Families traveling abroad for an international adoption should consider taking the antibiotic Zithromax (prescription) as a back-up for ear infections and respiratory infections. While many antibiotics are available overseas, it is wise to take an FDA-approved drug. Although 99 percent of colds do not become complicated, the typical course of respiratory infections in children begins with a cold. A cold virus in the nose or throat can affect the middle ear, where fluid can accumulate and become infected. That infected fluid in the middle ear, with an inflamed eardrum, is known commonly as an ear infection. The eardrum becomes red and swollen and is quite painful. The ear infection manifests itself in a number of ways. About 20 percent of children with ear infections actually grab their ears, and about 80 percent will not. Note, that sometimes children grab their ears for other reasons such as teething pain or sore throats. Some children grab their ears just because it is a fun activity! With an ear infection, though, the child becomes uncomfortable. Appetite, sleep, and mood are affected. In this setting, parents frequently call their pediatrician and say, "She's just not herself." An ear infection may or may not be accompanied by an elevated body temperature. A child can have a very low-grade temperature with little to no fever and still have an ear infection. Certainly, fever heralds underlying disease because it means the body is fighting infection, but generally, kids can have ear infections without displaying dramatic signs. Remember the subtle manifestations of disease in children: changes in mood, appetite,sleep patterns, and behavior.

Also Zithromax may be taken for respiratory infection, which may affect either the upper or lower respiratory tracts. When the virus moves into the lower aspect of the respiratory tract and causes inflammation of the airways, it is pneumonia. Symptoms include high fever, a productive-sounding cough, and fast breathing. As with an ear infection, the child usually starts off with a cold. After a few days, a high fever develops and breathing becomes very, very rapid. This combination undoubtedly disrupts sleep patterns and eating, and the child is diagnosed with pneumonia. Upper respiratory infections are usually viral and do not require antibiotic therapy. The cough from a cold is most likely a postnasal drip and sounds worse than it really is. Children commonly pool secretions in the back of their throat. Saliva from teething can cause a little cough from time to time as well. It is very important to distinguish the difference between an upper and lower respiratory tract infection.

Parents should take Zithromax as a powder when traveling abroad. It is dosed once daily and does not require refrigeration. Do not reconstitute the powder until the antibiotic is needed. Directions for adding the appropriate amount of water are written on the bottle by the pharmacist. For ear infections, children take the medicine once a day for five days. For pneumonia, the course is 10 days of Zithromax. It is advisable to take enough Zithromax to last for 10 days. The dosage is weight-dependent and should be determined by a physician before traveling. To ensure that the child receives a full dose of medicine, give the medicine from a medicine dropper, not in the feeding bottle. Some medicine applicators look just like a nipple, so the baby will suck the medicine down easily. Other medicine applicators resemble eyedroppers. A syringe without a needle may also be used.