How good is Seretide for colds?

Dear Dr. Donya,

Thanks for your help in analyzing my child's behavior. Now I need more help.

My daughter often gets colds. It generally begins with sneezing, then goes on to running nose and coughing with phlegm. The color of the mucus is initially white and turns yellowish later.

I take her to her pediatrician after home medication proves ineffective. The doctor ends up giving her antibiotics, saying she has developed an infection. She has been like this for the last one and a half months, and didn't get better even after three different antibiotics were prescribed in a period of two weeks.

Her doctor suspects it to be an underlying condition like sinuses or allergies, and also has prescribed an anti-allergy medication to be given to her for two weeks.

I have also been asked to put her on Seretide for three months, tapering down from four times a day to once a day. What I'd like to know is how to distinguish between a common cold and one that is caused by allergy/sinus problems?

How good is Seretide in treating this kind of condition and what are its side effects? Should I see an allergy specialist? Can food like cow's milk trigger this? Thank you once again. --Vindhiya

Dear Vindhiya,

Looking into the nose to examine the mucus can sometimes help in differentiating between allergies and colds. Typically an allergy is accompanied by pale mucus where an infection has red mucus.

It is difficult to diagnose accurately when a child who has an allergy gets an infection because the mucus turns red. Other signs are dark eyes and marks on the nose from rubbing.

Again, if any cold does not respond to treatment then an allergy should be considered.

Does your doctor say what kind of allergy your daughter has? Is it allergic rhinitis or asthma?

Seretide is indicated in the regular treatment of asthma where the use of a combination of products (long-acting beta-2-agonist and inhaled corticosteroid) is appropriate.

Allergic rhinitis is an inflammation or irritation of the mucous membranes that line the nose. Common symptoms include sneezing, a stuffy or runny nose, itchy eyes, nose and throat, and watery eyes.

Other symptoms are a nasally voice, noisy breathing, snoring, feeling chronically tired, loss of appetite, nausea, frequent headaches and some difficulty hearing and smelling.

From the symptoms you have described, I suspect that your daughter probably has allergic rhinitis, which is not always easy to diagnose. Many of its symptoms are similar to those of a cold, so if you use cold preparations it may seem to improve for short periods of time.

The medications used to treat allergic rhinitis are antihistamines, which block the histamines that trigger the reaction, decongestants to relieve nasal stuffiness and corticosteroid via nasal spray. Another treatment is immunotherapy.

I have not examined or seen your daughter, but the medication your doctor has given her sounds like treatment for asthma. You did not mention any difficulty in breathing or the presence of a wheezing sound, so I am concerned that there may be some confusion between us. Ask your doctor the same questions you asked me, and I am sure he will be willing to explain what he thinks is happening with your daughter.

Thank you for the letter and I am sorry for not being of more help.

Dr. Donya