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Recurrent bronchitis in children
Last reviewed: 04.07.2025
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Recurrent bronchitis is bronchitis without obstruction, episodes of which are repeated 2-3 times over 1-2 years against the background of acute respiratory viral infections. Episodes of bronchitis are characterized by the duration of clinical manifestations (2 weeks or more).
[ Causes and pathogenesis of recurrent bronchitis
The provoking factor in the development of the first episode of recurrent bronchitis is ARVI (mainly influenza or parainfluenza virus type 1), which is characterized by prolonged viremia and persistence of the virus in the child's body. In case of relapses of bronchitis, a bacterial infection (pneumococcus, Haemophilus influenzae) and mycoplasma join in.
The main thing in the pathogenesis is (violation of the ventilation and drainage function of the bronchi!
Predisposing factors for recurrent bronchitis
- family predisposition to bronchopulmonary diseases;
- unfavorable prenatal and postnatal background (toxicosis of pregnancy, fetal asphyxia, birth injuries);
- constitutional features of the child (lymphohypoplastic and exudative diathesis);
- acquired immunodeficiency;
- chronic foci of infection in the ENT organs (chronic tonsillitis, sinusitis);
- a number of social and hygienic reasons: passive smoking, air pollution, unfavorable material and living conditions;
- climatic and geographical features: high humidity, significant fluctuations in air temperature and atmospheric pressure.
Frequent relapses of bronchitis are associated with allergic heredity, genetically determined insufficient response to infection, “local” inferiority of the bronchopulmonary system (damage to the phagocytosis function, impaired tracheobronchial clearance), carriage of a pathological gene and deficiency of alpha1-antitrypsin, dysgammaimmunoglobulinemia, group deficiency of antiviral antibodies, deficiency of IgG and SlgA, interferon.
Symptoms of recurrent bronchitis
After another acute respiratory viral infection, a dry cough persists for several weeks, then a wet cough during the day or more in the morning. A clear sound with a slight shortening in the interscapular region is determined by percussion over the lungs. Against the background of harsh breathing, wheezing of varying sonority is heard, and during the acute stage of the process, wet large- and medium-bubble, variable in the nature of the sound and localization. Under the influence of therapy, an improvement in the process in the lungs is observed, and then clinical signs of bronchial damage appear again, especially under the influence of another viral infection or cold.
Recurrent bronchitis in some patients may be a clinical manifestation of cystic fibrosis, pulmonary malformations, and ciliary dyskinesia syndrome. If these diseases are suspected, examination in the pulmonology department is necessary.
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Treatment of recurrent bronchitis
In the acute period of relapse, bed rest is prescribed for 5-7 days. The child must be provided with access to fresh air (frequent ventilation). The diet is complete, taking into account the patient's age, with the maximum content of vitamins, hypoallergenic. To thin the sputum, it is recommended to take sufficient fluids - cranberry and lingonberry fruit drinks, fruit and vegetable juices, tea with lemon, mineral waters.
Antibiotics are prescribed for viral-bacterial infections and exacerbation of a chronic infection for 5-7 days. Oral antibiotics are used: amoxicillin, augmentin, azithromycin, clarithromycin, cefuroxime.
In case of recurrent bronchitis, therapy aimed at restoring the drainage function of the bronchi is of particular importance. For this purpose, inhalations of 10% acetylcysteine solution, 2% sodium bicarbonate solution, as well as phlegm thinning agents and mucolytics (bromhexine, ambroxol, bronchosan) are used in combination with postural drainage. The frequency of the procedure is 2-3 times a day, the first is best done in the morning immediately after the patient wakes up.
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