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Treatment of catarrhal-respiratory syndrome
Last reviewed: 06.07.2025
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Laboratory diagnostic methods play a decisive role in confirming the diagnosis of diseases with catarrhal-respiratory syndrome, among which are:
- aimed at identifying the pathogen;
- aimed at identifying specific antibodies in the blood serum of patients.
The immunofluorescence method is the most preferable, as it allows for precise morphological analysis with high specificity. It is easy to reproduce and provides results within a few hours.
ELISA is widely used to detect specific antibodies in the blood serum of patients with viral or bacterial diseases.
The diagnosis of ARI is established in the absence of a clear predominance of a certain nosological form. It implies both bacterial and viral nature of the disease. The term "ARVI" implies a viral etiology of the disease with the presence of catarrhal-respiratory syndrome.
The treatment strategy for catarrhal-respiratory syndrome is determined in accordance with the mechanisms of pathogenesis, etiology and common clinical manifestations of the disease.
For etiotropic treatment of ARVI, drugs of the adamantane series (rimantadine), drugs of the indole group [arbidol (methylphenylthiomethyl-dimethylaminomethyl-hydroxybromindole carboxylic acid ethyl ester)] and neuroaminidase inhibitors (oseltamivir) are used for influenza. Arbidol is prescribed for other ARVIs.
The use of interferons and their inducers is effective; they have antiviral properties, regulate the processes of lipid peroxidation on cell membranes, promote the restoration of disturbed homeostasis, have an immunomodulatory effect, enhance the activity of natural killers and accelerate the production of specific antibodies.
Human leukocyte interferon is used intranasally, in the form of aerosols and applications to the mucous membrane, instillations into the conjunctival sac; leukinferons - in aerosols; recombinant interferons (interferon alpha-2) - in the form of nasal drops or rectal suppositories.
Interferon inducers (tilorone, sodium ribonucleate, kagocel, meglumine acridonacetate, sodium oxodihydroacridinyl acetate) stimulate the formation of endogenous interferon a.
An important role in the development and severity of the infectious process is played by the imbalance between the activity of proteolysis, necessary for the destruction of pathogens, with the formation of free radicals to maintain aminoprotease and antioxidant protection. Therefore, it is advisable to prescribe drugs that can inactivate proteolytic processes (aprotinin, aminobenzoic acid, aminocaproic acid, ribonuclease, deoxyribonuclease).
Systemic antibacterial treatment is carried out only for acute respiratory infections of bacterial etiology (infectious diseases caused by streptococci, mycoplasmas, chlamydia, meningococci, hemophilic bacilli).
In mild cases of the disease with catarrhal-respiratory syndrome, preference is given to symptomatic and pathogenetic treatment. Symptomatic treatment of rhinitis includes rinsing the nose with isotonic sodium chloride solution, using vasodilator drops and sprays. In moderate cases, local bacteriostatic antibiotics, fusafungine may be prescribed.
In case of pharyngitis, a gentle diet, gargling with alkaline solutions, antiseptic solutions, and decoctions of medicinal herbs (sage, chamomile, calendula) are recommended. Painkillers or local anesthetics are used [strepsils plus (amylmetacresol ~ dichlorobenzyl alcohol + lidocaine)].
In tonsillitis, systemic antibacterial treatment is carried out only if the etiology of the disease is bacterial. The drugs of choice for the treatment of acute streptococcal tonsillitis are: phenoxymethylpenicillin, amoxicillin, macrolides. In the development of co-resistance of the oral flora, augmentin (amoxicillin + clavulanic acid) is used. For symptomatic treatment, local antiseptic drugs are used.
Treatment of laryngitis without stenosis is carried out with emollients and local antibacterial drugs. In case of obsessive cough, antitussives (butamirate, codeine) are prescribed. Inhalations of warm steam or dosed aerosols (salbutamol, fenoterol) are used.
In case of epiglottitis, parenteral administration of antibiotics active against Haemophilus influenzae (amoxicillin + clavulanic acid, cefuroxime, cefotaxime, ceftriaxone) is indicated; their combination with aminoglycosides is possible.
In case of acute bronchitis with mycoplasma and chlamydial infection, systemic antibacterial treatment is prescribed (macrolides, tetracyclines). Antitussives of central and peripheral action, mucolytic drugs (bromhexine, ambroxol) are also used. The simultaneous administration of antitussives and mucolytic drugs is unacceptable due to the risk of "swamping" the respiratory tract when the cough reflex is suppressed.