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Mortuaire, G., de Gabory, L., François, M., Massé, G., Bloch, F., Brion, N., ... Serrano, E. Rebound congestion and rhinitis medicamentosa: Nasal decongestants in clinical practice. (2013, June 1). Critical review of the literature by a medical panel. European Annals of Otorhinolaryngology, Head and Neck Diseases , 130(3), 137-144. Retrieved from https:///#!/content/playContent/1--S1879729612001378?returnurl=http:%2F%%2Fretrieve%2Fpii%2FS1879729612001378%3Fshowall%3Dtrue&referrer=https:%2F%2F .
Most likely due to a viral illness (most common) followed by bacterial super-infection (bacteria super-infection means when a bacterial infection occurs in setting where viral illness is also present). Less common is bacterial infection alone. A viral component is most likely present if symptoms do improve partially with antibiotics followed by immediate recurrence of symptoms after antibiotics completed resulting in repeated courses of antibiotics. In this scenario, it is best to avoid antibiotics unless the child is quite ill as only time will allow for the viral illness to resolve which is the main problem. Conservative care with saline spray to the nose followed by bulb suctioning is recommended. Daily Xlear Nasal Spray may also be helpful.