Dawaa Reference

infectious

Acute Bronchiolitis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources5 sources

MSF Essential Drugs 2024 - paracetamol (oral) · No dose - supportive care, no medicine given · Erickson EN, Bhakta RT, Tristram D, Mendez MD. Pediatric Bronchiolitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: January 12, 2025. · AAP Clinical Practice Guideline: Bronchiolitis 2014 · NICE Guideline NG9: Bronchiolitis in children 2021

Verified against3 documents
  • MSF Essential Drugs 2024 - paracetamol (oral)
  • No dose - supportive care, no medicine given
  • Pediatric Bronchiolitis - disease-level clinical article (bronchiolitis-infantile-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • Cough, congestion, and runny nose come first, with or without fever, as the virus initially affects the upper airway [cough · runny nose]
  • Parents notice fast or labored breathing, trouble feeding, or blue discoloration of the lips and nailbeds after a cold-like start [breathlessness · cyanosis]

Signs — what you find (5)

  • Low fever with a fast respiratory rate and low oxygen saturation are common on exam [fever · hypoxia]
  • Breathing faster than 100 times a minute is typical and often makes feeding difficult
  • Grunting, flared nostrils, retractions between the ribs, and belly breathing are key exam findings [chest recession]
  • Widespread wheezing heard on both breathing in and out across the lungs is the classic auscultation finding [wheeze]
  • A tired, pale infant with poor air movement warns of impending respiratory failure needing urgent airway support [fatigue · pallor]

Tests (4)

  • Oxygen saturation helps decide on hospital admission and the need for supplemental oxygen
  • Fast breathing over 60 breaths per minute or saturation below 92% should prompt considering admission and oxygen
  • Rapid viral testing on a nasal sample can identify the causative virus and guide isolation and room placement
  • Chest x-ray is not usually recommended, since findings like hyperinflation and interstitial markings are nonspecific

If not this — what else fits (2)

  • Reflux disease, aspiration pneumonia, and an inhaled foreign body in the lower airway are alternatives to consider
  • Congenital vascular rings or slings, an asthma flare, or anaphylaxis can present similarly

SourceStatPearls "Pediatric Bronchiolitis" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (SUPPORTIVE CARE)

1st line
Adult dose and duration

Bronchiolitis is a disease of infants, usually under 12 months. There is no effective drug treatment: management is small frequent feeds, nasal saline and suction if feeding is blocked, and watching the work of breathing. - Supportive, through the illness

Paediatric dose

This IS the paediatric entry - the condition does not occur in adults. Admit if feeding drops below about half of normal, or if there is apnoea, grunting, marked recession or cyanosis.

Dose source

No dose - supportive care, no medicine given

Why

Supportive care is the mainstay - hydration, feeding, nasal suctioning, and oxygen for hypoxaemia - alongside recognising the infant who is tiring. Steroids are not recommended, and antibiotics are reserved for clear evidence of a superimposed infection. Bronchodilators are not universally effective, though a trial of aerosolised salbutamol may be considered for an infant with severe respiratory compromise.

Cautions
  • A DISEASE OF INFANTS - it does not occur in adults, so no adult regimen applies.
  • Inhaled or oral steroids do not alter the course, and antibiotics are only for clear evidence of a superimposed infection. Bronchodilators are not universally effective, but a trial of aerosolised salbutamol may be considered, especially for an infant with severe respiratory compromise.
  • Admit if feeding falls below roughly half of normal intake.
  • RED FLAG - Apnoea episodes, marked respiratory distress with grunting, severe recession or nasal flaring, or poor feeding or dehydration.
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Pediatric Bronchiolitis - disease-level clinical article (bronchiolitis-infantile-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - The criteria for hospitalization and supplemental oxygen are tachypnea >60 breaths/min, SpO2 <92%, or inability to feed.
3

PARACETAMOL

add-on - not a substitute

Strength500 mg

Formoral.solid

Adult dose and duration

For fever or discomfort in the infant, dosed by weight - see the paediatric calculation. Bronchiolitis does not occur in adults, so the adult column does not apply here. - As needed for pain or fever

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.)

Dose by weight
3kg45 mg/dose
4kg60 mg/dose
5kg75 mg/dose
6kg90 mg/dose
7kg105 mg/dose
8kg120 mg/dose
9kg135 mg/dose
10kg150 mg/dose
11kg165 mg/dose
12kg180 mg/dose
13kg195 mg/dose
14kg210 mg/dose
15kg225 mg/dose
16kg240 mg/dose
17kg255 mg/dose
18kg270 mg/dose
19kg285 mg/dose
20kg300 mg/dose
21kg315 mg/dose
22kg330 mg/dose
23kg345 mg/dose
24kg360 mg/dose
25kg375 mg/dose
26kg390 mg/dose
27kg405 mg/dose
28kg420 mg/dose
29kg435 mg/dose
30kg450 mg/dose
31kg465 mg/dose
32kg480 mg/dose
33kg495 mg/dose
34kg500 mg/dose (capped)
35kg500 mg/dose (capped)
36kg500 mg/dose (capped)
37kg500 mg/dose (capped)
38kg500 mg/dose (capped)
39kg500 mg/dose (capped)
40kg500 mg/dose (capped)
41kg500 mg/dose (capped)
42kg500 mg/dose (capped)
43kg500 mg/dose (capped)
44kg500 mg/dose (capped)
45kg500 mg/dose (capped)
46kg500 mg/dose (capped)
47kg500 mg/dose (capped)
48kg500 mg/dose (capped)
49kg500 mg/dose (capped)
50kg500 mg/dose (capped)
Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Symptomatic relief of the pain and fever only. It does not treat the cause, and the dose is the same whatever the cause is.

Cautions
  • Dose the INFANT by weight - the adult figure carried on other screens is not the dose here.
  • Relief only - it does not treat what is causing the pain or fever.
  • Check every other product the patient is taking for paracetamol; combination cold and flu preparations are the usual route to an accidental overdose.
  • Reduce the dose in significant liver disease, chronic alcohol use, or low body weight.
  • RED FLAG - Admit or refer the infant for apnoea episodes, marked respiratory distress with grunting, severe chest retraction or nasal flaring, poor feeding or dehydration, or low oxygen saturation or a bluish colour. A very young infant, or one with underlying heart or lung disease or prematurity, warrants a lower threshold for admission.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.