprovedene kod dece za većinu ovih grupa lekova su malobrojne ili ih uopšte nema, što otežava pripremu preporuka zasnovanih na dokazima. Dostupni su nazalni dekongestivi, antitusici, mukolitici, ekspektoransi, antipiretici/analgetici i lokalni preparati za ublažavanje simptoma upale grla, u odgovarajućim farmaceutskim oblicima i jačinama za određeni uzrast. Kako se mnogi od njih izdaju bez lekarskog recepta (OTC), potrebno je striktno voditi računa o uzrastu deteta u kome se smeju koristiti i pravilnom doziranju. Višekomponentni preparati nose rizik od primene nepotrebnih lekova i njihovih neželjenih efekata. Primena više OTC lekova nosi rizik od predoziranja komponente koja može biti sastojak različitih preparata. Odgovarajuće nefarmakološke mere (npr. oralna hidratacija, primena fiziološkog rastvora u nos ili ispiranje nosa, med) mogu biti od pomoći i treba ih koristiti kad god je to moguće zbog njihove bezbednosti.