Duration of common pediatric respiratory infections estimated

By Joanna Lyford, Senior medwireNews Reporter

An international research team has systematically reviewed the literature to formulate up-to-date estimates of the duration of common childhood respiratory tract infections.

They say that these estimates will help parents to know when to seek medical care and healthcare professionals to know whether antibiotics are needed in the management of conditions such as earache, sore throat, and bronchiolitis.

Noting that one of the most common questions asked by parents is “how long will my child’s symptoms last?” Matthew Thompson (University of Washington, Seattle, USA) and colleagues set out to answer this by searching the literature for studies involving children with acute respiratory tract infections in primary care or emergency settings.

A total of 23 randomized trials and 25 observational studies met their inclusion criteria. All of the studies were conducted in high-income countries and involved treatment with either a placebo or an over-the-counter medicine.

The median duration of symptoms varied for individual conditions. The most short-lived was croup, which typically resolved within 2 days, while the most enduring was acute cough, which generally lasted for 25 days.

Of the other conditions, earache generally lasted for 7–8 days, sore throat for 2–7 days, bronchiolitis for 21 days, the common cold for 15 days, and non-specific respiratory tract infections for 16 days.

Each of these figures represented the duration of time at which symptoms had resolved in 90% of children on average.

For most of the conditions, the estimates were in line with received wisdom. For earache (otitis media), however, the evidence-based estimate of 7–8 days is considerable longer than the 2 and 4 days cited by US and UK health authorities, respectively.

Conversely, acute cough symptoms were resolved in 50% of children by 10 days and in 90% by 25 days – considerably shorter than the average duration of 21 days cited by the UK health authority.

Writing in the BMJ, Thompson et al say that their review “provides evidence that can be put to daily use by clinicians and parents caring for children with respiratory tract infections, as well as informing health policy and evidence based treatment guidelines.”

They add: “Future research should also focus the evaluation of new and existing interventions in children with the most severe illness trajectories.”

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