Treatment of Haemophilus influenzae infection

Indications for hospitalization

Clinical: presence of meningeal syndrome, respiratory failure, laryngeal stenosis, local purulent-inflammatory processes (phlegmon, cellulitis, arthritis, osteomyelitis).

The hospital regime is bed rest.

Diet

Table No. 13. For epiglottitis - table No. 1A, parenteral or tube feeding.

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Drug treatment of hemophilic infection

Etiotropic treatment of hemophilic infection (generalized forms)

Preparation

Daily dose, mg/kg

Frequency of administration, times

Route of administration

First-line drugs

Chloramphenicol	25-50, with meningitis - 80-100	3-4	Intravenous, intramuscular
Amoxicillin-clavulanic acid	30	3-4	Orally, intravenously
Cefotaxime	50-100, with meningitis - 200	4	Intravenous, intramuscular
Ceftriaxone	20-80, with meningitis - 100	1-2	Intravenous, intramuscular

Second-line drugs

Meropenem	30, with meningitis - 120	3	Intravenously
Ciprofloxacin	20, with meningitis - 30	2	Orally, intravenously

Treatment of hemophilic infection should last at least 7-10 days.

For the treatment of localized forms the following are also used:

• azithromycin at a dose of 10 mg/kg orally once;
• roxithromycin - 5-8 mg/kg twice a day orally;
• co-trimoxazole - 120 mg twice a day orally for 3 days.

Pathogenetic treatment of hemophilic infection is prescribed based on clinical indications and is carried out according to general rules. In case of meningitis, dehydration therapy is indicated (furosemide, acetazolamide in average therapeutic doses; dexamethasone at a dose of 0.5 g/kg per day intravenously or intramuscularly).

In case of cerebral edema and swelling, artificial ventilation, oxygen therapy, and anticonvulsants are used.

In acute epiglottitis, tracheal intubation, loop diuretics, glucocorticoids, and antihistamines are indicated.

In case of local suppurative processes (phlegmon, osteomyelitis), surgical treatment methods are used.

What is the prognosis for Haemophilus influenzae infection?

In meningitis, septicemia, epiglottitis - hemophilic infection has a serious prognosis, in other forms of Hib infection - favorable. After meningitis, persistent hearing loss is possible. hydrocephalic-hypertensive syndrome.

The period of incapacity for work due to meningitis is 1-2 months after discharge from the hospital.

In case of Hib meningitis it is indicated. Carried out by a neurologist, duration not less than 1 year.

Prevention of Haemophilus influenzae infection

Specific prevention of hemophilic infection is carried out according to individual indications (frequent acute respiratory viral infections, pathology of pregnancy and childbirth in the mother, CNS lesions in the child). Vaccination against hemophilic infection is used:

• Act-HIB (France) at a dose of 0.5 ml intramuscularly or subcutaneously (from 2-3 to 6 months - three times with an interval of 1-2 months with a single revaccination after 1 year; from 6 to 12 months - twice with an interval of 1 month and revaccination after 18 months; from 1 year to 5 years - once);
• Hiberix (Belgium) at a dose of 0.5 ml subcutaneously or intramuscularly (from 3 weeks to 6 months - three times with an interval of 1-2 months and revaccination after 1 year; from 6 months to 1 year - twice with an interval of 1 month and a single revaccination after 18 months; from 1 year to 5 years - once).