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Starting a conversation about SARS, we stand on shaky ground. Treatment of respiratory infections – the science is not correct. SARS – the disease, prone to self-healing. You can treat it so, and it is possible differently – and in any case the matter will almost certainly end in recovery. It is not surprising that there are different approaches to this issue. It is surprising, sometimes, the other – as are intolerant to each other adherents of different approaches, with some (I want to say – religious) conviction they are ready to prove the correctness of his views exceptional.

And I do not want someone to prove something (crossed out: come up with evidence-based products). And you do not want to offer another “the only correct treatment instructions SARS.” I do not know of such a statement, and I am afraid that it does not exist. Questions too simple formulation ( “and whether or not to treat a cold?” “Do I need antibiotics for SARS?” “Churn or not the temperature below 39 degrees?”, Etc.) – do not have the right answer in terms of domestic medical schools It focused on the individual patient. By the way, yes, the national school of medicine still alive – as long as alive at least one doctor who is familiar with its traditions.

I will try to present their own views on the treatment of respiratory infections in children. Based mainly on the publications of Soviet authors in different years, and his modest medical experience. Let’s get started.

The basis of the treatment of respiratory infections – symptomatic therapy. That is – the treatment of individual symptoms of the disease, which can be divided into common manifestations of infection (intoxication, fever), and local features of various respiratory tract inflammation. A more modest role in the treatment of the so-called occupied etiotropic agents (ie drugs that act on the cause of disease – viruses and bacteria).

PART ONE. TREAT SYMPTOMS.

General measures

sick baby diet should be sufficiently complete and easily digestible. As a source of carbohydrate well suited lekgousvoyaemyh fruits and vegetables, as a protein source and fat – milk products. Do not offer the child a “heavy” foods like soups, fast food or cakes. Feed the baby should be strictly in accordance with its appetite.

It is very important desoldering child with acute infection. Drinking plenty of fluids – the best way to deal with intoxication (show weakness, lethargy and sleepiness). It is important to remember that the body’s need for drinking increases significantly with increasing body temperature. On the secrets watering baby I wrote in more detail in an article devoted to intestinal infections . Child breastfed better more often applied to the chest, but in the case of a fever, and he will need dopaivanie water.

Ill child the best fit relaxed lifestyle without strenuous exercise and ambient temperature changes of the environment. I advise you not to bathe the child in those days, when he is in a fever; quite simply wash it or wipe. I do not think that will be useful temperaturyaschih child walks outside in bad weather (and the weather is good the children are ill often).

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Fever

What temperature should be reduced? Usually you have to give fever with a body temperature above 38,5-39,0 degrees. This rule has several exceptions. When febrile child fever, pale skin and cold palms (called fever “pale type”) – this indicates that the temperature will rise rapidly in the next few minutes. Give in this case the child antipyretic already at 38,0-38,5 C. In newborn infants, better to shoot down the temperature, starting from 38,0-38,5 C. If the child once in his life had seizures, or have a serious illness nervous system – you need to shoot down any temperature above 37,5-38,0 C (otherwise there is the risk of recurrence of seizures).

What we expect from the effect of the drug? It is necessary that the temperature did not rise above the “taboo” of numbers for at least 6 hours (in this case it is not necessary that it has come back to normal). 6-8 hours – this is the minimum time after which it is possible to give the next dose of fever-reducing, without fear of overdose.

How to reduce? Safer drugs based on paracetamol (Panadol, Efferalgan, Tsefekon and many other trade names). Therefore, you should start with them. But they are also the least effective (especially – in older children). With the ineffectiveness of paracetamol (and we remember that inefficiency – is antipyretic effect, lasting less than 6 hours) it is necessary to use ibuprofen (brand name drugs: Nurofen, Ibufen et al.). But the ineffectiveness of ibuprofen I advise nimesulide (NIMULID, Nise); among the “children” of fever-reducing medications are the most powerful drug with the longest action. Information about the terrible side effects of this medication seem to me a little bit exaggerated, and yet I do not recommend to start a fight with a fever is with this medication without testing other. But I am quite sure that one single dose of nimesulide is more secure than kilograms of paracetamol and Nurofen (who have to give the child in the event of lack of effectiveness of these medicines).

The so-called physical methods of cooling – undressing, sponging with cool water or vodka (no vinegar!) – Can reduce the body temperature without the use of fever-reducing medicine. But only for a short time, and moreover, these methods are not effective during chill and “pale” fever with cold palms.

There are a few little tricks reduce fever in children. The child definitely need a well-ful – then the temperature will be much easier to get off. If a baby has a fever, pale skin or cold palms – good rub his hands and feet and let with antipyretic Nospanum (¼ to whole tablets, depending on age). If after taking antipyretic temperature does not drop immediately, or even continues to grow, do not rush to give the next dose of medication – Undress the baby, wipe it with cool water or vodka (can be several times) and wait until the analgesic begins to act. This remark refers to ibuprofen and especially to nimesulide (the beginning of his actions sometimes have to wait up to six hours).

Now we can go to the local treatment of the symptoms of SARS arising from inflammation of various parts of the respiratory tract. It is understood that the treatment will depend on whether it is inflamed separated. Let us examine these departments in turn, in the direction of “top down”

Rhinitis (runny nose) – an inflammation of the nasal mucosa.

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It is manifested by edema ( “congestion”) and secretions from the nasal passages. In the treatment of the common cold will not be unnecessary nasal lavage with saline (akvamaris, Akvalor – or, at worst, normal saline). And who of us with a strong and nasty nasal congestion does not drip vasoconstrictive drops itself? I do not need to feel sorry for these drops for the baby (special children’s forms have Nazivin preparations Otrivin, Nazol et al.). Use they can be, if not regularly, at least occasionally, while strengthening congestion (an infant nasal congestion is a sign of forced interruptions in sucking – kid when every minute breaks away from the breast or bottle to breathe). It must be remembered that any vasoconstrictive drops should not be used longer than 5-7 (by force – 10) days. When protracted course of the common cold with purulent (green, yellow, “cloudy”) snot – it is appropriate to use the drops with antibacterial effect (for example, Izofra or Sialor).

Rhinosinusitis – inflammation of the paranasal sinuses in acute respiratory infection. In humans, there are several of these sinuses with their names. Inflammation of the sinuses called sinusitis, frontal – frontal sinusitis, ethmoid cells – etmoidita etc. (all – “variety” of sinusitis).

Subordinate (or paranasal) sinuses – these are natural resonators. The thick walls of St. Sophia Cathedral in Kiev walled earthen pitchers, open their mouths in the premises of the cathedral; These pitchers create unique acoustics. And in our skull “imbedded” air sinuses, narrow anastomoses that open into the nasal cavity; These sinuses create volume and beauty of the sound of our voice. When inflammation of the sinuses instead of air gap is filled with significantly thickened mucous membrane or fluid (mucus). This can manifest strong ‘nasal’ voice, nasal congestion or stand one half of it, a shallow cough, feeling of heaviness and discomfort in the brow or paranasal area (sometimes enhanced by rapid head tilt). The diagnosis “sinusitis” best supply ENT doctor. To help him in this is an X-ray (which, however, needs to be done is not always).

In this state, it is very important to achieve a free message sinus with the nasal cavity – to remove swelling of the mouth of the sinuses. This will require drugs with anti-edematous effect – antihistamines (Fenistil, Zyrtec and other or Erespal), as well as regular use of vasoconstrictive drops 3 times a day (regardless of whether the nose breathing is currently good). When persistent edema can be used with caution hormonal topical (Nasonex). As a rule, it is necessary preparations thinning mucus and makes it fluid (eg, ACC or Sinupret).

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Adenoids – inflammation of adenoids.

We are sure that your child does not have adenoids? They have anyone. Adenoids – a cluster of protective lymphoid tissue (tonsil), located in the nasopharynx, near posterior regions of the nasal passages. The adenoids are at all, it’s okay. “Abnormal” situation – is to increase the adenoids in size. But respiratory infections can inflame as enlarged and completely “normal” adenoids.

Signs adenoiditis – “stuffy” nose without discharge from the nasal passages, snoring at night (suddenly appeared during SARS), a small swelling of the nose, choking cough and shallow in the supine position (often – when laying the baby in bed). This cough can last for a long time and “take away” from the mother and the doctor correct diagnosis, to find diseases of the bronchi and lungs. Often in adenoids increase posterolateral cervical lymph nodes. On examination, the doctor can see the throat mucus or pus flowing down the back of the throat.

Treatment adenoiditis is “deep” washing of the nose, better after instillation of vasoconstrictor drops. Do not use sprays with a strong jet of pressure (eg, spray or Akvalor Physiomer) – it is likely that their use in adenoids provoke the development of otitis media. It is better to fill the nose more solution (preferably in the form of droplets), but without a large pressure. Most likely, in the treatment of adenoiditis required drops and sprays with antibacterial action (Izofra, Sialor, Miramistin et al.) Long course. hormonal agents may be required in severe and prolonged nasal congestion (Nasonex, Polydex with phenylephrine).

Tonzillofaringit – inflammation of the throat and tonsils (with no signs of suppuration).

“Red throat” accompanies almost any viral infection. It may not require treatment – if you do not cause any discomfort. And with sore or pain when discomfort during swallowing may require different aerosols, older children – “sosalki” and gargling.

Laryngitis – inflammation of the larynx.

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Larynx – the vocal cords location (specific “strings” that form due to its vibration of our voice sounds). The main sign of inflammation of the larynx – hoarseness or hoarseness (until the complete lack of it). And yet – a special, “barking” cough. Paroxysmal, with a special “impurity” high tone of voice; really like a little raucous yelping dogs. Attacks of “barking” cough are more common at night. In young children (under the age of 3-5 years) acute laryngotracheitis dangerous development of stenosis of the larynx, which is the old fashioned way is often called croup. Stenosis of the larynx except the indomitable barking cough, manifested labored and noisy breath. The more pronounced difficulty inhaling, the more dangerous this condition. Croup – a serious complication of respiratory infections, which may require a call for an ambulance and hospitalization of the child.

Treatment of laryngitis – Frequent inhalation to alleviate cough and moisturizing irritated throat. In addition to inhalation Lazolvanom and other tools to improve expectoration of sputum, a good effect will have frequent inhalation of saline or mineral water. A little secret: the “worse” and cheaper model of the inhaler, the better it is suitable for the treatment of laryngitis (more and more “advanced” inhalers are designed to deliver drugs into the lower respiratory tract, and therefore the better the inhaler, the smaller the aerosol get larynx). Useful constant humidification of the room.

Young children with croup or threat of its initial manifestations of help tools that reduce mucosal edema. It antihistamines (Fenistil, Suprastin other or Erespal) or more powerful tool – Pulmicort inhalation. Assist and distracting treatments such as a warm bath for the feet (with a water temperature of 40 ° C).

Tracheitis – inflammation of the trachea.

Externally trachea remotely similar to the corrugated hose that carries air from the larynx to the bronchi. This is the widest of the “tube” along which the air inhaled by us. When inflammation of the trachea cough occurs very special sound – rough and bass, “both in the iron pipe.” And trachea – a respiratory tract of land, the richest sensitive nerve endings. Therefore, when the cough frequent tracheitis, hacking, often – painful. And the cough may persist for a long time (up to months) after recovery from infection. Not because of the fact that delayed the inflammatory process, but only because of the “overstimulation” of nerve receptors.

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Cough with tracheitis often frightens a child my mother – and his basovitym tone (it seems mom “deep”), and pain, and the duration of its presence. However traheitny cough, though unpleasant, but not dangerous. To mitigate its need frequent moisturizing inhaled (as with laryngitis), in severe pain can drink Libeksin. It is a drug that reduces the sensitivity of nerve receptors (Remind your child to swallow a pill once – if it to dissolve, there short-term “numbness” language). If a dry cough after recovery from SARS tracheitis with a long shelf life – you can drink drugs that suppress the cough reflex (eg Sinekod, Terpinkod).

Bronchitis – an inflammation of the bronchi.

In this disease there is a really deep cough coming from the “inside” of the chest. In the early days – dry, harassing the child at any time. Then cough often turns into a wet, stronger in the morning (after waking up from a night’s sleep). When listening to the baby’s lungs doctor hears a dry or moist rales on both sides. The diagnosis of “bronchitis” could put a doctor – and only on the clinical picture.

When bronchitis need medicines that affect the phlegm; they can be used in and / or by inhalation. Their choice depends on the character of cough. In the early days, you can use any drugs on the basis of expectorant herbs – they increase the production of “liquid” sputum and increase its expectoration. But wet cough with a sufficiently large amount of sputum, with frequent coughing, especially in young children, these drugs are not needed; preferably the use of drugs on the basis of ambroxol (Lasolvan, Ambrobene et al.). When moist cough with small amounts of viscous sputum trudnoothodimoy in children older than two to three years will approach based drugs karbotsisteina (Fluditek, Fluifort) or acetylcysteine (NAC or Fluimucil).

There are two secrets that are not less important than the appointment of expectorants. The first – all the same excessive drinking. To make mucus thinner and improve the discharge of primarily needs water; and if the child does not ful – no expectorant drugs can not cope with this task. Second – drainage measures to facilitate the removal of mucus from the bronchi. Usually this vibrating massage (massage the chest with a “tap”) in the situation of the child with his head ( “head and shoulders below priests”). Saying “A” you need to say “B”; if we phlegm using expectorants, we must help the child to cough up the good liquefaction of sputum. Be sure to hold the drainage massage after each inhalation expectorant drug, but otherwise there is no need to do inhalation.

Obstructive bronchitis – an inflammation of the bronchi, accompanied by a narrowing of the lumen.

We remember that the narrowing of the larynx difficult child to breathe. By contrast, narrowing of the lumen of the bronchi difficult exhalation. Shortness of breath with difficulty exhaling – this is a manifestation of a sufficiently strong bronchoconstriction in obstructive bronchitis (and not only with him); This condition may require a call to “03” and first aid. More frequent symptom of obstructive bronchitis – cough, which may be deep, dry or unproductive ( “wet-dry”), amplified at night. This paroxysmal cough: Short and frequent cough shocks follow each other in a series of different duration. At the end of such a series is often heard a kind of easy “sibilation”, in more severe cases can be heard whistling breath. When listening to the lung doctor hears an elongated breath and wheezing. The diagnosis of “obstructive bronchitis” always puts the doctor.

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Treatment of obstructive bronchitis – is expectorant drugs in combination with inhaled bronchodilators. In young children, preferred inhalation through a nebulizer drug Flomax (just make sure whether it will cause increased heart rate). Suitable for older children Salbutamol and its analogs, applied via a nebulizer or metered ingalyatorov- as “cartridges.” With the lack of effectiveness of bronchodilator drugs, especially in young children, you need to add inhaled decongestant and anti-inflammatory agent – Pulmicort. In more severe cases may require hospitalization.

Of course, the above “separation” signs of SARS on the inflammatory changes of individual sections of the respiratory tract – are too schematic and conditional. In real life, these symptoms are combined in a variety of options and proportions (laryngotracheitis, bronchitis, etc.), and their treatment is an interesting and creative occupation.

PART TWO. TREAT THE CAUSE.

Antibiotics

Do I need antibiotics for bronchitis? And with sinusitis? In the language of rubbed corn from the same answers to these questions: in some cases necessary, while others are not necessary. Not only are bronchitis or sinusitis – with any syndrome, respiratory infections may require antibiotics. A may not be necessary.

When the virus causes inflammation of the airways, any of their department – it is always accompanied by activation of the bacteria. The so-called opportunistic bacteria normally live peacefully in our body, and the weakening of its protective abilities begin to behave aggressively and cause disease. Acute respiratory infections, viruses are almost always operate in tandem with the “awakened” by bacteria. But usually the role of bacteria in the tandem modest, and for the suppression of their activity does not require use of systemic antibiotics. Less commonly, the bacteria begin to play “first violin”, and then antibiotics may be needed. And will need to treat sinusitis and bronchitis, and even laryngotracheitis. Therefore wrong to think that exhibited the diagnosis of viral infection (eg, adenovirus, or influenza) automatically excludes the use of antibiotics. This diagnosis does not require antibiotics, but never excludes their use in case of need.

And when the need arises? That’s a very good question. Let’s throw out of my head the question “whether or not antibiotics for bronchitis?”, But rather talk about in what cases may need antibiotics for bronchitis (sinusitis, adenoids, tonsillitis, laryngotracheitis).

Thus, bacterial complication SARS likely in the case where:

– The child expressed symptoms of intoxication: weakness, lethargy, loss of appetite, headache; and these effects persist at normal body temperature (after antipyretics). An exception is the flu – with this infection even severe symptoms of intoxication may not testify in favor of the bacterial process.

– For three or four days is not a trend towards reduction in the height of fever, or the tendency to rise of her; This situation is often indicative of a bacterial process. It is also true exceptions to this rule are many – adenoviral, enterovirus infection, influenza, infectious mononucleosis and other. Most often, these infektsii “exceptions” have a characteristic clinical picture on which they can be suspicious and not to worry about the long fever. But if you recognize the “exception” is not possible, it is worried.

– “Second wave” of intoxication and fever after a few days of improvement. Most often, she says accession of bacterial complications.

– The development of sinusitis / bronchitis / adenoiditis / laryngitis in the later stages of the disease, when other manifestations of infection have become fade.

– The presence of the visible manifestations of purulent process (pus snot, purulent discharge on the back of the throat, purulent raids on the tonsils, purulent sputum).

– Expressed pain in the inflammation may testify in favor of the bacterial process (though it is not very reliable sign). Severe pain on swallowing (as well as – a painful inflammation of the lymph nodes) is more typical for a bacterial sore throat, pain in the sinuses – for purulent sinusitis.

– In cases of doubt, should be encouraged to assist the laboratory. About bacterial complications of SARS will testify neutrophilic leukocytosis nature (blood count), a significant increase in erythrocyte sedimentation rate and C-reactive protein blood.

Each of these features individually still no evidence of bacterial inflammation. But their different combinations correlated with the overall picture of the disease and the doctor’s experience, can provide enough reliable information on the need for antibiotics. If the hand is not an experienced doctor – it is better to locate it, and do not start feeding the child an antibiotic without medical examination. Think about that in the civilized world, it is absolutely impossible to buy antibiotics without a doctor’s prescription.

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But there are manifestations of respiratory infections, which in most cases are caused by bacteria. And almost always require antibiotics. For example:

Otitis media – inflammation of the middle ear.

The middle ear called the tympanic cavity and its contents. Middle – because it conducts sound vibrations from the ear canal (ie, outer ear) to the organ of perception of sounds (ie the inner ear). Pass these vibrations through the eardrum and ossicles located in the tympanic cavity. This air cavity remotely similar to the hollow interior of the drum, is connected to the nasopharynx via the auditory tube.

When inflammation of the middle ear is usually caused sharp pain of varying intensity and duration. Infants cry of pain manifests no apparent reason, pain with pressure on the tragus of the ear. For infants is characterized by increased pain during chewing and sucking, sometimes leading to the rejection of food (compliant child skull pass into the middle ear pressure that occurs when the movements of the jaw in the temporomandibular joint). If you have older children, pain while eating usually indicates a bacterial sore throat, then kids it is – a sign of otitis media. In addition to the pain of otitis media is characterized by hearing loss, ringing in the ear, and other “foreign” sound experience. otitis media diagnosis can only be made a doctor who knows how to carry out otoscopy ( “watch ears” with the help of special devices).

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Conventional antibiotics are with otitis high therapeutic doses (allowing the drug to penetrate the tympanic cavity in sufficient concentration). In addition to antibiotic ear drops are needed, relieve pain (otinum, Otipaks); and in severe pain – painkillers for oral administration (eg Nurofen). Necessarily regular use of vasoconstrictor nose drops (to relieve swelling of the mouth of the auditory tube and tympanic cavity free communication with the nasopharynx).

Purulent angina – bacterial inflammation of the tonsils.

It manifested purulent overlays in the “folds” (the gaps) of the tonsils – lacunar angina. Or purulent “balls” (follicles), shines through the thin mucous membrane of the tonsils – tonsillitis. In addition to bacterial angina is characterized by bright ( “burning”), red throat, a thick coating on the tongue, unpleasant putrid breath, increased anterior cervical lymph nodes (these signs are unstable and are complementary in the diagnosis). Usually, the pain occurs during swallowing.

In addition to antibiotics, bacterial angina requires frequent gargling, but in young children – throat irrigation with antiseptic solutions (Geksoral, Miramistin et al.). It is advisable to feed the baby crushed, non-irritating to the throat food comfortable temperature.

Pneumonia – an inflammation of the lung tissue.

One of the main external signs that distinguish pneumonia from viral bronchitis is intoxication, which can be manifested by lethargy, weakness of a child, loss of appetite, sweating, pale skin. When extensive lesions of the lung tissue may be shortness of breath. In this shortness of breath (dyspnea unlike narrowing airways) not difficult either breath or exhale. The child is breathing heavily and often simply because it can not “breathe”, as if he lacks a bit of air. But the shortness of pneumonia does not occur very often; a constant feature of this disease is cough. The cough can be very different; more often it is deep and not too strong, dry or wet. The doctor may hear wheezing or breathing attenuation on a separate portion of the lung, but quite often (especially in the early days of pneumonia) not to hear anything unusual. To confirm pneumonia necessarily have to do an X-ray of the chest (the decision on the need for this study takes a pediatrician, and he’s putting the final diagnosis after the radiologist image description).

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In addition to antibiotics (which you need to take a more long-term than in some other bacterial complications of acute respiratory viral infection), pneumonia necessarily need expectorant drugs and drainage activities. Often requires examination and treatment in a hospital.

To put a fat point in talking about antibiotics, it is necessary to mention that there are specific respiratory infections usually require antibiotic treatment simply on the fact of their detection.

Atypical infection

It is an infection caused by the so-called atypical pathogens – Chlamydia, Mycoplasma, and others. No, no, do not worry, it’s not the chlamydia and mycoplasma, which you thought. It’s their family. Now we are talking about those chlamydias and mycoplasmas, which are transmitted by droplets through sneezing and coughing.

Usually these infections manage to not suspected in the early days of the disease. They need to think about when a child (usually a school or adolescence) longer than usual symptoms of respiratory infection are drawn with a slight rise in body temperature, compulsive dry or unproductive cough, sometimes – with signs of obstructive bronchitis. In this case, it makes sense to pass tests (blood for antibodies to chlamydia and mycoplasma infection, blood or throat swab PCR). In the case of laboratory signs of acute infection, the child will have to take antibiotics macrolide (Klatsid, Vilprafen et al.) The course of 10-14 days. Just remember that not every detection of antibodies in the blood speaks of acute infection – assign this analysis and interpret the results (correlating them with the clinical picture of the disease) must be a doctor.

With regard to the antiviral treatment, its effectiveness is highly dependent on how it is caused by a virus infection. For the purpose of antivirals is important to answer the question: “Flu or SARS?”

Flu

We are used to answer this question is simple: if you get sick very seriously – so we have the flu, if the body temperature does not reach 40 ° C, then it is definitely a “simple” SARS. Besides grammatical errors (the word “SARS” feminine!) And terminology errors (flu also included in the group of diseases collectively called “SARS”), this statement contains a significant factual error.

In fact, and influenza can be hard, and easy; with a temperature of 41 C, and 37.5. To distinguish the flu from any other acute respiratory viral infection, it is better to focus on other signs:

– Obscheinfektsionnye the flu symptoms (fever, intoxication, headache, and muscle aches) always come suddenly and immediately come to the fore,

– Catarrhal phenomena (sore throat, dry cough infrequent) fade away into the background, and a day or two or three “late” for fever and intoxication,

– There is a very high probability of encounter with the flu during the epidemic rise of incidence of ailments (which usually lasts no longer than a couple of months), and the probability is quite low – meet it at another time of the year.

If you remember these three simple rules, we can distinguish the flu from other types of acute respiratory viral infection with a high degree of probability. And if in doubt – there are methods for rapid diagnosis, allowing as soon as possible to confirm the presence of influenza virus proteins in a smear from the throat or nose.

Why is all this necessary? The fact that only for the treatment of influenza exist sufficiently efficient antivirals – and Relenza, Tamiflu. Last approved for use in Russia in children from the age of one year, and in some countries and used at an earlier age. The “old” drugs against influenza, such as rimantadine (child form – Orvirem), Tamiflu significantly inferior performance. And one could really write them off – if not dull lack of Tamiflu in pharmacies during the epidemic (to paraphrase a famous saying, it is appropriate to give advice: “Buy Tamiflu summer”). It should be remembered that Tamiflu (as, indeed, and almost all of antiviral drugs) is only effective when given in the first two days of the onset of infection.

By the way, highly efficient ways of preventing the disease also exist only for the flu. This vaccination (which creates protection against influenza during the flu season) or the appointment of the same dose of Tamiflu in prevention (for protection for a shorter period, for example, in the case of contact with the patient).

So, in our arsenal there are medications to treat the flu. And what other respiratory viral infections? And there is no effective means of acting on the virus to their treatment. With rare exceptions: a respiratory infection caused by a family of herpes viruses (eg, infectious mononucleosis) is sometimes possible to treat such antiviral drugs like Acyclovir, Valtrex or Isoprinosine. But it really is the exception that proves the rule: respiratory infections other than influenza, do not need to be treated with antiviral medication of direct action. And what to do with them? Well, theoretically, still antivirals indirect action, is simply called immunomodulators.

Immunomodulators

The use of immunomodulators in acute respiratory viral infections – so battered and controversial topic that I would very much like to get around it tactfully (and thereby avoid many swear words in the address). But words can not erase songs, and anything on the subject would have to say. I will say this: I personally see a moderate clinical efficacy in the treatment of certain immunomodulators SARS. But now that I see the effect of the drug and recognize him immunomodulatory effect, that I have a desire to use the drug if possible at least – to no great need not interfere with the immune system, which we have, in spite of the great achievements of immunology, we know so little .

Gradually, I have developed some rules for the appointment of immunomodulators with SARS (because hard person to live without rules, even as they themselves invented). I did recommend candles Viferon short course in cases where the alleged presence of infection, prone to non-smooth flow (eg, moderate forms of adenovirus or enterovirus infections). Or when I’m dealing with the patient prone to non-smooth flow of SARS. Or in the case of mixed infections or re-infection “tail” of the prior disease. In short, when assuming that a viral infection with a high probability can not proceed smoothly. Careful I treat immunomodulatory drugs more complex (and hence the broader) the mechanism of action, although sometimes they appoint. For example, some of the interferon inducers. Or “cocktail” of old Soviet immunomodulators called Tsitovir-3. We must bear in mind that all of these drugs have clinical benefit only in the case of the appointment in the early days of SARS.

Much more friendly I feel about the same immunomodulatory drugs in the forms for topical administration. So, as an ointment or gel Viferon spray Genferon Light or joined them Derinat. These drugs, I recommend widely – for the treatment of initial manifestations of respiratory infections and for their prevention

Well, perhaps, and that’s enough of that.

Remember that in most cases, acute respiratory infections in children require treatment only individual symptoms; learn to treat some of these symptoms independently. In more severe cases may require exposure to an infectious agent; in order to do it right, better get the doctor’s advice. Do not be ill!

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