What are the recommended first-line treatments for acute cough in children under 5 years old?

Recommended first-line treatments for acute cough in children under 5 years old:

• For children with signs suggestive of pneumonia, prescribe antibiotics, with amoxicillin as the first-line oral antibiotic choice.
• Children under 2 years with mild lower respiratory tract infection symptoms usually do not require antibiotics but should be reviewed if symptoms persist.
• Alternatives to amoxicillin include co-amoxiclav, cefaclor, or a macrolide such as clarithromycin if there is no response to first-line therapy.
• Antibiotics are generally prescribed for 5 days, depending on clinical response.
• For symptomatic relief, advise parents/carers to use either paracetamol or ibuprofen to treat distress due to fever, but not solely to reduce temperature.
• Encourage regular fluid intake and continued breastfeeding for infants.
• Oral corticosteroids are only recommended if the child has suspected or confirmed asthma with acute wheeze.

These recommendations emphasize careful clinical assessment to distinguish viral from bacterial causes, with antibiotics reserved for suspected bacterial infections, and supportive care for symptom relief.

References: NICE CKS