Duration of symptoms of respiratory tract infections in children: systematic review

Abstract

Objective To determine the expected duration of symptoms of common respiratory tract infections in children in primary and emergency care.Design Systematic review of existing literature to determine durations of symptoms of earache, sore throat, cough (including acute cough, bronchiolitis, and croup), and common cold in children.Data sources PubMed, DARE, and CINAHL (all to July 2012).Eligibility criteria for selecting studies Randomised controlled trials or observational studies of children with acute respiratory tract infections in primary care or emergency settings in high income countries who received either a control treatment or a placebo or over-the-counter treatment. Study quality was assessed with the Cochrane risk of bias framework for randomised controlled trials, and the critical appraisal skills programme framework for observational studies.Main outcome measures Individual study data and, when possible, pooled daily mean proportions and 95% confidence intervals for symptom duration. Symptom duration (in days) at which each symptom had resolved in 50% and 90% of children. ResultsOf 22 182 identified references, 23 trials and 25 observational studies met inclusion criteria. Study populations varied in age and duration of symptoms before study onset. In 90% of children, earache was resolved by seven to eight days, sore throat between two and seven days, croup by two days, bronchiolitis by 21 days, acute cough by 25 days, common cold by 15 days, and non-specific respiratory tract infections symptoms by 16 days. ConclusionsThe durations of earache and common colds are considerably longer than current guidance given to parents in the United Kingdom and the United States; for other symptoms such as sore throat, acute cough, bronchiolitis, and croup the current guidance is consistent with our findings. Updating current guidelines with new evidence will help support parents and clinicians in evidence based decision making for children with respiratory tract infections.

Therapie des unspezifischen Hustens bei Kindern

“…Diese Untersuchungen zeigen auch, dass 10 Ta ge nach einer akuten viralen Atemwegs infektion noch 40% der Kinder und nach 25 bis 28 Tagen noch annähernd 10% der Kinder husten [11,12]. Nur ein klei ner Teil der Kinder weist also einen über 3 Wochen hinausgehenden subakuten und auch chronischen unspezifischen Husten auf (Dauer >8 Wochen, [13]).…”

“…Damit können kumula tiv infektionsgetriggerte Hustenphasen vorkommen, die die Definition des chro nischen Hustens erfüllen, aber tatsäch lich einer physiologischen bzw. zu erwar tenden Auseinandersetzung mit Atem wegsinfektionen entsprechen [11,12,14]. Aufgrund dieser Überlegungen und des selbstlimitierenden Verlaufs sind die Ziele der Therapie des unspezifischen Reizhus tens die Verkürzung der Hustendauer und die Linderung von Symptomen, die durch den Husten ausgelöst werden (Schmer zen, gestörter Nachtschlaf u.…”

Predicting prolonged duration of fever in children: a cohort study in primary care

“…It is believed that the median duration of 14.5 hours between initial contact and the home visit did not alter significantly the presence or absence of the remaining signs (such as, coughing, rhinorrhoea, palpable lymph nodes, signs of throat infection, or earache resulting in altered reaction or sleeping pattern). 22 A further limitation is the substantial loss to follow-up; that is, insufficient data to calculate duration of fever. A completecase analysis was performed with the final model, showing a stronger relation of the included variables to prolonged duration of fever (data not shown).…”

Zinc Sulfate: An Effective Micronutrient for Common Colds in Children: A Double-Blind Placebo Controlled Trial

“…Overall, cold is a completely benign disease, however, it could cause significant complications (5)(6)(7). This disease is more common in children than in adults and usually requires more attention and care (8). Zinc is one of the micronutrients necessary for growth and proper functioning of the immune system.…”