Treatment of acute bronchitis in children

Treatment of acute bronchitis (simple) should be comprehensive, taking into account the reactivity of the sick child's body, the characteristics of the nature of the course and period of it. With this form of bronchitis, home regime is preferable. Hospitalization is possible only in case of severe concomitant pathology or severe course of a viral infection. The regime in the acute period is bed rest for several days. It is necessary to provide the freshest air possible (frequent blood ventilation). The diet should include the most vitaminized food, include easily digestible products with a physiological, age-appropriate content of proteins, fats and carbohydrates, with complete proteins and unsaturated fatty acids. To thin phlegm, it is recommended to drink plenty of fluids - milk with sodium bicarbonate, Borjomi, tea with milk, cranberry and lingonberry fruit drinks, linden tea.

In most cases of acute simple bronchitis, antibiotics are not used. However, in young children, there are a number of indications for their use: suspected bacterial flora (symptoms of intoxication, purulent sputum, signs of bacterial infection according to general blood analysis); children with an unfavorable premorbid background (severe rickets, dystrophy, secondary and primary immunodeficiencies; severe anemia); children with severe congenital lung or heart defects. In such cases, oral antibiotics are used: amoxicillin, azithromycin, augmentin, clarithromycin, midecamycin suspension, cefuroxime, ceftriansone. The course is 5-7 days.

From the first days of bronchitis, it is necessary to prescribe sputum thinning agents and expectorant anti-inflammatory drugs. Mixtures with marshmallow root with the addition of sodium benzoate, thermopsis, chest collection No. 1, infusions of elecampane root, coltsfoot are used. Mucolytic agents: mucaltin, mukomist, fluimucil, mucosalvan, bromhexine. Inhalations of 2% sodium bicarbonate solution are used. In order to stimulate the regeneration of the respiratory epithelium of the bronchi, vitamin A and metacil in age-related doses are indicated. To increase the protective properties of the body, vitamins C, B1, B2, B6 are used in treatment; ginseng root, especially during the convalescence period.

Vibration massage with postural drainage is indicated. Patients are prescribed exercise therapy and massage. Chronic foci of infection are sanitized.

Expectorants increase the secretion of the liquid component of sputum and improve the transport of sputum by increasing bronchial motility. When prescribing expectorants, it is necessary to ensure sufficient hydration, since water loss increases the viscosity of sputum. Mixtures based on marshmallow root infusion with the addition of sodium benzoate, potassium iodide and ammonia-anise drops are used. Bronchicum, Doctor Mom also belong to expectorants.

Mucolytic agentspromote liquefaction of sputum by chemical action on the mucin molecule. In case of lower respiratory tract diseases with formation of thick viscous sputum, it is advisable to use preparations containing acetylcysteine (ACC, Mukomist, Fluimucil, Mukobene). The mechanism of action of acetylcysteine is associated with the ability of free sulfhydryl groups to break intra- and intermolecular disulfide bonds of mucopolysaccharides of sputum, which leads to a decrease in sputum viscosity. Its antioxidant effect has been proven, helping to maintain the functional activity and morphological integrity of respiratory tract cells.

Derivatives of the alkaloid vazicin - bromhexine, bisolvon, mucosalvan - have a mucolytic effect. These drugs reduce the viscosity of secretion, restore mucociliary clearance, and stimulate the synthesis of endogenous surfactant.

Carbocisteines (mucodin, mucopront, bronkatar) have both mucoregulatory and mucolytic effects. Under the influence of drugs of this group, regeneration of the mucous membrane of the bronchi, restoration of its structure, reduction of the number of goblet cells, restoration of IgA secretion, improvement of mucociliary clearance occur.

Inhalations of proteolytic enzymes (chymotrypsin, chymopsin, etc.) are excluded from the arsenal of pulmonology, as they can contribute to the development of fibrotic changes in the lungs.

Postural drainage(positional drainage) and vibration massage are powerful methods of evacuating sputum. Effective are hanging the body from the bed on the stomach with the hands on the floor immediately after waking up for 15-20 minutes (with breaks) with repetition of the manipulation 2-3 times a day.

First generation antihistamines and cough suppressants are not indicated for acute simple bronchitis.

If there are signs of bacterial inflammation, it is necessary to prescribe antibacterial therapy (oral cephalosporins, amoxicillin, macrolides) in an age-appropriate dosage. The course of treatment is usually 5-7 days.