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Treatment of recurrent bronchitis
Last reviewed: 19.10.2021
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In an acute period of relapse appoint a bed rest for 5-7 days. The child must provide access to fresh air (frequent ventilation). A full-fledged diet, taking into account the age of the patient with the maximum content of vitamins, hypoallergenic. For liquefying sputum, a sufficient introduction of liquid is recommended - cranberry and cowberry fruit drinks, fruit and vegetable juices, tea with lemon, mineral waters.
Antibiotics are prescribed for a virus-bacterial infection and exacerbation of a chronic foci of infection for 5-7 days. Oral antibiotics are used: amoxicillin, augmentin, azithromycin, clarithromycin, cefuroxime.
With relapsing 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 hydrogen carbonate solution, as well as mucolytics and mucolytics (bromhexine, ambroxol, bronchosan) in combination with postural drainage are used. The frequency of the procedure 2-3 times a day, the first is better to spend the morning immediately after awakening the patient.
It is useful to vibrate the massage by applying rhythmic strokes with the tips of the fingers on the chest of the child along the intercostal spaces. The duration of inhalation therapy with relapsing bronchitis to 3-4 weeks, including carrying it in the inhalator of a children's polyclinic and at home using household inhalers.
For the treatment of recurrent bronchitis, antioxidants are prescribed: vitamins A, E, C, B 15.
On the 4th-5th day of relapse, physiotherapeutic procedures are performed: UHF with low-heat doses from 5 to 8 minutes to 5 procedures; UFR of thorax fractionally; Microwave for 8-10 minutes for 6-8-12 procedures; in the period of improvement: electrophoresis of calcium, magnesium, dimexide, platifillin on the chest area, the duration of the procedure is 5-10 minutes. Course 10-15 sessions.
With persistent viral-bacterial infection, a complex preparation of viferone can be assigned, which includes recombinant alpha interferon, vitamins E and C, which causes synthesis of a-interferon, an increase in the number of T-lymphocytes, and normalization of humoral immunity. Young children are prescribed 150 000 IU of interferon per suppository every 2 times every 12 hours for 10 consecutive days, then 3 times a week for 2 suppositories. The course of treatment up to 2-2,5 months.
A new approach in anti-infective therapy was the creation of ribosomal drugs containing the spectrum of the antigenic structure inherent in the entire microbial cell. To such preparation concerns "Ribomunil", let out in 4 forms: tablets, powders, an aerosol and solutions for infections. The composition includes ribosomes of the main causative agents of respiratory infections: Klebsiella pneumoniae, Streptococcus pyogenes, Hemophilus influenzae, Diplococcus pneumoniae and proteoglycans of the cell membrane of Klebsiella pneumoniae. The appointment of ribomunil leads to the active development of specific antibodies against these pathogens, secretory IgA and the creation of post-vaccination immunity. The enhancement of the immune effect of the ribosomes included in the ribomunil is achieved due to the presence in the preparation of non-antigenic membrane proteoglycans Klebsiella pneumoniae, stimulating phagocytosis, the synthesis of a-interferon, IL-1 and IL-6, and killer cells. For children, ribomunil is prescribed according to the scheme: 3 tablets once a day (in the morning on an empty stomach 4 times a week) for 3 weeks of the first month, then in the same dose on the first 4 days of the 2nd and 3rd months. In the case of acute respiratory viral infection, the use of the drug does not stop. Immunocorrectors of bacterial origin are devoid of toxic properties, their high efficiency is due to vaccine-like action, in addition they have a direct effect on local immunity. In the period of remission of recurrent bronchitis, the centers of chronic infection are sanitized, a multicomponent phytospora No. 26 is prescribed for two weeks to restore the function of the ciliated epithelium.
Composition of collection No. 26:
- elecampane (root and rhizome - 2 parts);
- plantain, leaves - 1 part;
- sage, leaves - 1 part;
- linden heart-shaped, flowers - 1 part;
- oregano, grass - 1 part.
The intake of the mixture provides an anti-inflammatory, expectorant, enveloping action that enhances the function of the ciliary epithelium of the bronchi, spasmolytic, stimulating reparative processes, as well as choleretic and diuretic action. They use plant adaptogens from the group Araliev: ginseng, eleutherococcus, Chinese magnolia vine, golden root. Continue exercise therapy: fortifying complexes and aimed at strengthening the respiratory muscles; chest massage: stroking, kneading, rubbing, vibration. Segmental massage in the region of cervical and thoracic segments reflexively influences pulmonary hemodynamics.
It is desirable to conduct a complex of therapeutic effects in a hospital for a short stay patient.
Dispensary supervision is carried out 2 times a year. Conduct general restorative therapy in late autumn and early spring, sanation of chronic foci of infection. All year round appoint LFK, massage, according to an individual plan, the child is tempered.