Antibiotics for tracheitis: when you can not do without them and when they are not needed?

In modern clinical medicine, tracheitis is considered a disease of a viral origin, however, bacteria are also involved in its development, in particular, staphylococci, streptococci and, especially, gram-positive aerobes of the genus Moraxella catarrhalis. It is in connection with the presence of a bacterial factor in the etiology of tracheitis that the question arises: are antibiotics necessary for tracheitis?

Practical unhindered way of "migration" of pathogenic microbes is aerogenic. Airborne and airborne dust pathogens fall into the human respiratory tract, causing various diseases. One of them is tracheitis, in which the mucous membrane of the windpipe - the trachea - is inflamed.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

Treatment of tracheitis with antibiotics

Tracheitis occurs in two forms - acute and chronic. Acute tracheitis, the main symptom of which is the throat-stubborn, persistent dry cough, in most cases is combined with acute inflammation of the nasal mucosa (rhinitis), inflammation of the pharyngeal mucosa (pharyngitis) and larynx (laryngitis). All these inflammatory processes are the result of a viral infection. As is known, viruses do not have a cellular structure and are introduced into living cells, so antibiotics for acute tracheitis of viral origin are powerless, and cough is treated with antitussive drugs (in the form of tablets or potions), alkaline inhalations, decoctions of medicinal plants, etc.

But infectious tracheitis can develop due to the effects of bacterial infection. And, as microbiologists note, bacteria can become both the root cause of the disease and accompany with already existing viruses. This is because viruses, by suppressing human immunity, facilitate the development of pathogenic bacteria in the body.

In this situation, antibiotics for tracheitis and bronchitis, as well as for other diseases of the respiratory tract of bacterial origin, fulfill their main therapeutic task - they suppress the growth of pathogenic microorganisms.

Indications for starting to use an antibiotic for tracheitis in adults are: suspected pneumonia (pneumonia); duration of cough exceeds three weeks; From the very beginning of the disease, the temperature is kept at + 37.5-38 ° C and continues to grow; there are signs of inflammation of the tonsils (sore throat), ears (otitis) or sinuses of the sinuses (sinusitis).

It should be noted that in time not cured acute tracheitis can go into a chronic form. But chronic inflammation of the mucosa of the trachea can be associated with anatomical features of the human respiratory tract or with the presence of pathological changes in them, as well as with frequent changes in the temperature regime of the environment. As a rule, chronic tracheitis - with coughing attacks at night and after sleep - affects heavy smokers and people who abuse alcohol, as well as those whose work is associated with a variety of chemicals whose vapors irritate the mucosa of the respiratory throat and cause its inflammation. In addition, allergy sufferers are the cause of allergic tracheitis is dust. In these cases, otolaryngologists never administer trachea treatment with antibiotics.

Which antibiotic is better for tracheitis?

So, according to anamnesis, all the symptoms, as well as from the clinical analysis of blood and bacteriological examination of phlegm and smears from the throat, the doctor determined that the tracheitis is caused by bacteria. That is, the treatment of tracheitis with antibiotics is inevitable.

When appointing antibiotics to get rid of tracheitis, all should be taken into account: the clinical picture of the disease, the age of the patient and the presence of concomitant pathologies, the spectrum of the specific drug and its contraindications. And the recommended dosage of an antibiotic is determined by the degree of severity of the inflammatory process.

According to many experts, the most effective antibiotics for tracheitis are penicillin group drugs administered parenterally. But there are a lot of medicines of this group that are taken inside or have several forms. In addition, they have a broader spectrum of antibacterial activity. For example, the drug Augmentin (synonyms - Amoxicillin, potentiated with clavulanate, Amoxiclav, Amoclavine, Klavocin) contains amoxicillin (semisynthetic penicillin antibiotic) and clavulanic acid (which protects amoxicillin from decay and expands its antibacterial spectrum). This drug is produced in the form of tablets, powder for the preparation of an injection solution and powder for the preparation of a suspension.

Augmentin (tablets 1 g) is used to treat adults and children over 12 years - one tablet twice a day (at the beginning of eating). In severe forms of acute tracheitis and other bacterial infections of the respiratory tract - on a tablet 3 times a day. With gastrointestinal diseases, infectious mononucleosis and chronic renal failure, this antibiotic should be used with caution. And during pregnancy, especially in the first trimester, and during lactation it is not recommended.

If patients are intolerant to penicillin and its derivatives, antibiotics of the cephalosporin group or macrolide group are prescribed. In bacterial or viral-bacterial acute tracheitis, doctors recommend the use of cephalexin (synonyms - Ospexin, Keflex), which has a bactericidal effect on a wide range of pathogens. Active substances of the drug begin to act, disrupting the synthesis of the cell wall of microorganisms, 1-1.5 hours after ingestion, and from the body are completely removed after 8 hours - with urine. This antibiotic is available in the form of capsules, tablets and powder for the preparation of a suspension.

The daily dose of Cefalexin (in capsules of 0.25 g) for adults is 1-4 g, the drug should be taken every 6 hours, half an hour before meals, drinking 150-200 ml of water. The course of treatment is up to two weeks. The medicine has side effects: from weakness, headache, hives and dyspepsia up to cholestatic jaundice and leukopenia. Contraindications are intolerance to cephalosporins and antibiotics of the penicillin series, as well as children under 12 years of age.

Further in the list of antibiotics with tracheitis are macrolides, which are among the least toxic agents of the family of antibiotics. Macrolides perfectly cope with Gram-positive cocci and pneumococci; they act on causative agents of pertussis and diphtheria, legionella and spirochete, chlamydia and mycoplasma. Antibiotics of this pharmacological group accumulate in the tissues of the respiratory organs, including in the mucosa of the trachea, due to which their therapeutic effect becomes stronger.

Antibiotic-macrolide Azithromycin is available in the form of capsules (0.25 grams), tablets (0.125 g and 0.5 g), as well as in the form of powder for the preparation of a suspension (in bottles of 15 ml and 30 ml). Scheme of application of this drug to adults: 0.5 g per day for three days or 0.5 g - on the first day and 0.25 g for four more days. The whole dose is taken at a time - one hour before a meal.

The drug Josamycin (a synonym - Wilprafen) also belongs to the group of natural antibiotics-macrolides and in 2012 was introduced into the Russian "List of vitally important and essential drugs". It is used in the treatment of infectious inflammation of the respiratory tract and oral cavity, in the treatment of chlamydia, gonorrhea, syphilis, scarlet fever, dysentery and other diseases. With tracheitis of bacterial etiology, Jozamycin for adults and children over 14 years of age is prescribed 1-2 g per day - in three divided doses. This drug can be used during pregnancy and during breastfeeding.

Serious adverse reactions in the treatment of antibiotics group of macrolides are rare and are manifested by nausea, vomiting and abdominal pain. And among their contraindications expressed expressed liver dysfunction and individual hypersensitivity to the drugs of this group.

Antibiotics for tracheitis in children

In acute viral tracheitis in children, the treatment is mostly symptomatic, and with coughing they struggle with the help of mustard plasters, ointments for rubbing, inhalations, cough mixtures. If the trachea is bacterial, antibiotics are used.

Pediatricians recommended antibiotics for tracheitis in children: Augmentin (a preparation of the penicillin group), Azithromycin and Sumamed (macrolide antibiotics). For infections of mild to moderate severity, the daily dose of Augmentin in the suspension is:

Children up to a year - 2 ml three times a day (before meals), from 1 year to 6 years - 5 ml three times a day, children 7-12 years - 10 ml in three divided doses.

Azithromycin in the form of a syrup (100 mg / 5 ml and 200 mg / 5 ml) can be administered at a dosage of 10 mg per kilogram of body weight during the day - at one time, one hour before meals. Duration of admission is three days. According to the second scheme, it is recommended to give such quantity of syrup only on the first day of treatment, and in the next four days - 5 mg per kilogram of body weight (also in one session).

Among the antibiotics for tracheitis in children, Sumamed and Sumamed forte are widely used in the form of supesi. Its dosage is also calculated by the weight of the child's body - 10 mg / kg body weight once a day for 3 days. The course of treatment is 30 mg per kilogram. Children older than 6 months with a body weight of up to 10 kg are prescribed 5 ml of suspension per day.

The suspension and antibiotic Josamycin is available (the dosage for adults was indicated above). Children's otolaryngologists prescribe this drug to newborns and infants - at the rate of 30-50 mg per kilogram of body weight per day (in three divided doses).

[11], [12], [13], [14]

Antibiotics for inhalations with tracheitis

Etiological inhalation treatment of tracheitis with antibiotics is quite effective, since it allows creating high concentrations of the drug directly in the inflammatory focus. In addition, with inhalation of antibiotics, the risk of their systemic side effects is much lower than with internal admission or injections.

Now in the treatment of acute bacterial tracheitis special inhalation forms of antibiotics are used - in the form of solutions and powders for inhalations.

For example, the broad-spectrum antibiotic Fluimutsil is prescribed by doctors not only for tracheitis of bacterial origin, but also for tonsillitis, pharyngitis, bronchitis and pneumonia, and also for suppurative diseases of the lungs. To prepare the inhalation solution, 5 ml of saline is added to the flacon with Fluuimcil powder. On 1 inhalation almost half of the received solution - 2 ml leaves. The procedure should be carried out 2 times a day, children up to 6 years old are enough once. The course of treatment should not exceed 10 days. This drug should not be used in parallel with the use of other antibiotics, as their absorption decreases.

Aerosol preparation Bioparox is an antibiotic for topical application, it has no systemic effect. When bacterial tracheitis in adults, one inhalation (4 injections) is used every 4 hours, in children - one inhalation every 6 hours. The duration of the standard course of therapy is 5-7 days.

[15], [16], [17], [18]

How to cure tracheitis without antibiotics?

If antibiotics with tracheitis are used only for bacterial or viral-bacterial origin of the disease, then with conventional viral tracheitis, doctors cope with other methods.

For example, using traditional symptomatic therapy aimed at relieving cough and getting rid of it. Among the expectorant drugs with an unproductive (dry) cough, doctors recommend taking Ambroxol or not much different from Bromhexine.

Ambroxol (synonyms - Lazolvanum, Ambrolitic, Bronchoprot, Fluixol, Lindoxil, Mukosan, Mukovent, Secretil, Viskomcil) increases the secretion of mucus in the airways and is given to adults by tablet 2-3 times a day (after meals). Dosage of the drug in the form of a syrup for children is as follows: up to 2 years - 2.5 ml 2 times a day, 2-5 years - 2.5 ml 3 times a day, 5 years older - 5 ml 2-3 times in a day. As side effects may be heartburn, dyspepsia, nausea, vomiting, skin rash.

Mucolytic drug with a coughing effect - Bromhexine (Bronchostop, Solvin) - is available in the form of dragees, tablets, drops, solution for injection, solution for ingestion, as well as syrup and tablets for children. The therapeutic effect of the drug is manifested after 2-5 days from the beginning of treatment, to increase it you need to drink a sufficient amount of liquid. It is prescribed for adults and children over 14 years - 8-16 mg 3-4 times a day; children older than 2 years - 2 mg three times a day, 2-6 years - 4 mg 3 times a day, 6-14 years - 8 mg 3 times a day. Duration of application - no more than 5 days. Among the contra-indications of this drug are hypersensitivity, peptic ulcer, pregnancy (first trimester), lactation period, children's age (up to 6 years - for taking tablets).

To relieve attacks of dry cough, doctors can prescribe medications that reduce the sensitivity of the mucous membrane of the respiratory tract to irritants, for example, Libexin. The average dose for adults is 100 mg (1 tablet) 3-4 times during the day. And the average dose for children, depending on the age and body weight, is 25-50 mg (0.25-0.5 tablets) 3-4 per day.

A positive therapeutic effect in acute non-bacterial tracheitis is given by various potions based on the root of althaea, licorice, and thermopsis. You can also use special piles of medicinal plants, brew them and drink according to the recommendation indicated on the package. And for internal use, herbal decoctions are prepared on the basis of mother-and-stepmother, sweet clover, three-tone violet, angelica, plantain, oregano or thyme. Herbal teas should be drunk warm, 100 ml twice a day, they also need to gargle.

They help to relieve the condition with trachea inhalation with pine buds, eucalyptus leaves, sage or thyme. It is necessary to prepare a decoction of these plants (a tablespoon for a glass of boiling water), and then (if there is no special inhaler) to breathe over a slightly cooled composition, covering the head with a terry towel.

And remember that with all the variety of medicines, including antibiotics for tracheitis, no therapeutic effect on the body of natural honey and ordinary hot tea with lemon was not canceled ...