Rhinitis and antibiotics

Question

Hello, my 3-year-old son with CF has a rhinitis for 4 or 5 days; since yesterday, cough became productive, while the nose dries. He also began yesterday to inhale with Pulmozyme® (rh-DNAse). During the physiotherapy session yesterday, the physiotherapist got a little sputum, but from nose, not from bronchi. My son has physiotherapy twice a week, and no fever and no loss of appetite or special fatigue. Is it necessary to put him on antibiotics or to increase physicotherapy sessions? Or should we wait to see if the rhinitis stops? Thank you in advance.

Answer

Hello,
Your son has some modifications in his usual state, that you describe well: running nose for 4-5 days, then yesterday cough and a bit expectoration. These are early signs of pulmonary exacerbations, which require early action: washing the nose with saline solution several times per day, ensuring good hydration, increasing chest physiotherapy. If it is not enough, and depending on your child’ specificities, your CF centre can advise you to plan a sputum analysis, or to begin an antibiotic treatment. To learn how to recognize the signs of pulmonary exacerbations and what to do, it is also possible to attend patient education sessions; please talk about this with your CF centre staff.
Sincerely
Dr Michèle Gérardin

10.12.2014