acute respiratory infections (acute respiratory diseases, acute infections respiratory tract, cold) do not manifest themselves immediately; the first signs in children may be restlessness, refusal to eat, and poor sleep. And only later do signs of illness appear, such as a runny nose, sneezing, fever, and cough. And here you can’t do without a doctor. After all colds with improperly organized and inadequate care, including self-medication, often lead to the formation of a group of frequently ill children, the development of chronic foci of infection, diseases gastrointestinal tract, kidneys, favor the formation allergic diseases and delayed psychomotor and physical development.
Error one: in the treatment of acute respiratory infections and acute respiratory viral infections, the desire to “bring down” the temperature. An increase in body temperature (hyperthermia, fever) can occur against the background of acute infectious diseases (acute respiratory infections, pneumonia, intestinal infections and a number of others), with dehydration, overheating, damage to the central nervous system, etc. Therefore, before the temperature begins to decrease, it is necessary to establish the reason that caused its increase. A doctor will help you do this. In addition, it must be remembered that lowering the temperature improves well-being, but does not affect the cause of the disease. High temperature is primarily a protective reaction, and lowering its level is not always justified. Many viruses and bacteria stop reproducing at temperatures above 37–38°C; with fever, the absorption and digestion of bacteria increases, and lymphocytes are activated - blood cells involved in the fight against infectious agents, stimulates the formation of antibodies - protein substances that neutralize the effect of microorganisms; a number of protective substances, including interferon, a protein that has antiviral effect, are released only at temperatures above 38°C. Therefore, doctors strongly recommend not using antipyretics if the child’s temperature does not exceed 38.5°C. In this situation, it is usually enough to improve heat transfer: uncover the baby, wipe with water at room temperature, let the water dry without dressing the baby (evaporation increases heat transfer), put a damp, cold towel on the forehead. Currently, it is not recommended to wipe with vodka, because... possible absorption of alcohol (especially in young children) and poisoning of the child’s body until development comatose state. However, parents need to clearly know the situations when, before the doctor arrives, the child needs to be given an antipyretic drug:
It must be remembered that antipyretics do not affect the cause of fever and its duration; moreover, they increase the period of viral shedding in acute respiratory infections. To reduce a child’s temperature, we can recommend drugs based on paracetamol (effective for 2–3 hours) or ibuprofen (effective for up to 6 hours, have a fairly pronounced anti-inflammatory effect, but more often give side effects– abdominal pain, nausea, vomiting, abnormal bowel movements, bleeding); and here analgin(causes severe damage to the hematopoietic system) and aspirin(can cause Reye's syndrome - severe damage to the liver and brain) according to the decision of the Pharmaceutical Committee of the Russian Federation, it is not indicated for children under 16 years of age! Children are also contraindicated amidopyrine, antipyrine And phenacetin due to their adverse effects on hematopoietic system, frequent allergic reactions, the likelihood of provoking a convulsive syndrome. A repeat dose of the antipyretic drug should be given only after a new increase in temperature to the level indicated above, but not earlier than four hours later - this reduces the risk of overdose.
Error two: regular use of antipyretics. Long-term regular use (2-4 times a day) of antipyretics should be avoided due to the danger of side effects and possible difficulty in diagnosing bacterial complications (otitis media, pneumonia, etc.). If you regularly give your child antipyretics, you can create a dangerous appearance of well-being! With such a “course” tactic, a signal about the development of a complication (pneumonia or other bacterial infection) will be masked and, accordingly, time will be missed to begin its treatment. Therefore, a repeat dose of the antipyretic should be given only when the temperature rises again. The simultaneous prescription of an antipyretic drug and an antibiotic makes it difficult to assess the effectiveness of the latter.
Error three: uncontrolled use medicinal herbs. Medicinal herbs (herbal medicine) are widely used in the treatment of acute respiratory infections. Since ancient times, people have been treated with herbs and accumulated large number knowledge about their properties. It is important to use this experience wisely. For acute respiratory infections, the doctor may recommend preparations based on chamomile, calendula, sage, eucalyptus, etc. (for gargling, inhalation, oral administration). However, the use of medicinal herbs must be approached with caution: one must remember the dose and do not forget about contraindications. Prescribing “herbs” to your child without understanding their effects is simply dangerous. Herbal medicine should be used with particular caution by people with allergies and children under 12 years of age, in whom the use of any medicinal herbs is possible only after consultation with a doctor.
Error four: the desire to dress warmly when the temperature is hot. A child with a fever should not be dressed warmer than usual. The processes of heat formation and heat transfer are interconnected; they help maintain a constant body temperature. “Wrapping up” a child against the background of increased heat generation leads to disruption of heat transfer, which contributes to sharp deterioration general condition, up to loss of consciousness from overheating. When body temperature rises, everything must be done to ensure that the body has the opportunity to lose heat: clothing should be loose and light.
Error five: fear of hypothermia in a child. A sick child needs fresh air. You should ventilate the room as often as possible (this is possible in the absence of the child), and carry out wet cleaning regularly (2 times a day). Frequent ventilation makes breathing easier and reduces runny nose. The room where the child is located should have a constant temperature (20–22°C) and optimal humidity (60%).
Error six: taking antibiotics for any acute respiratory infection. As is known, the majority of acute respiratory infections (90% or more) are caused by respiratory viruses (they are often called ARVI - acute respiratory viral infections); bacterial acute respiratory infections are few. Viruses, unlike bacteria (single-celled microorganisms), have a very simple structure and are not cells; they cannot live and reproduce on their own and do this only inside other organisms (including humans), or rather, inside cells. Antibiotics do not act on viruses; moreover, they not only do not prevent bacterial complications, such as pneumonia (pneumonia), otitis media (middle ear inflammation), sinusitis (inflammation of the paranasal sinuses), but also suppress growth normal microflora, open the way for the colonization of the respiratory tract by microorganisms resistant to antibiotics. Irrational use of antibiotics for acute respiratory viral infections often leads to negative consequences - an increase in the number of drug-resistant microorganisms, the development of dysbiosis (changes in the composition of the microflora) of the intestine, and a decrease in the child’s immunity. Uncomplicated acute respiratory viral infections do not require antibiotics. They are indicated only for bacterial complications, which only a doctor can determine (and also select the appropriate antibacterial drug). Preference is given to penicillins ( amoxicillin, synonym flemoxin), not used biseptol(pathogens to it bacterial acute respiratory infections acquired stability). One way to limit overuse antibacterial agents The general effect for acute respiratory infections is the use of drugs that act locally and suppress pathogenic flora in the mucous membrane of the respiratory tract, with virtually no effect on the entire body ( bioparox– used in children over 30 months).
Error seventh: treatment of a runny nose in acute respiratory infections with vasoconstrictor drugs until “recovery”. Vasoconstrictor drugs (Nazivin,naphthyzin,otrivin,galazolin etc.) only temporarily facilitate nasal breathing, but do not eliminate the causes of a runny nose. In addition, they can only be used for the first three days, with more long-term use they can even worsen a runny nose and cause side effects, including atrophy (thinning with subsequent dysfunction) of the nasal mucosa. It should also be remembered that vasoconstrictor drops from the nasal cavity in children can be quite quickly absorbed into the blood and have general action on the body, leading to increased heart rate, increased blood pressure, headache, general anxiety. The question of their use and dosage is decided only after consultation with a doctor. It is recommended to use for nasal rinsing in children. isotonic solutions (salin,aquamaris, physiometer). They are prepared from sea water, sterilizing it and bringing the salt content to an isotonic concentration (corresponding to the concentration of salts in the blood). The drugs help normalize the fluidity and viscosity of mucus. It is believed that contained in sea water salts and microelements (calcium, potassium, magnesium, iron, zinc, etc.) help increase motor activity cilia, which remove bacteria, dust, etc. from the nasal cavity, activation of restorative, wound-healing processes in the cells of the nasal mucosa and normalization of the function of its glands. Rinsing is carried out 4-6 times a day (if necessary, more often) alternately in each nasal passage.
Error eight: taking medications to “treat cough” (antitussives, expectorants, sputum thinners). Cough is a defensive reaction aimed at removing foreign particles (viruses, bacteria, etc.) from the respiratory tract, and its suppression does not lead to cure. Antitussives ( glaucine, libexin, butamirate etc.) are indicated to reduce dry, frequent cough, leading to vomiting, sleep and appetite disturbances (painful, debilitating cough), which is very rarely observed in acute respiratory infections. More often, a cough with acute respiratory infections quickly (within 3-5 days) turns into a wet one, and then taking antitussive drugs is simply contraindicated, since it interferes with the outflow of sputum. Expectorants - drugs, more often plant origin, facilitating the production of sputum when coughing. At acute infections there is no need to use them; they are indicated only when chronic processes. Expectorants are used especially carefully in young children, because excessive stimulation of the vomiting and cough centers in the medulla oblongata, which are located nearby, can lead to aspiration (the entry of vomit into the respiratory tract). Question about the use of mucolytics (sputum thinners), such as bromhexine, ambroxol, acetylcysteine, can only be decided by a doctor. They are used in the presence of thick, viscous, difficult to separate sputum.
Error nine: taking antihistamines. Antihistamines belongs important place in the treatment of allergic diseases, which is determined by the key role of histamine (a biologically active substance released during allergies) in the formation clinical manifestations allergies. In particular, these drugs are highly effective for rhinitis (runny nose) of an allergic nature (second generation drugs are mainly used - cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (telfast). Currently, most doctors are inclined to reduce the drug load in acute respiratory infections, including refusing to use antihistamines, since there is no evidence of the need for their use. Drugs in this group are prescribed for acute respiratory infections only to children with allergic diseases.
Error ten: physiotherapy, incl. "home remedies". Mustard plasters, cups, burning patches and rubbing should not be used in children. Their effectiveness has not been proven, moreover, they are painful, dangerous with burns, and can lead to the development of allergic reactions. The effectiveness of irradiation has also not been proven. chest(warming), and visits to the clinic for a course of physiotherapy are dangerous in terms of re-infection.
Error eleven: the desire to force feed the child. In sick children during acute respiratory infections, the secretion of digestive juices decreases and changes in intestinal motility appear. Poor appetite is a natural reaction of the body to a disease, since all its resources are aimed at fighting infection, and digestion of food is a fairly energy-intensive process. If the baby refuses to eat, he should not be forced (this can lead to vomiting); he should be fed several times a day with small portions of easily digestible food (omelet, chicken broth, low-fat yoghurt, baked fruit). At the same time, it is important to give your child plenty of fluids: warm tea with honey (only for children over 1 year old in the absence of allergies), jam, lemon, cranberry or lingonberry juice, dried fruit compote, alkaline mineral waters still (can be with milk), fruit juices or plain water. General rule is that the body should not be overloaded, and the child’s nutrition should be of proper density, liquid or semi-liquid; the patient is prescribed food in small portions, taking into account, of course, the baby’s taste characteristics. However, you should avoid spicy foods, hard-to-digest foods, and canned foods.
Error twelve: the sick child must remain in bed. The baby's regimen should correspond to his condition: bed - in severe cases, semi-bed (with alternating moderately active wakefulness and rest in bed, as well as mandatory nap) - when the condition improves and normal - 1-2 days after the temperature drops.
Error thirteen: use of self-medication, neglect of consultation with a doctor when there is a change in the child’s condition. It must be remembered that manifestations of ARVI can be signs of more severe diseases, such as tonsillitis, scarlet fever and a number of other infections. Diphtheria and meningitis (inflammation of meninges), in which delay in diagnosis and treatment can lead to fatal outcome! Put correct diagnosis in these cases it is not very easy. Therefore, at the first signs of the disease, you must consult a doctor who will prescribe appropriate treatment. All therapeutic measures carried out only as prescribed and under the supervision of a doctor!
Runny nose, cough, high temperature– the main signs of acute respiratory infections in both adults and children. And if the first two symptoms are usually not a cause for great concern for parents, then the presence of a fever in a baby often raises many questions. In particular, regarding how long the temperature lasts during ARVI in a child in at different ages and whether it needs to be reduced. Let's look at this question in more detail.
During an acute respiratory infection, an increase in temperature in a child is a normal phenomenon, which indicates that the body is fighting a viral infection. There is no need to be afraid of this process, even if it occurs in a baby.
At the same time, experts distinguish several degrees of high temperature during acute respiratory infections and other diseases:
By the way, there is such a concept as low temperature. In most cases, this phenomenon occurs after the end of the disease or as a result of overwork. IN medical practice in this case, the term “loss of strength” is often used.
We all know that a runny nose helps get rid of the virus that is in the nose, coughing frees the lungs and bronchi from accumulated phlegm. What role does high and low temperature play in a child?
Fever performs several important functions in the baby’s body:
That is why you should not lower the temperature, which is only 37 degrees. And this rule applies even to babies under one year old who first fell ill with acute respiratory infections.
What role does low temperature play? Its main function is to slow down all processes of the body, thanks to which it recovers faster after an infection. Typically, this condition is observed during the first three days from the moment of recovery. But in cases where, even after 3-4 days, the low temperature has not returned to normal, it is better to show the baby to a doctor. After all, almost every parent knows how to reduce fever, but here the problem is completely opposite. And only a specialist can tell you what the right thing to do is based on the age and characteristics of the child’s body. In particular, this applies to babies under one year old, since “standard” methods of raising the temperature are contraindicated for them (vitaminized juices, warming the feet in a basin of hot water, and so on).
So, how many days can a child have a high temperature with acute respiratory infections? It is quite difficult to give a definite answer to this question. After all, each person’s body has its own individual characteristics. If we consider the situation in general terms, we can say that with a viral infection, the increase in the child’s body temperature does not last that long. For example, in the normal course of acute respiratory infections without any complications, fever is observed only for 3 days. Upon completion of this period the fever usually disappears, but other symptoms of the disease (cough, runny nose) may persist for up to a week or more.
As for infants, their fever can last up to 5-6 days. This is due to the characteristics of the body of a child several months old. Their immunity is still quite weak and cannot defeat the virus in a short time.
But during adenovirus infection both in infants and in children over one year old, elevated temperature can last up to 10 days or more. The same is observed with the development of various complications of acute respiratory infections.
It was already mentioned above that fever during ARVI in children (even if they are younger than one year old) is normal. This is especially true in cases where the thermometer readings are within the range of 38-38.5 degrees. In such a situation, there is no need to reduce the fever so as not to interfere with the body’s ability to fully perform its work. The only thing that is required from parents is to provide the child with peace, give him plenty of fluids to drink (tea with lemon, rosehip infusion, orange juice). This is necessary to avoid dehydration. After all, no matter how many days the fever lasts, the body partially gets rid of the heat by eliminating fluid in the form of increased sweating and frequent urination.
If a baby under one year old has a high temperature, there is no need to wrap him in a blanket or several warm sweaters. In this way, you can achieve not sweating, but overheating, which will only intensify the fever. The amount of clothing should not be excessive. The ideal option would be to put a thin blouse and pants made of natural breathable fabric on the baby or leave him naked for a while. But in the latter case, room temperature plays an important role. It should be at least 22-23 degrees.
Also, we must not forget about one more important point. It is necessary to pay special attention to how many days the sub lasts febrile temperature at the baby's. If the period is more than 5 days, this may indicate the presence of not only acute respiratory infections (even if there are no other symptoms besides cough and runny nose), but hidden inflammatory processes. What to do in such a situation? The answer is logical: see a doctor as soon as possible for an accurate diagnosis.
So, based on all of the above, we can draw a conclusion about what temperature needs to be lowered. For children it is 38-38.5 degrees. For a child under one year old, in some cases it is allowed to reduce the fever with the help of medications when it reaches 37.5 degrees. But this is only in cases where the baby has become capricious, refuses to eat, or has convulsions.
How often it is necessary to take antipyretics depends on the characteristics of the child’s body. At the same time, you do not need to set yourself the goal of reducing the temperature to 36.6. In most cases this is impossible to do. With acute respiratory infections, it is enough to simply reduce it to 37.5 degrees.
It is best to reduce the temperature in children under one year of age and older with the help of ibuprofen-based syrups. An example of such a drug would be the well-known Nurofen. Paracetamol-based suppositories also do an excellent job. But “adult” drugs in the form of tablets (Aspirin and others) are strictly contraindicated for children.
One of the most popular pediatricians and famous TV presenter Evgeniy Olegovich Komarovsky gives a lot useful information regarding the treatment of ARVI in children, and also pays enough attention to the temperature of children. To the question “how many days does the temperature last in children with viral diseases?”, he gives an answer similar to our conclusions. On average this period is 3 days. Komarovsky recommends measuring body temperature using the old proven method - in armpit mercury thermometer, since modern infrared thermometers can overestimate it, and it will seem to you that the temperature is elevated, although in fact it is not.
This disease is considered acute inflammatory. In this case, the child's airways are affected. Treatment differs from acute respiratory viral infection in that antibiotics can be used.
At this tender age, babies receive antiviral protection through mother's milk.
Signs of acute respiratory infections in babies under one year old:
Basically, disease therapy consists of creating favorable conditions for recovery:
Treatment of cough requires maximum caution, so do not use vasoconstrictor drops. Only in cases where the cough is very severe, leading to vomiting, can the doctor prescribe antitussives. When the cough becomes wet, expectorants are prescribed. But you should be careful with them, especially with very young children.
Acute respiratory infections in children are usually caused by viruses, so treatment begins with the use of antiviral drugs.
Reception rate:
This medicine is given to patients only in the first days of the disease. For a baby under one year old, it is preferable to instill igterferon - two drops in each nostril.
You need to lower the temperature medicines based on paracetamol. For babies, use candles. Calpol and Panadol in the form of syrups are also suitable for this.
A three-year-old child can be given drugs that activate the body’s protective functions - anaferon, influcid, griphel.
Acute respiratory diseases (ARI) are a large group of infections that have much in common in pathogenesis and transmission routes: we are talking mainly about airborne infections, although contact (through dirty hands) the transmission route plays an equally important role. This term is used to combine acute nonspecific infections, regardless of their location - from rhinitis to pneumonia. However, as a clinical diagnosis of acute respiratory infections, it requires deciphering: there must be an indication of either organ damage (otitis media, bronchitis, pharyngitis, etc.), for which the spectrum of pathogens is known, or a possible etiology of the disease (viral, bacterial acute respiratory infections). Since up to 90% of acute respiratory infections are caused by respiratory viruses and influenza viruses, in the absence of signs of bacterial infection, justify the term “acute respiratory viral infection"(ARVI) and the prescription of antiviral therapy.
According to the authors of a series of works carried out under the auspices of WHO, in different countries - both developed and developing - young children suffer 5-8 acute respiratory infections annually, and in rural areas they get sick less often than in cities, where a child can suffer 10- 12 infections per year. Children who are early childhood have less contact with sources of infection and therefore get sick less during this period, “get the missing infections” in elementary school. Statement of this fact, of course, should not be the reason for the development of fatalism regarding ARVI - children should be hardened and, if possible, protected from sources of infection, properly fed and treated for diseases ( chronic tonsillitis, allergies), against the background of which acute respiratory infections develop especially often. At the same time, it is necessary to protect sick children in every possible way from unnecessary therapeutic interventions, since acute respiratory infections are the reason for unnecessary treatment and the most common cause of side effects of drugs.
Strictly speaking, antiviral therapy is indicated for any respiratory viral disease. Unfortunately, antivirals, available to us, often do not give a pronounced effect, and the mildness of most episodes of ARVI, limited to 1-3 feverish days and catarrhal syndrome for 1-2 weeks, does not justify chemotherapy. But in more severe cases, especially with influenza, antiviral drugs have a certain effect and should be used more widely than is considered appropriate today.
The basic rule for the use of antiviral chemotherapy drugs is their administration in the first 24-36 hours of illness, in more late dates their effect is not visible. The main anti-influenza drug, which also acts on a number of other viruses, is rimantadine, which suppresses the reproduction of all strains of influenza type A. Rimantadine also inhibits the reproduction of respiratory syncytial (RS) and parainfluenza viruses. Recommended; 5-day course at the rate of 1.5 mg/kg/day in 2 doses for children 3-7 years old; 50 mg 2 times for children 7-10 years old - 3 times a day - over 10 years old. At an early age, rimantadine is used in the form of algirem (0.2% syrup): in children 1-3 years old, 10 ml; 3-7 years - 15 ml: 1st day 3 times, 2-3rd days - 2 times, 4th - 1 time per day. The effectiveness of rimantadine increases when taken with the drug no-shpa (drotaverine) orally, at a dose of 0.02-0.04 g for children 4-6 years old and 0.04-0.1 g for patients 7-12 years old. especially when heat transfer is impaired (cold extremities, marbling of the skin).
Arbidol has a similar antiviral effect, inhibiting the fusion of the lipid membrane of influenza viruses with the membrane of epithelial cells. It is also an interferon inducer. This low-toxic drug can also be prescribed for moderate ARVI from the age of 2: for children 2-6 years old, 50 mg per dose, 6-12 years old, 100 mg, over 12 years old, 200 mg per dose 4 times a day. Both rimantadine and arbidol reduce the febrile period by an average of 1 day both in influenza A2, mixed infections, and in non-influenza ARVI.
Ribavirin (ribamidil, virazole) is an antiviral drug originally used (mainly in the USA) as having activity against the RS virus in bronchiolitis in the most severely ill patients with an unfavorable premorbid background (premature infants, with bronchopulmonary dysplasia). The drug is used for this purpose in the form of continuous (up to 18 hours a day) inhalations through a special inhaler at a dose of 20 mg/kg/day; Due to the high price and side effects, it is practically not used in Europe. It also turned out that this drug is active against influenza viruses, parainfluenza, herpes simplex, adenoviruses, as well as coronavirus, the causative agent of severe acute respiratory syndrome(SARS). For influenza in adolescents over 12 years of age, it is used orally at a dose of 10 mg/kg/day for 5-7 days. For SARS, ribavirin is administered intravenously.
Progress in the treatment of influenza caused by both type A and type B viruses may be due to the use of the neuraminidase inhibitors oseltamivir-Tamiflu and zanamivir-Relenza. These drugs, when taken early, reduce the duration of fever by 24-36 hours and have preventive action, but there is little experience in their use in children (from 12 years old) in Russia, and even in reference books recent years Almost no one writes about them. Relenza is used in the form of powder inhalations (in the USA from 7 years of age) - 2 inhalations (5 mg each) per day with an interval of at least 2 hours (on the 1st day) and 12 hours (from the 2nd to the 5th day treatment). Tamiflu (75 mg capsules and 12 mg/ml suspension) in adults and children over 12 years old is used at 75 mg once a day for 5 days (in the USA, doses for children 1-12 years old: weighing up to 15 kg - 30 mg 2 times a day, 15-23 kg - 45 mg 2 times a day, 23-40 kg - 60 mg 2 times a day). This drug is the only one to which H5N1 avian influenza is sensitive, and a number of countries are currently stockpiling it in case of an epidemic, which apparently limits its use with relatively small production (Hoffman-La Roche, Switzerland, produces 7 million doses of Tamiflu in year).
The drugs Florenal 0.5%, oxolinic ointment 1-2%, bonafton, lokferon and others used locally (in the nose, in the eyes) have some antiviral activity; they are indicated, for example, for adenovirus infection. Although their effect is difficult to assess, the low toxicity justifies the use of these agents.
Proteolytic processes occurring during the synthesis of viral polypeptides, as well as the fusion of viruses with cell membranes, can inhibit aprotinins - contrical, gordox, etc., as well as amben. These drugs can be used for severe forms of respiratory infections with high inflammatory activity, usually with signs of disseminated intravascular coagulation (as fibrinolysis inhibitors) and microcirculatory disorders. Ambien is part of hemostatic sponges. Contrical is used at a dose of 500-1000 IU/kg/day. Olifen and Erisod, used in adults and included in this group of drugs, have not yet been tested in children.
Interferons and their inducers have universal antiviral properties, suppressing the replication of both RNA and DNA, while simultaneously stimulating the immunological reactions of the macroorganism. Early use of interferons can, if not interrupt the course of the infection, then mitigate its manifestations.
Native leukocyte interferon α (1000 IU/ml - 4-6 times a day by mouth in a total dose of 2 ml on the 1st-2nd day of illness) is less effective than recombinant interferon preparations. Among the latter, the use of influenza feron - interferon α-2β (10,000 IU/ml) with thickeners is promising; it is administered in the form of drops in the nose - 5 days, for children under one year old - 1 drop 5 times a day ( single dose 1000 IU, daily dose- 5000 IU), children from 1 to 3 years old, 2 drops 3-4 times a day (single dose 2000 IU, daily dose - 6000-8000 IU), from 3 to 14 years old - two drops 4-5 times a day ( single dose - 2000 IU, daily dose - 8000-10,000 IU). The administration of interferon drugs parenterally, practiced, for example, for the treatment chronic hepatitis, is hardly justified for the vast majority of respiratory infections. However, a number of studies have shown effectiveness against influenza and ARVI. rectal suppositories Viferon - interferon α-2β + vitamins E and C. Viferon-1 (150,000 IU) is used in children under 6 years old, Viferon-2 (500,000 IU) in children over 7 years old - they are prescribed 2-3 times a day within 5 days. Viferon is also used prophylactically for frequently ill children.
Laferon - interferon α-2β powder - is used in the form of nasal drops, and in children over 12 years of age it is administered intramuscularly at a dose of 1-3 million IU.
In addition to arbidol, a number of drugs are used as interferon inducers. Amiksin (Tilorone) has gained the most popularity among children over 7 years of age - it is administered at the first symptoms of acute respiratory infections or flu orally after meals, 60 mg 1 time per day on the 1st, 2nd, and 4th day from the start of treatment. Children's anaferon- homeopathic doses of affinity-purified antibodies to interferon α, it is used 1 tablet every 30 minutes for 2 hours, then 3 times a day, however, little convincing data on its effectiveness has yet been collected.
In children with ARVI, it is often necessary to treat a primary herpesvirus infection that occurs as severe febrile stomatitis. Children with atopic dermatitis often develop Kaposi's eczema, a herpesvirus infection of the affected skin that is also severe. In older children, ARVI is the most common reason reactivation of herpes viruses in the form of specific rashes on the lips, wings of the nose, and less often on the genitals. This infection responds well to treatment with acyclovir - it is used at 20 mg/kg/day in 4 divided doses, in severe cases - up to 80 mg/kg/day or intravenously at 30-60 mg/kg/day. Valacyclovir does not require divided administration; its dose for adults and adolescents over 12 years of age is 500 mg 2 times a day.
In practice, it is widely used for the treatment of acute respiratory viral infections. larger number products, including herbal origin (adaptogens, dietary supplements, tinctures, etc.). There is no data on the effectiveness of the vast majority of them, but side effects are often encountered.
Bacterial acute respiratory infections in children, as in adults, are relatively few in number, but they pose the greatest threat in terms of development serious complications. Making a diagnosis of bacterial acute respiratory infections at the bedside of an acutely ill child is very difficult due to the similarity of many of their manifestations with those of acute respiratory viral infections (fever, runny nose, cough, sore throat), and rapid methods of etiological diagnosis are practically unavailable. And the identification of a microbial pathogen in the material of the respiratory tract does not indicate its etiological role, since most bacterial diseases are caused by pathogens that constantly grow in the respiratory tract.
Under these conditions, naturally, the doctor, at the first contact with the child, tends to overestimate the possible role of the bacterial flora and use antibiotics more often than necessary. Our data show that in Moscow antibiotics are prescribed to 25% of children with ARVI; in some Russian cities this figure reaches 50-60%. The same trend is typical for other countries: antibiotics for ARVI are used in children in 14-80% of cases. Indicators close to our data are given by authors from France (24%) and the USA (25%). In developing countries antibacterial drugs in acute respiratory infections they are also used too widely, although this process is hampered by their lower availability. In China, 97% of children with acute respiratory infections who seek medical help receive antibiotics. It is obvious that with a viral etiology of the disease, antibiotics are at least useless and, most likely, even harmful, since they disrupt the biocenosis of the respiratory tract and thereby contribute to the colonization of them by unusual, often intestinal, flora.
Antibiotics are used more often in children with ARVI than in bacterial diseases, cause side effects- various rashes and other allergic manifestations. During bacterial processes in the body, a powerful release of a number of mediators (for example, cyclic adenosine monophosphate) occurs, which prevent the manifestation of allergic manifestations. This does not happen with viral infections, so allergic reactions are implemented much more often.
Another danger of excessive use of antibiotics is the spread of drug-resistant strains of pneumotropic bacteria, which is observed in many countries around the world. It is obvious that the unjustified use of antibiotics also leads to unnecessary treatment costs.
The effect of antibiotics on the development of the child’s immune system should not be ignored. The predominance of the immune T-helper response type 2 (Th-2), characteristic of a newborn, is inferior to the more mature T-helper response type 1 (Th-1), largely under the influence of stimulation by endotoxins and other products of bacterial origin. Such stimulation occurs both during a bacterial infection and during an acute respiratory viral infection, since a viral infection is accompanied by increased (albeit non-invasive) proliferation of pneumotropic flora. Naturally, the use of antibiotics weakens or even suppresses this stimulation, which, in turn, contributes to the preservation of the Th-2 direction of the immune response, which increases the risk of allergic manifestations and reduces the intensity of anti-infective protection.
Recommendations from professional pediatric societies in most countries emphasize the importance of not using antibacterial agents in children with uncomplicated respiratory viral infection. The recommendations of the US Academy of Pediatrics emphasize that antibiotics are not used not only for uncomplicated ARVI, but also mucopurulent runny nose is also not an indication for prescribing antibiotics if it lasts less than 10-14 days. The French consensus allows the use of antibiotics for ARVI only in children with a history of recurrent otitis, in children under 6 months of age, if they attend a nursery, and in the presence of immunodeficiency.
The recommendations of the Union of Pediatricians of Russia indicate that for uncomplicated ARVI, systemic antibiotics are not indicated in the vast majority of cases. This document lists the manifestations of the disease observed in the first 10-14 days that cannot justify the administration of antibiotics.
The question of prescribing antibiotics in a child with ARVI arises if he has a history of recurrent otitis media, an unfavorable premorbid background (severe malnutrition, birth defects development) or in the presence of clinical signs of immunodeficiency.
The following are signs of a bacterial infection that require antibacterial treatment:
More often than these obvious lesions, the pediatrician sees only indirect symptoms of a probable bacterial infection, among which the most common are persistent (3 days or more) febrile temperature, shortness of breath in the absence of obstruction (respiratory rate above 60 per minute in children 0-2 months of age , more than 50 per 1 minute at the age of 3-12 months and more than 40 in children 1-3 years old), asymmetry of auscultatory data in the lungs. Such symptoms force one to prescribe an antibiotic, which, if the diagnosis is not confirmed during subsequent examination, should be immediately discontinued.
For initial treatment of bacterial acute respiratory infections, a small set of antibiotics is used. For otitis and sinusitis, amoxicillin 45-90 mg/kg/day is prescribed orally to suppress the main pathogens - pneumococcus and Haemophilus influenzae. In children who have recently received antibiotics, amoxicillin/clavulanate 45 mg/kg/day is used, which suppresses the growth of probably resistant Haemophilus influenzae and Moraxella in these patients.
Acute tonsillitis requires differential diagnosis between adenoviral sore throat, infectious mononucleosis and streptococcal tonsillitis. Viral tonsillitis is characterized by cough and catarrhal syndrome, streptococcal tonsillitis is characterized by absence of cough, and mononucleosis is characterized by blood changes. Antibiotics (penicillin vau, cephalexin, cefadroxil) are indicated for streptococcal tonsillitis; The use of amoxicillin is undesirable, since in case of mononucleosis it can cause toxic rashes. Although adenoviral tonsillitis does not require the prescription of an antibiotic, the presence of severe leukocytosis (15-25x10 9 / l) and increased levels C-reactive protein justify their use in many cases.
Bronchitis is usually viral disease, which does not require antibacterial treatment. The exception is bronchitis caused by mycoplasma; when they are detected, the use of macrolides (azithromycin, midecamycin, etc.) is indicated. Clinical signs Mycoplasma bronchitis are:
Selection of antibacterial agents for initial treatment community-acquired pneumonia is also not very large, since most of the “typical” pneumonias are caused by pneumococcus or Haemophilus influenzae (the exception is the first months of life, when the causative agent can be staphylococci and intestinal flora), while “atypical” forms can be treated with macrolides. The choice of starting antibiotic for pneumonia is determined taking into account the likely causative agent of the disease.
For typical pneumonia (febrile, with a focus or homogeneous infiltrate), the following is used:
For atypical (with inhomogeneous infiltrate) pneumonia:
These methods include interventions used for acute laryngitis and obstructive forms of bronchitis.
Acute laryngitis and croup are conditions that require assessment of the degree of stenosis, as judged by the intensity of inspiratory retractions of the chest, pulse and respiration rates. Grade 3 croup requires emergency intubation, grade 1 and 2 croup is treated conservatively. Antibiotics are not administered to a patient with laryngitis; according to global consensus, intramuscular dexamethasone 0.6 mg/kg is most effective, which stops the progression of stenosis. Further treatment continue with inhaled steroids (dosed or through a nebulizer - Pulmicort) in combination with antispasmodics (salbutamol, Berotec, Berodual in inhalations).
Laryngeal stenosis can be caused by epiglottitis (the main role in its etiology belongs to H. influenzae type b) - it is characterized by high temperature and increased stenosis in the supine position; Prescribing an antibiotic (cefuroxime, ceftriaxone) in this case is mandatory.
Difficulty breathing and expiratory dyspnea often observed with bronchiolitis and obstructive bronchitis, as well as during an asthma attack against the background of ARVI. Since bacterial infection is rare in such cases, antibiotics are not justified. Treatment - inhalation of sympathomimetics (in young children it is better in combination with ipratropium bromide) and the use of steroids in refractory cases - makes it possible to cope with obstruction in 1-3 days.
As stated above, acute respiratory infections are the most common reason for using medications, in particular symptomatic remedies, which occupy most of the pharmacy shelves. It is important, however, to clearly understand that the mere presence of a particular symptom should not be the basis for intervention; one must first of all assess the extent to which this symptom interferes with life and whether the treatment will be more dangerous than the symptom.
Fever accompanies most acute respiratory infections and is defensive reaction, so reducing its level with antipyretics is justified only in certain situations. Unfortunately, many parents and doctors consider fever the most dangerous manifestation of the disease and strive to normalize the temperature at all costs. According to our research, 95% of children with ARVI receive antipyretics, including 92% of children with low-grade fever. This tactic cannot be considered rational, since fever, as a component of the body’s inflammatory response to infection, is largely protective in nature.
Antipyretics do not affect the cause of fever and do not shorten its duration; they increase the period of viral shedding in acute respiratory infections. With most infections, the maximum temperature rarely exceeds 39.5°. This temperature does not pose any threat to a child older than 2-3 months; Usually, in order to feel better, it is enough to lower it by 1-1.5°. Indications for reducing temperature:
The safest antipyretic for children is paracetamol, its single dose is 15 mg/kg, daily dose is 60 mg/kg. Ibuprofen (5-10 mg/kg per dose) often produces side effects (with a similar antipyretic effect); it is recommended for use in cases where an anti-inflammatory effect is required (arthralgia, muscle pain, etc.).
Not used for acute respiratory infections in children acetylsalicylic acid(aspirin) - in connection with the development of Reye's syndrome, metamizole sodium (analgin) orally (danger of agranulocytosis and collaptoid state), amidopyrine, antipyrine, phenacetin. Nimesulide is hepatotoxic; unfortunately, its childhood forms have been registered in Russia, although they are not used anywhere else in the world.
Treatment of a runny nose vasoconstrictor drops improves nasal breathing only in the first 1-2 days of illness; with longer use, they can worsen a runny nose and also cause side effects. At an early age, due to pain, only 0.01% and 0.025% solutions are used. Convenient (after 6 years) nasal sprays, which allow the drug to be evenly distributed at a lower dose (dlyanos, vibrocil). But the most effective way to cleanse the nose and nasopharynx, especially with thick exudate, is saline solution (or its analogues, including a solution of table salt prepared at home: add salt to 1/2 cup of water on the tip of a knife) - 2-3 pipettes in each nostril 3-4 times a day, lying on your back with your head hanging down and back. Orally administered remedies for the common cold containing sympathomimetics (phenylephrine, phenylpropanolamine, pseudoephedrine) are used after 12 years of age; from 6 years of age, Fervex for children, which does not contain these components, is prescribed. Antihistamines, including second generation, effective in allergic rhinitis, WHO does not recommend use for acute respiratory infections.
Indications for prescribing antitussives (non-narcotic central action- glaucine, butamirate, oxeladin) is only a dry cough, which with bronchitis usually quickly becomes wet. Expectorants (their cough stimulating effect is similar to an emetic) have questionable effectiveness and in young children they can cause vomiting, as well as allergic reactions, including anaphylaxis. Their purpose is more a tribute to tradition than necessity, expensive means from this group have no advantages over conventional herbal remedies; WHO generally recommends limiting oneself to “home remedies”.
Among the mucolytics, acetylcysteine is the most active, but acute bronchitis children have practically no need to use it; carbocisteine is prescribed for bronchitis - based on its beneficial effect on mucociliary clearance. Ambroxol for thick sputum is used both orally and inhalations. Aerosol inhalations of mucolytics are used for chronic bronchitis; Aerosol inhalations of water, saline, etc. are not indicated for acute respiratory infections.
For long-lasting cough (whooping cough, persistent tracheitis), anti-inflammatory drugs are indicated: inhaled steroids, fenspiride (erespal). Emollient lozenges and sprays for pharyngitis usually contain antiseptics and are used from 6 years of age; starting from 30 months, a local antibiotic, fusafyungin, is used, produced in an aerosol (bioparox) and used both nasally and orally.
Mustard plasters, cups, and burning patches, which are still popular in Russia for bronchitis, should not be used in children; In case of acute respiratory infections, there are rarely indications for physiotherapy. Surprising is the popularity of halochambers, the purpose of which is to “inhale table salt vapors,” as in a salt mine. But in a salt mine, the patient is not exposed to salt (which is not a volatile substance), but to clean air, free of dust and other allergens; In addition, they are not there for 15 minutes. Treatment in a halochamber is not included in the consensus on asthma, however, many clinics spend a lot of money on their construction.
The means indicated in this section, with a few exceptions, cannot be considered mandatory for ARVI; Moreover, we are often faced with side effects resulting from such treatment. Therefore, one should make it a rule to minimize drug loads in cases of mild ARVI.
The problem of acute respiratory infections in childhood remains relevant not only because of their prevalence, but also due to the need for revision and optimization therapeutic tactics. Accumulated data show that the approaches prevailing in pediatric practice at least do not contribute to the development of the child’s immune system, therefore, a revision of tactics should be primarily aimed at modifying therapeutic activity, in particular at reducing cases of unjustified prescriptions of antibacterial and antipyretic drugs.
V. K. Tatochenko, Doctor of Medical Sciences, Professor
SCCD RAMS, Moscow
High temperature may rise as with acute respiratory infections, as well as with influenza, acute respiratory viral infections. All this - medical terms, therefore, when prescribing treatment, doctors take into account test results, also additional symptoms(cough, sneezing, runny nose, pain and congestion in the throat).
ARVI- the most common disease, but it is quite successfully treated and does not lead to complications. However, any – any introduction of infection into the body requires elimination, so you should not rely on a common cold and the rapid passing of symptoms.
If the temperature does not go away after 3-4 days, then you need to consult a doctor and undergo an examination
ARVI (acute respiratory viral infection) Unlike a cold, it is a disease caused by viruses and has a slightly different course of acute respiratory infections or influenza. Although the external signs are similar, only a detailed blood test, namely a leukocyte count, will help doctors clarify the diagnosis.
Infection with viruses occurs in humans much more often. If bacteria are added, then we are talking about acute respiratory infections. Often, specialists make a diagnosis at random. Although ARVI and acute respiratory infections are not the same thing. Treatment for infections with viruses and bacteria is somewhat different.
In the fall, during times of stress and vitamin deficiency, a person’s immunity weakens, so it is so important to strengthen it. The drug is completely natural and allows you to short time recover from colds.
It has expectorant and bactericidal properties. Strengthens protective functions immunity, perfect as a prophylactic agent. I recommend it.
ORZ - it is rather a general term in medicine, implying the unclear nature of the damage to the respiratory tract. The causative agent can be both viruses and bacteria, and yeast-like fungi.
The diagnosis of acute respiratory infections is usually made with tonsillitis, laryngitis, bronchitis, pharyngitis, rhinitis, mycoplasmosis, pneumonia due to complications.
Acute respiratory infections occur in different ways, so doctors use this term to mean any infectious lesion of the respiratory tract. In this case, the symptoms resemble a cold and doctors often make a diagnosis at random.
Immunity is a natural reaction that protects our body from bacteria, viruses, etc. To improve tone, it is better to use natural adaptogens.
It is very important to support and strengthen the body not only by the absence of stress, good sleep, nutrition and vitamins, but also with the help of natural herbal remedies.
It has the following properties:
In medicine, there are more than 300 microorganisms (viruses, bacteria, fungi, microbes).
Even vaccinations against many of them are ineffective. If your immune system is weakened, you may become infected with influenza during an epidemic.
Certain strains of viruses and bacteria pose a threat to the development serious illnesses and consequences.
Routes of transmission of viruses:
With acute respiratory infections, the consequences and complications can be more serious in the case of active proliferation of bacteria, when the symptoms are obvious
The drops are completely natural and not only made from herbs, but also with propolis and badger fat, which have long been known as good folk remedies. My main function does it perfectly, I recommend it."
ARVI and acute respiratory infections lead to damage to the respiratory tract. The difference is that in acute respiratory viral infections, viruses become the causative agent, and in acute respiratory infections, bacteria and viruses become the causative agent, when the diagnosis is made for rhinovirus, adenovirus, influenza, parainfluenza, i.e. manifestation of mixed infection.
Symptoms for acute respiratory viral infections and acute respiratory infections are similar, although treatment varies significantly
The main cause of bronchitis accompanied by sputum is a viral infection. The disease occurs due to damage by bacteria, and in some cases, when the body is exposed to allergens.
Now you can safely buy excellent natural preparations, which alleviate the symptoms of the disease, and in up to several weeks allow you to completely get rid of the disease.
ARVI is more severely tolerated by people and clearly has pronounced signs already from the first days:
Symptoms begin acutely but quickly subside. ARVI usually does not lead to complications.
With acute respiratory infections, symptoms begin with a sharp rise in temperature, redness in the throat and the appearance white plaque on the tongue in case of bacterial infection.
Distinctive features for acute respiratory infections:
The disease is progressing. The temperature stays at 38-39 degrees for more than 5 days, the following appears:
High temperature occurs both with acute respiratory infections and acute respiratory viral infections. This only means that the body begins to actively fight pathogens.
If the high temperature lasts for more than 4 days and does not get better, then we can assume complications of a particular disease or the activation of pathogenic bacteria or the addition of a bacterial infection.
This happens with ARVI, when the temperature rises to 39 g and lasts for more than 5 days in a row. This reaction of the body indicates that it is necessary to reconsider the treatment and undergo additional tests if after 4-5 days the symptoms have not subsided and the condition has not improved.
Only laboratory tests will help doctors identify the true causes of the development of pathology, in particular the pathogen.
Basic diagnostic methods:
In infections caused by viruses, the level of white blood cells in the blood is increased. The microflora of the nasal mucosa can be mixed. When infected with staphylococcus or streptococcus, the doctor takes into account the patient’s symptoms.
Usually this is a runny nose, yellow or green discharge thick discharge, cough with sputum, weakness, low-grade fever, white or purulent plaque on the tonsils.
With ARVI, symptoms last no more than 5-7 days and quickly subside. If the high temperature persists for more than 1 week and other signs of infection appear in the body, complications are possible.
Doctors say that the disease has taken a severe course, and often redirect to a chest x-ray if pneumonia or pneumonia is suspected. This most often applies to elderly people with weakened immune systems and infants, when pneumonia is diagnosed, which can be fatal.
In case of complications, patients are advised to undergo hospitalization and, for example, in case of pneumonia, round-the-clock medical supervision
In acute respiratory infections, in the case of a bacterial infection and damage to the tonsils in the mouth, the following may develop:
All these diseases can be caused by viruses, as well as diabetes mellitus oh, glomerulonephritis. Taken together, the pathologies can have serious consequences.
Although the symptoms are often mild and become chronic, sluggish.
This poses a particular danger when serious illness disguised as a common cold.
It happens that the patient experiences a slight malaise, although in fact he needs urgent treatment. ARI or ARVI can cause complications, and the consequences can become unpredictable.
To avoid complications, acute respiratory infections require an integrated approach to treatment. Only a doctor will be able to identify the nature of the development of the disease and, after an initial examination, will redirect it for testing. laboratory tests to get a clear clinical picture illness.
It is important to direct measures to remove, expel pathogenic microflora from the nasal mucosa.
Prescribed for acute respiratory infections caused by bacteria:
If the effect is not observed and local therapy is helpless for 3-4 days, then there may be complications, the transition of an ordinary acute respiratory infection to bronchitis, tracheitis.
Systemic treatment with stronger antibiotics is prescribed (Flemoxin, Amoxiclav, Azithromycin, Erythromycin)
For acute respiratory infections caused by viruses, antibiotics are powerless and can only be prescribed if a bacterial infection is associated. Antibiotics have no effect on viruses and can only lead to dysbiosis, complicated by the course of the disease.
For ARVI you need integrated approach to treatment. Viruses are able to multiply inside cells, which are difficult for many medications to reach. Doctors often prescribe drugs that destroy viruses together with infected cells.
Usually, with ARVI, severe intoxication of the body is observed, so detoxification and fluid replenishment are required.
Treatment for ARVI:
When infected with viruses, it is important to regulate nutrition and replenish the body with fluid to speed up the elimination of viral decay products from the body.
Symptoms of ARVI occur in different ways. Diseases caused by viruses are not considered dangerous, but the risk group includes people with concomitant diseases: diabetes mellitus, tuberculosis, heart failure.
To avoid complications, it is imperative to treat ARVI, and this group there are still people long months after recovery under the strict supervision of doctors.
You should no longer postpone a visit to the doctor if there is no improvement within 4-5 days from the onset of the disease and the temperature does not subside.
Symptoms after 1 week on days 7-8 appear progressively and are completely uncharacteristic of a common acute respiratory viral infection or acute respiratory infection.
There are differences between ARVI and influenza and ARVI. But prevention comes down to preventing infection and eliminating sources that can lead to unpleasant consequences.
Protecting yourself from acute respiratory viral infections and acute respiratory infections means:
ARVI or acute respiratory infections in people with stable immunity usually occur in a mild form and complications are rare. Children and elderly people remain more vulnerable.
If the disease is not treated in time and the existing symptoms are not eliminated, then relapses, complications, and the transition of an existing infectious disease of the upper respiratory tract to the chronic stage are possible.
Inflammatory process upon penetration into more deep tissue the body has a negative impact on cardiovascular system, liver and kidneys. Maybe myocarditis, pericarditis or pneumonia.
They are at risk of developing chronic pathology people with weakened immune systems, HIV-positive people.
Bronchitis and pneumonia caused by bacteria and viruses are dangerous, when damage to both lungs at once can lead to death.
Even severe intoxication of the body and a high temperature that does not subside for a long time can cause death. Flu with severe course lead to meningitis and encephalitis - no less dangerous ailments.
It is important to learn to distinguish acute respiratory infections from acute respiratory viral infections and influenza. If symptoms appear increasing, do not subside, and additional symptoms appear unpleasant signs, then it is better not to delay contacting a doctor.
Only a specialist, based on the diagnostic tests performed, will prescribe the correct and complex treatment to avoid serious complications. Consequences from common cold can be quite heavy.
