Managing Colds, Cough, and Fever in Children
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Pediatric patients often suffer from viral upper respiratory
infections (“the common cold”)with symptoms including
congestion, rhinorrhea (runny nose), cough and, occasionally,
fever. Children experience approximately 3 to 8 colds each year,
about twice as many as adults. The annual cost of colds and
cold-like illnesses in the US is an estimated $40 billion – due to
lost work days for parents, medical appointments, and the cost
of medications. Cough, a common symptom of several childhood
illnesses, is the second most common reason for emergency
department visits by children aged 15 years and younger.
common symptom among children, fever, accounts for an
estimated 6% of all office visits to pediatricians.
Typically, colds and related symptoms of cough and fever
are self-limiting, but nondrug measures and over-the-counter
(OTC) medications may be used to relieve bothersome symptoms.
Although many OTC medications are recognized as safe
and effective through the FDA’s OTC monograph process, clinical
trial evidence to support their use in children is limited.
In 2001, concern began to escalate about serious adverse effects and
deaths related to cough and cold medication use in infants and
young children. In addition, adverse events related to
and cold medications were implicated as a common reason for
emergency department visits, especially among young children.11
These reports led to a 2008 Public Health Advisory from the
FDA recommending that cough and cold products not be used
in infants and children under the age of 2 years. Following this
recommendation, manufacturers voluntarily updated the cough
and cold product labels to advise against use in children younger
than 4 years.
Pharmacists and other easily accessible healthcare
providers are key sources of information about the drug
and nondrug options for treating colds, cough and fever
in children. Placing emphasis on nondrug options is
important to avoid unnecessary medication use and
potential side effects. When OTC medication is recommended,
caregivers need advice about identifying and
measuring the correct dose (which can be quite confusing)
as well as any contraindications or side effects of
concern for the individual child. This issue focuses on
OTC options for cold symptom management; prescription
medications (eg, ipratropium nasal solution for
rhinorrhea) are not included.
Publication Date: 01/20/2016
Expiration Date: 01/20/2019
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based
This program was developed by The Rx Consultant and published by Continuing Education Network, Inc.
The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and
is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased,
balanced information to health care practitioners.
Programs developed by The Rx Consultant are written by health care providers with expertise in the topic
area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure
that every program presents information that is current, accurate, relevant to "real world" health care
providers, and written in an easy reading, "plain English" style.
Kelly L. Scolaro, PharmD, is a Clinical Assistant Professor and
Director of Pharmaceutical Care Labs, Division of Practice
Advancement and Clinical Education, UNC Eshelman School
of Pharmacy at the University of North Carolina, Chapel Hill.
Courtney L. Bradley, PharmD, is an Assistant Professor of
Clinical Sciences and Applied Laboratory Coordinator at the
High Point University School of Pharmacy, High Point, NC.
Dr. Scolaro and Dr. Bradley report no financial relationship with the manufacturer(s) or provider(s) of any
commercial product(s) or service(s) that appears in this issue.
This accredited program is targeted to
Goals & Objectives
At the conclusion of this program, participants will be able to:
- Differentiate the common cold from allergy and influenza. Identify which children with cold, cough and/or fever should be referred to a primary care provider for further assessment.
- Describe how common cold viruses can be transmitted and discuss measures that may reduce transmission.
- Discuss nonprescription medications used for the treatment of cold symptoms, including appropriate pediatric dosing and potential side effects.
- Recommend nondrug strategies for managing cold symptoms to a parent or caregiver. Discuss alternative or complementary remedies that may be used to treat or prevent colds in children.
The Rx Consultant is a publication of Continuing Education Network, Inc.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a
provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.
ACPE Universal Activity Number: 0428-0000-16-001-H01-P
Exam & Credit Statement Procedures
Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and
Editorial and Review Board
Chief Editor and CE Administrator
Terry M. Baker, PharmD
Tracy Farnen, PharmD
James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA
Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA
Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA
Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System
Adjunct Clinical Professor
College of Pharmacy
Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Visiting Associate Professor and Lecturer
Samuel Merritt University
Pamela Mausner, MD
Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Senior Editorial Advisor
Gerard Hatheway, PharmD, PhD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD
Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners
Meuleman, RN, C, MS
About the Rx Consultant
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