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Treatment of catarrhal respiratory syndrome
Last reviewed: 19.10.2021
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A decisive role in the confirmation of the diagnosis of diseases with catarrhal respiratory syndrome is played by methods of laboratory diagnosis, among which there are:
- aimed at identification of the pathogen;
- aimed at identifying specific antibodies in the blood serum of patients.
The method of immunofluorescence is most preferable, since it allows accurate morphological analysis with high specificity. It is simple in reproduction and gives the opportunity to get the result within a few hours.
ELISA is widely used to detect specific antibodies in the blood serum of patients with viral or bacterial diseases.
Diagnosis of acute respiratory infections is established in the absence of a clear predominance of a definite nosological form. It implies both the bacterial and viral nature of the disease. The term "ARVI" assumes a viral etiology of the disease with the presence of a catarrhal-respiratory syndrome.
The strategy for the treatment of the catarrh-respiratory syndrome is determined in accordance with the mechanisms of pathogenesis, etiology and the generality of the clinical manifestations of the disease.
For etiotropic treatment of acute respiratory viral infections, drugs of the adamantane series (rimantadine), preparations of the indole group [arbidol (methylphenylthiomethyl-dimethylaminomethyl-hydroxybromoindole carboxylic acid ethyl ester)] and neuraminidase (oseltamivir) inhibitors for influenza. With other ARVI, arbidol is administered.
Effective use of interferons and their inductors, which have antiviral properties, regulate the processes of lipid peroxidation on cell membranes, which contribute to the restoration of disturbed homeostasis. They have an immunomodulatory effect, which enhance the activity of natural killers and accelerate the production of specific antibodies.
Interferon leukocyte human is applied intranasally, in the form of aerosols and applications on the mucous membrane, instillation into the conjunctival sac; leukinferons - in aerosols; recombinant interferons (interferon alfa-2) - in the form of drops in the nose or rectal suppositories.
Interferon inductors (tilorone, sodium ribonucleate, kagocel, meglumine acridon acetate, sodium oxodihydroacridine acetate) stimulate the formation of intrinsic endogenous interferon a.
An important role in the development and severity of the course of the infectious process is played by the imbalance between the activity of proteolysis necessary for the destruction of pathogens and the formation of free radicals for the preservation of 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 performed only in acute respiratory infections of bacterial etiology (infectious diseases caused by streptococci, mycoplasma, chlamydia, meningococci, hemophilic rods).
In the mild course of the disease with catarrhal-respiratory syndrome, preference is given to symptomatic and pathogenetic treatment. Symptomatic treatment of rhinitis includes washing the nose with isotonic sodium chloride solution, using vasodilating drops and sprays. With an average course of the disease, it is possible to prescribe local bacteriostatic antibiotics, fusafungin.
With pharyngitis, there is a gentle diet, gargling with alkaline solutions, solutions of antiseptics, decoctions of herbs (sage, chamomile, calendula). Apply anesthetics or topical anesthetics [strepsils plus (amilmetakrezol ~ dichlorobenzyl alcohol + lidocaine)].
With tonsillitis systemic antibacterial treatment is carried out only with bacterial etiology of the disease. Drugs of choice for the treatment of acute streptococcal tonsillitis: 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 by softening and local antibacterial drugs. For obsessive cough, antitussive drugs (butamyrate, codeine) are prescribed. Applied inhalation of warm steam or metered aerosols (salbutamol fenoterol).
When epilotitis is indicated, parenteral administration of antibiotics active against the hemophilic rod (amoxicillin + clavulanic acid, cefuroxime, cefotaxime, ceftriaxone), possibly their combination with aminoglycosides.
In the case of acute bronchitis with mycoplasmal and chlamydial infection, a systemic antibacterial treatment (macrolides, tetracyclines) is prescribed. Also used antitussive drugs of central and peripheral action, mucolytic drugs (bromhexine, ambroksol). Simultaneous administration of antitussive and mucolytic drugs is unacceptable because of the danger of "swamping" of the respiratory tract with oppression of the cough reflex.