Causes

• Secretions
• Infection

Interventions

• Antibiotics*
• Anticholinergics (hyoscine hydrobromide or glycopyrronium)*

*  NB  Effects of antibiotics and anticholinergics are mutually counter-productive.  Anticholinergics reduce the volume of secretions, but increase their viscosity which may interfere with mucociliary clearance.  Antibiotics may improve infection but carry their own adverse effects.  The best approach needs individual assessment, taking into account the priorities of child and family.