Treatment of recurrent bronchitis

In the acute period of relapse, bed rest is prescribed for 5-7 days. The child must be provided with access to fresh air (frequent ventilation). The diet is complete, taking into account the patient's age, with the maximum content of vitamins, hypoallergenic. To thin the sputum, it is recommended to take sufficient fluids - cranberry and lingonberry fruit drinks, fruit and vegetable juices, tea with lemon, mineral waters.

Antibiotics are prescribed for viral-bacterial infections and exacerbation of a chronic infection for 5-7 days. Oral antibiotics are used: amoxicillin, augmentin, azithromycin, clarithromycin, cefuroxime.

In case of recurrent 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 bicarbonate solution, as well as phlegm thinning agents and mucolytics (bromhexine, ambroxol, bronchosan) are used in combination with postural drainage. The frequency of the procedure is 2-3 times a day, the first is best done in the morning immediately after the patient wakes up.

Vibration massage by applying rhythmic blows with fingertips to the child's chest along the intercostal spaces is useful. The duration of inhalation therapy for recurrent bronchitis is up to 3-4 weeks, including its implementation in the inhalation room of a children's clinic and at home using household inhalers.

For the treatment of recurrent bronchitis, antioxidants are prescribed: vitamins A, E, C, B ₁₅.

From the 4th-5th day of relapse, physiotherapeutic procedures are carried out: UHF with weak thermal doses from 5 to 8 minutes up to 5 procedures; fractional UFO of the chest; microwave for 8-10 minutes for 6-8-12 procedures; during the improvement period: electrophoresis of calcium, magnesium, dimexide, platifillin on the chest area, duration of the procedure is 5-10 minutes. The course is 10-15 sessions.

In case of persistent viral-bacterial infection, a complex drug Viferon can be prescribed, which includes recombinant a-interferon, vitamins E and C, which causes the synthesis of a-interferon, an increase in the number of T-lymphocytes and the normalization of humoral immunity. Young children are prescribed 150,000 IU of interferon in 1 suppository daily 2 times every 12 hours for 10 days in a row, then 3 times a week, 2 suppositories. The course of treatment is up to 2-2.5 months.

A new approach to anti-infective therapy was the creation of ribosomal preparations containing a spectrum of antigen structure inherent in the entire microbial cell. Such a preparation is "Ribomunil", produced in 4 forms: tablets, powders, aerosol and solutions for infections. The composition includes ribosomes of the main pathogens 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 production of specific antibodies against these pathogens, secretory IgA and the creation of post-vaccination immunity. The immune effect of ribosomes included in ribomunil is enhanced due to the presence of non-antigenic membrane proteoglycans of Klebsiella pneumoniae in the drug, stimulating phagocytosis, synthesis of a-interferon, IL-1 and IL-6, killer cells. Ribomunil is prescribed to children according to the following 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 during the first 4 days of the 2nd and 3rd months. In case of acute respiratory viral infections, the use of the drug is not stopped. Immunocorrectors of bacterial origin are devoid of toxic properties, their high efficiency is due to the vaccine-like effect, in addition, they have a direct effect on local immunity. During the period of remission of recurrent bronchitis, the foci of chronic infection are sanitized; to restore the function of the ciliated epithelium, a multicomponent herbal mixture No. 26 is prescribed for two weeks.

Composition of collection No. 26:

• elecampane (root and rhizome - 2 parts);
• plantain, leaves - 1 part;
• sage, leaves - 1 part;
• small-leaved linden, flowers - 1 part;
• Origanum vulgare, herb - 1 part.

Taking the mixture provides anti-inflammatory, expectorant, enveloping action, enhancing the function of the ciliated epithelium of the bronchi, antispasmodic, stimulating reparative processes, as well as choleretic and diuretic action. Plant adaptogens from the Araliaceae group are used: ginseng, eleutherococcus, Chinese magnolia vine, golden root. Continue with exercise therapy: general strengthening complexes and those aimed at strengthening the respiratory muscles; chest massage: stroking, kneading, rubbing, vibration. Segmental massage in the area of the cervical and thoracic segments reflexively affects pulmonary hemodynamics.

It is advisable to carry out a set of therapeutic interventions in a short-term hospital setting.

Outpatient observation is carried out twice a year. General strengthening therapy is carried out in late autumn and early spring, and chronic foci of infection are sanitized. Physical therapy and massage are prescribed year-round, and the child is hardened according to an individual plan.