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Should I Discontinue Azitral Junior Drops Despite Having Drowsiness In An Infant?

Posted on Wed, 14 Oct 2015

Question: Baby became sleepy/drowsy after taking azithral jr 1shOuld I discontinue baby is 7 weeks old and has chest congestion and breathing difficulty

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Please get her evaluated by a physician

Detailed Answer:
Hello

Thanks for asking on this platform

Azithral junior drop contains azithromycin (antibiotic).
Drowsiness as such is not a very well known side effect of azithromycin.
This may be due to breathing difficulty or cough/cold itself.
I would like to know if you are giving any other medication for cough apart from azithromycin.Few of cough drops/syrups contains antiallergic that may act as sedative also.
So please let me know if any.
If baby's oral acceptance is poor,there is increased respiratory rate or chest wall in drawing;I suggest you to get him evaluated by a pediatrician to rule out involvement of lower respiratory tract or spasm of the airways.
Drowsiness is not a side effect of azithromycin,si I don't think that discontinuing Azithral would help much.

Please let me know if you have any more query.
Wishing for your baby's speedy recovery.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (20 hours later)

Other medicines given to her are prescuf xp 6 drops 4 times/day, t-98 1 ml 4 Times / day, aazithral Jr 1 no 2 times / day, omnacortil drop 10 drop 2 times/ day. Do u think this may be because dose is a bit high for her age. Today also she was lethargic after taking t-98 and prescuf in morning
Her weight is 5 kg and she is 1 month 21 days pld

Answered by Dr. Pradeep Kumar Jain (27 minutes later)

Brief Answer:
Letharginess can be due to disease itself

Detailed Answer:
Thanks for follow up

Prescuf xp contains salbutamol a bronchodilator.Each ml(20 drops) of prescuf contains 2 mg of salbutamol.The dose is 0.1-0.15 mg/kg/dose.So dose of prescuf xp is appropriate for weight.
Omnacortil contains prednisolone 10 mg in each ml (20 drops).The dose is 2 mg/kg/day in two divided dosage(5 drops twice a day)
Likewise t-98 (paracetamol) and Azithral is also prescribed in appropriate dosage.
Baby can be lethargic due to the fever and respiratory illness.This improves with the treatment of the disease.
But if she is so much lethargic that not accepting feeds well or breathing problem worsens,I would like to get her clinically evaluated or get a second opinion from another doctor.

I shall be glad to help you out if you have any more queries.

Wishing for your baby's good health.
Take care.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (11 hours later)

What should be time difference between two dose like medicine which is 4 Times a day should be given after every 4 hrs or 6 hrs similarly what should be time difference between medicine which has to be given twice a day. Can all four medicines given together or there should be some gap.

Answered by Dr. Pradeep Kumar Jain (10 minutes later)

Brief Answer:
Details below

Detailed Answer:
Thanks for writing back

You can give Prescuf syrup at 8 in the morning then 1 in afternoon,6 in the evening and 10 at night.
Give T 98 which contains paracetamol,only when temperature is more than 100 F.You need not to give it if there is no fever.
Similarly omnacortil and Azithral can be given at an interval of 12 hours.
It is better to give Azithral 30 minutes before feed and omnacortil 10-15 minutes after feed.You can give both these medications once in the morning and then in evening or night.
It is not necessary to keep a gap between the medication.Depending on the baby's comfort you can give them simultaneously or after an interval of few minutes.

I shall be glad to answer if you have any more doubt.
Take care
thanks and regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (2 days later)

I m attaching her slip for ur reference to tell baby's health also c is scratching face n eyes ear nose from many days. C has reflux for which no medicine has been prescribed as per Doctor it will go once she will be of 3 month. Today I have noticed small XXXXXXX like prickly heat on her cheeks and chin 15-20 in no. Y is so. Is this due to medicines
Breathing is normal no fever phLegm in throat

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Please attach the image

Detailed Answer:
I have gone through the details and attached prescription.
The rashes due to drugs are usually generalized not localized.
The rashes on cheeks can be due to allergy(other than drug allergy).In most of the cases it get subsided within few days. Antiallergic like cetrizine helps in early recovery.I request you to attach the image so that I better able to help you out.
Mild reflux is common in early age if baby is thriving well and it is not too frequent.Burping after each feed helps in decreasing the severity and frequency of reflux.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (47 hours later)

Dr has azithral and t-98 two times for 3 more days. It's already been 9 days on antibiotic. Why is Dr prescribing antibiotic for so many days. there is no breathing difficulty and fever
Is it possible that the wheezing as mentioned in prescription is due to reflux.
Thirdly baby is rubbing face eyes and nose sometimes when she is sleepy and sometimes when she is awake
Baby is sucking her fist can u prescribe some safe sanitizer
Please prescribe baby safe mosquito repellant
C is 2 months old and weight is 6 kg

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Details below

Detailed Answer:
Wheezing is an audible musical breath sound and it occurs due to the spasm of airways.Antibiotic is not a treatment for wheeze.
Wheeze is usually associated with some respiratory distress.
I doubt if wheeze is still there.
Why has he prescribed T98(paracetamol) if there is no fever.
I DON'T THINK SHE NEEDS AZITHRAL OR T98 ANYMORE.
I suggest you to get a second opinion.
You can use Himalaya sanitizer. In fact you can use any branded sanitizer.
Similarly for mosquito repellent you can use any liquidator(like allout/goodnight).All contains pyrethrin and is safe for baby if not taken orally.
Better you use a mosquito net with the repellent.

I shall be glad to help you out if you have any more doubt.
Wishing for your baby's good health.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (10 minutes later)

As per him t-98 will reduce swelling in throat, c still has. Phlegm in throat

Answered by Dr. Pradeep Kumar Jain (12 minutes later)

Brief Answer:
T98 contains paracetamol and it is an antipyratic/analgesic

Detailed Answer:
There must be some confusion as T 98 contains paracetamol and it has nothing to do with cough and swelling in throat.
Wheeze is the only finding mentioned in the prescription and it can be there in viral or allergic respiratory ailment.
I strongly suggest you for a second opinion for better care of your baby.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (46 minutes later)

Please check now

Answered by Dr. Pradeep Kumar Jain (12 minutes later)

Brief Answer:
WALRI with respiratory distress

Detailed Answer:
Thanks for attaching the prescription

In history it is written that baby is suffering from cough,cold and fever.On examination there is wheeze(musical breath sound due to spasm of airways) and the diagnosis made by the physician is WALRI(Wheeze associated lower respiratory tract infection) with respiratory distress.
WALRI or bronchiolitis is infection of lower respiratory tract usually caused by some virus.You are saying that there is no fever or breathing difficulty and baby is feeding well but your physician has made the diagnosis of respiratory distress.
Again antibiotic Azithral is not need for 9 days even if there is wheeze or respiratory distress.
In viral infection there is no role of antibiotic and if it is a bacterial infection azithromycin is not the drug of choice for this age.
I again insist you to get a second opinion from a pediatrician.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar