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AI-Generated response:

What's the best treatment for mouth pain caused by herpangina in a twelve-month-old?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

For treating mouth pain caused by herpangina in a twelve-month-old, symptomatic treatment with oral fluids and analgesics is recommended.

Topical anesthetics like lidocaine should be used cautiously due to potential systemic toxicity, especially in children.[1-2]

  • Encourage the intake of oral fluids to prevent dehydration.[1]

  • Use analgesics to manage pain; however, specific dosages and types suitable for a twelve-month-old should be consulted with a pediatrician.[1]

  • Topical anesthetics such as lidocaine can be applied, but it is crucial to adhere strictly to dosing guidelines due to the risk of systemic toxicity in children.[2]

  • Avoid the use of throat lozenges and sprays like benzocaine in children under two years of age due to the risk of methemoglobinemia.[3]

  • Monitor the child closely for worsening symptoms or persistence of symptoms beyond one week, which may suggest an alternative diagnosis.[1]

Additional info

In managing herpangina in infants, it's essential to focus on supportive care to alleviate symptoms and ensure the child remains hydrated and as comfortable as possible. The use of topical anesthetics like lidocaine requires careful consideration of the dosage and frequency to avoid potential adverse effects, particularly in young children where the risk of systemic absorption and toxicity is higher. Always consult product labels for specific dosages and consider seeking advice from a pediatric specialist when managing such cases. Additionally, it's important to educate caregivers about the signs of potential complications or ineffective treatment, prompting further medical evaluation if symptoms do not resolve within the expected timeframe.

References

Reference 1

1.

Elsevier ClinicalKey Derived Clinical Overview

• Give symptomatic treatment for sore throat: Saline gargles and analgesics, and encourage oral fluids. • No antiviral therapy indicated; avoid antibacterial agents because they are ineffective, increase cost, might result in side effects, and promote antibiotic resistance.

• Generally, resolution of symptoms within 1 wk • Persistence of fever or mouth lesions beyond 1 wk suggestive of an alternative diagnosis (see “Differential Diagnosis”)

Reference 2

2.

Elsevier ClinicalKey Clinical Overview

Treatment Topical anesthetics are applied as needed for temporary local pain relief Advise patients to use only as needed, and to be aware that even with topical application, systemic toxicity (cardiac, neurologic) may occur with overuse, especially in children Lidocaine Topical dosage (ointment, jelly, gel, solution) Lidocaine Hydrochloride Topical gel; Children and Adolescents 2 to 17 years: Consult individual product labels for specific dosages. Generally, apply to affected area of skin no more than 3 to 4 times per day. Lidocaine Hydrochloride Topical gel; Adults: Consult individual product labels for specific dosages. Generally, apply to affected area of skin no more than 3 to 4 times per day. Viscous lidocaine 2% Lidocaine Hydrochloride Oromucosal solution; Infants and Children 3 years and younger: 1.2 mL (24 mg) applied to affected area with a cotton-tipped applicator. Separate doses by at least 3 hours (Max: 4 doses/12 hours). Limit use in this population; do NOT use to treat teething pain. Lidocaine Hydrochloride Oromucosal solution; Children and Adolescents 4 to 17 years: A single dose of lidocaine should not exceed 4.5 mg/kg (Max: 300 mg); swish and spit solution for use in mouth or gargle and swallow for use in pharynx. Separate doses by at least 3 hours (Max: 8 doses/day). Do NOT use to treat teething pain in young children. Lidocaine Hydrochloride Oromucosal solution; Adults: 15 mL/dose; swish and spit solution for use in mouth or gargle and swallow for use in pharynx. Separate doses by at least 3 hours (Max: 8 doses/day).

Reference 3

3.

Food and Drug Administration (DailyMed).

Publish date: January 2, 2024.

Dosage And Administration Table <table width="60%"><colgroup><col align="left" valign="top" width="35%"/><col align="left" valign="top" width="65%"/></colgroup><tbody><tr styleCode="Botrule"><td styleCode="Lrule Rrule">adults and children 6 years of age and older </td><td styleCode="Rrule">apply to affected area (one spray); gargle, swish around in the mouth, or allow to remain in place at least 1 minute then spit out. Use up to 4 times daily or as directed by a doctor or dentist. Children 6 to under 12 years of age <content styleCode="bold">SUPERVISE USE</content></td></tr><tr><td styleCode="Lrule Rrule">children under 6 years of age</td><td styleCode="Rrule"><content styleCode="bold">do not use</content></td></tr></tbody></table>

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