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Treatment of acute bronchitis in children
Last reviewed: 19.10.2021
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Treatment of acute bronchitis (simple) should be complex taking into account the reactivity of the organism of the sick child, the characteristics of the nature of the course and its period. With this form of bronchitis, home treatment is preferred. Hospitalization is possible only with severe concomitant pathology or in severe viral infection. The regime in the acute period for several days is bed rest. It is necessary to provide the most fresh air (frequent tsrovetrivaniya). In the diet should provide the most vitaminized food, include easily assimilated products with physiological, age-appropriate content of proteins, fats and carbohydrates, with full proteins and unsaturated fatty acids. For liquefaction sputum recommend a plentiful drink - milk with sodium hydrocarbonate, borzom, tea with milk, cranberry and cowberry mors, lime tea.
In acute simple bronchitis, in most cases, antibiotics are not used. However, in infants, a number of indications can be identified for their use; suspicion of joining the bacterial flora (symptoms of intoxication, sputum purulent sputum, signs of bacterial infection according to the general blood test); children with an unfavorable premorbid background (severe rickets, dystrophy, secondary and primary immunodeficiency, severe anemia); children with severe congenital malformations of the lungs or heart. In such cases, oral antibiotics are used: amoxicillin, azithromycin, augmentin, clarithromycin, a suspension of midecamycin, cefuroxime, ceftriaansone. Course 5-7 days.
From the first days of the disease, bronchitis should be prescribed funds that dilute sputum, and expectorant anti-inflammatory drugs. Apply potions with the root of the althea with the addition of sodium benzoate, thermopsis, breast collection number 1, infusions of the root of elecampane, mother-and-stepmother. Mucolytic agents: mucaltin, mucomist, fluimucil, mucosalvan, bromhexine. Apply inhalation 2% solution of sodium bicarbonate. In order to stimulate the regeneration of the respiratory epithelium of the bronchi, the appointment of vitamin A, metacil in age doses is indicated. To improve the protective properties of the body, "the treatment uses vitamins C, B1, B2, B6; the root of ginseng, especially in the period of convalescence.
Shows a vibrating massage with postural drainage. Patients prescribed exercise therapy, massage. The sanation of chronic foci of infection is being carried out.
Expectorants increase the secretion of the liquid component of sputum and improve the transport of sputum due to the enhancement of bronchial motility. When prescribing expectorants, it is necessary to ensure sufficient hydration, as the loss of water increases the viscosity of phlegm. Apply potions based on the infusion of the root of the althea with the addition of sodium benzoate, potassium iodide and ammonia anise drops. Bronchicum, "Doctor Mom" also refer to expectorants.
Mucolytic agents help to dissolve sputum by chemical action on the mucin molecule. When the disease of the lower respiratory tract with the formation of thick viscous sputum, it is advisable to use drugs containing acetylcysteine (ACTS, mukonist, fluimucil, mucobene). The mechanism of action of acetylcysteine is associated with the ability of free sulfhydryl groups to disrupt intra- and intermolecular disulfide bonds of sputum mucopolysaccharides, which leads to a decrease in the viscosity of sputum. Its antioxidant effect is shown to promote the maintenance of functional activity and the morphological integrity of respiratory tract cells.
Mucolytic action has derivatives of alkaloid vazicin - bromhexine, bisolvon, mukosalvan. These drugs reduce the viscosity of secretion, restore mucociliary clearance, stimulate the synthesis of endogenous surfactant.
Carbocysteines (mucodin, mucoproton, bronchitis) have both mucoregulatory and mucolytic effects. Under the action of drugs of this group, regeneration of mucous membranes of the bronchi occurs, restoration of its structure, reduction of the number of goblet cells, restoration of secretion of IgA, improvement of mucociliary clearance.
Inhalations of proteolytic enzymes (chymotrypsin, chymopsin, etc.) are excluded from the pulmonary arsenal, as they can contribute to the development of fibrotic changes in the lungs.
Postural drainage (drainage by position) and vibration massage are powerful methods of sputum evacuation. Effective stitching the torso from the bed on the abdomen with the palm resting on the floor immediately after awakening for 15-20 minutes (with interruptions) with a repetition of manipulation 2-3 times a day.
Antihistamines of the first generation and agents that depress cough, with acute simple bronchitis are not shown.
In the presence of signs of bacterial inflammation, antibacterial therapy (oral cephalosporins, amoxicillin, macrolides) should be prescribed in the age-related dosage. The course of treatment is usually 5-7 days.