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Antibiotics for bronchitis in adults and children

Bronchitis is an inflammatory disease of the bronchial tubes, which may be caused by the following reasons:

  • Viral infection;
  • Bacterial infection;
  • Mixed infection;
  • Atypical causative agents;
  • Chemical exposure (Smoking, harmful production);
  • Allergic reaction.

In the majority of cases bronchitis acts as a complication of viral colds, so treat it with antibiotics is not only pointless, but dangerous. Antimicrobial medicines are ineffective against the viruses, in addition, they inhibit the immune system and interfere with the body's ability to deal with the threat themselves. The most reasonable tactics in viral bronchitis is bed rest, plentiful drink, warming treatments, intake of Immunostimulants and symptomatic treatment otharcivatmi drugs.

Treatment of bronchitis with antibiotics is appropriate only in two cases:

  • To viral infection bacterial joined, and the body is unable to cope with it for three weeks or more;
  • The disease is chronic, often relapsing or atypical.

Thus, the diagnosis of "bronchitis" in no case does not automatically mean that a person needs to be treated with antibiotics. Without a thorough examination and determine the cause of the disease any medication can not be assigned, especially to themselves. Depending on the type of bronchitis, a qualified specialist will choose the best option for drug therapy.


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Types of bronchitis

Acute bronchitis

This term refers to an inflammatory process in the bronchi, arisingamid seasonal cold or flu. Virus attack is a serious blow to the immune system that rush to take advantage of living in almost any body of bacteria: staphylococci, pneumococci, streptococci. They multiply in bronchi and cause first bouts of painful dry cough, and then the stagnation of viscous mucus which is difficult to get rid of.

Before resorting to extreme measures, you should try to help the patient cope with the bronchitis on your own, using rest, plentiful drink and symptomatic treatment of cough preparations (Pour, Libeksin), expectorants (Bromhexine, Lasolvan) and treatments (inhalations, mustard, rubbing). Of course, with the fever warming impact is unacceptable. Acute bronchitis usually goes away within two weeks.

Treatment of acute bronchitis with antibiotics are shown in the following cases:

  • Cough lasts more than three weeks in a row;

  • The patient is kept subfebrile or febrile body temperature (37,5-38,5 C);

  • Expectoration of opaque, yellow-green, interspersed with bloody, fetid;

  • There are signs of strong intoxication (nausea, loose stools, gray complexion, weakness, profuse sweating);

  • Blood tests show leukocytosis, high erythrocyte sedimentation rate and a shift formula to the right;
  • The patient complains of chest pain;
  • When breathing she could hear a distinct wheezing and visible intercostal retraction.

Chronic bronchitis

Is considered chronic bronchitis, which lasted together for more than three months for two years. This disease is accompanied by severe cough with abundant expectoration of bronchial mucus, poorly to symptomatic treatment and recurs at the first weakening of the immune system. Most dangerous is chronic obstructive bronchitis and chronic bronchitis of the smoker – these diseases often provoke the development of lung cancer. Allergic and asthmatic chronic bronchitis also requires special attention because of risk of suffocation.

The treatment of such complex diseases is a topic for another conversation, and today, we will discuss antibiotics. It is advisable to appoint patients (especially the elderly and very young) who have any hypothermia is wrapped in a new outbreak of chronic bronchitis. The reason lies in a weakened immune system andnumerous colonies of bacteria lurking in the bronchi. With antibiotics should be applied in this hotbed of pre-emptive strike to the common cold becoming, once again, in a multi-day nightmare.

Atypical bronchitis

In very rare cases, bronchitis cause anaerobic pathogens, such as chlamydia or Mycoplasma. Atypical bronchitis occurs in people with weak immune systems, the elderly, recently undergone another serious infectious disease. Deceit anaerobic microorganisms lies in their incredible durability, resistance to many antibiotics and consistent, but very slow destructive effect on the respiratory system.

People suffering from atypical bronchitis, usually do not go to the doctor. Slight fever, moderate cough, sputum little. But over time, it gets worse: increase chest pain and muscle weakness, intoxication. Before a patient is finally going to visit doctor and pass the tests, the worse, because the fight against anaerobic pathogens, even considering the power of modern antibiotics, it takes months.


Treatment for bronchitis in adults

Depending on the type of bronchitis, the treatment is as follows:

  • Acute viral bronchitis is bed rest, drinking plenty of fluids, immune and symptomatic treatment, refusal of antibiotics;
  • Uncomplicated chronic bronchitis (less than four relapses per year) – antibiotics from the group aminopenicillins or macrolides (in case of intolerance to penicillins);
  • Complicated chronic bronchitis (more than four relapses per year, patient age older than 65 years) – aminopenicillins, cephalosporins, macrolides;

  • Chronic bronchitis with concomitant diseases (renal and/or cardiac insufficiency, diabetes) – fluoroquinolones;

  • Mycoplasma bronchitis – macrolides;
  • Chlamydial bronchitis – tetracyclines, fluoroquinolones, macrolides.

List of antibiotics for bronchitis in adults

Modern physicians prescribe for adult patients with bronchitis following groups of antimicrobial drugs:

Treatment of bronchitis is simple penicillins and sulfonamides currently not possible due to their high toxicity and low efficiency, caused by a mutation of the majority of pathogens.

Aminopenicillin – first-line antibiotics

This group of drugs can destroy the cell membrane of bacteria and thereby cause their death. Aminopenicillin active against pneumococci, streptococci, staphylococci and most other bacteria that cause bronchitis. Why they are considered the first-line antibiotics? Because in human body there are no cells, although any similar structure on the cell membrane of pathogenic bacteria. Thus, aminopenicilline consume only of the agent, and does not injure the healthy tissue.

The penicillins are the best antibiotics to treat bronchitis in adults and children, but even they have two drawbacks:

  • Common side effects such as allergies;

  • Low effectiveness against mutated pathogens that have the enzyme beta-lactamase.

If the first negative point nothing can be done – you have to choose an antibiotic from another group, then the second, scientists have learned to cope. Beta-lactamase, which was acquired in the evolution of some particularly insidious bacteria, destroys penicillin. That is, everything happens exactly, but on the contrary – not the antibiotics kill the bronchitis and bronchitis destroys the antibiotics. To neutralize the enzyme beta-lactamase, to add amoxicillin sulbactam or clavulanate (klavulanova acid). These components are specific inhibitors of beta-lactamases, and therefore, they enter into synergy with penicillins, helping them to fight bacteria.

The result of this discovery began aminopenicilline last generation:

  • Amoxiclav;
  • Flemoksin Soljutab;
  • Augumentin;
  • Ecolaw;
  • Arlet.

The cost of these drugs varies from 50 to 500 rubles, depending on the brand. Keep in mind that the most affordable are the powders and tablets of domestic production, on the package and it says: "amoxicillin + sulbactam or amoxicillin + clavulanic acid.

Macrolides – antibiotics the second row

Drugs in this group inhibit the synthesis of protein in the cells of pathogens, thereby not allowing them to multiply. This approach to the treatment of bronchitis in adults optimal if we are talking about chronic, prolonged, often recurrent disease. Macrolides goodthe fact that they, unlike the penicillins, is able to penetrate the anaerobic microorganisms. This means that the macrolide antibiotics to treat atypical forms of bronchitis caused by chlamydia and Mycoplasma.

Macrolides have a long half-life, accumulate well in tissues and do not need frequent doses. They are usually well tolerated by patients and does not cause side effects even during long-term treatment of bronchitis. If the patient individual intolerance to the antibiotic penicillin, macrolides are the first choice.

Often used for bronchitis macrolides:

  • Erythromycin;
  • Azithromycin;
  • Hemomitsin;
  • Midecamycin.

Erythromycin is a macrolide first generation, which initiated the development of antimicrobial drugs in this group. A better antibiotic, Azithromycin, known by many trade names: Azitral, Azitroks, Sitrus, Asize, Sumamed. Moreover, the cost of packaging of three domestic capsules Azithromycin is 80-120 rubles, while widely advertised branded generics Sumamed is 450-600 rubles.

Fluoroquinolones

Bronchitis treatment with fluoroquinolones is valid only in adult patients, and only in the case of individual intolerance of antibiotics of the first and second row. Fluoroquinolones have a wide spectrum of action, effectively destroying the DNA of bacteria, but very often cause allergies and side effects. Long-term treatment with fluoroquinolones is not possible without supportive therapy aimed at maintaining a healthy microflora of the internal organs, otherwise avoid dysbacteriosis and fungal infections.

For the treatment of bronchitis in adults antibiotics following use of fluoroquinolone:

  • Ofloxacin;
  • Pefloxacin;
  • Ciprofloxacin;
  • Levofloxacin
  • Moxifloxacin.

The cost of the first generation fluoroquinolones, Ofloxacin, penny – 20-30 rubles per pack, the most popular drug of the second generation, Ciprofloxacin (Tsifran, Tsiprolet) is 80-120 rubles, and the third and fourth generation fluoroquinolones (Levofloxacin and Moxifloxacin) – is quite expensive antibiotics (400-1200 rubles).

Cephalosporins

Drugs in this group are considered as reserve antibiotics in the treatment of bronchitis. They can be useful if patient has Allergy to all three of the above groups of drugs, or if you need a complex antibiotic therapy with highly complicated, protracted bronchitis. Cephalosporins act only on growing and breedingbacteria, paralyzing the cell membrane and preventing cell division. These antibiotics cause allergic reactions and dysbiosis almost as often as simple penicillins, and therefore also require maintenance therapy with long-term use.

Treatment of bronchitis in adults by using the following cephalosporin antibiotics:

  • Cefazolin;
  • Cephalexin;
  • Cefixime;
  • The Ceftriaxone.

The cost of the ampoules for injection varies from 10 to 50 rubles apiece, and the drug in capsules (Suprax, Iksim, Panzer) will cost you about 500-1500 rubles.

Which antibiotic works best for bronchitis?

With this sacramental question patients often turn to their physicians and pharmacists pharmacy. The answer is simple – it is best for bronchitis helps the antibiotics to which sensitive is your "culprit" of the disease. To identify the pathogen that caused the disease, we need to take the analysis of bronchial mucus for culture.

For several reasons, bacterial sputum bronchitis is very rare:

  • Sowing ripens 5-7 days, and if the patient is in serious condition, all the time devoid of antibacterial therapy, this may end badly;
  • The bacteriological labs are becoming less and qualified staff, so in terms of modern medicine, you are unlikely to do such an analysis;
  • Aminopenicillin active against almost all possible causes of bronchitis, this means that they will help you regardless of what kind of bacteria caused the disease.

Children's bronchitis: do we need antibiotics?

When the sick baby, parents are willing to pay any money for medications, and rake from the pharmacy literally everything that can help him. Seeing the suffering of children, mothers usually honor do not require a pediatrician appointment of antibacterial drugs, and if he refuses, run for the pills themselves, the blessing, they are released without a prescription. Actually, this is not good and the real evil.

The treatment of infantile bronchitis with antibiotics is almost always counterproductive and here's why:

  • In 99% of cases bronchitis in children is viral in nature and is not complicated by bacterial infection. Strong, youngimmunity to cope with illness alone for 1-2 weeks. The only exceptions are premature babies, and sickly babies under the age of three years;

  • Even in the presence of bacterial infection it is wiser to try to maintain the child's immunity, but not poison his body with antibiotics, on the contrary, lowering defenses and activating other dormant bacteria;
  • Whenever a child receives treatment with antibiotics, it increases the risk of Allergy development and its pathogenic microflora gets acquainted with drugs and adapts to them. In the future this may deprive people of the opportunity to get help when it is really is vital, because some antibiotics he will be allergic, and the other agents are already insensitive.

All this speaks in favor having to do with receiving the immunostimulant (Imudon, Afobazol) and symptomatic therapy (hot drink, inhalation, rubbing, mucolytic agents). It is very important to provide the child with rest and proper diet during illness (read about it below).

Here is a list of reasons that may encourage a pediatrician to appoint a young patient antibiotics for bronchitis:

  • The cough does not stop to three weeks or more;
  • The acquired pathological sputum color and odor;
  • A blood test shows a high leukocytosis and increased erythrocyte sedimentation rate above 20 mm/h;
  • There are wheezing, shortness of breath, intercostal ceasing and chest pain;

  • Fever life threatening (temperature above 39 and falls);

  • There are signs of large-scale intoxication of the organism;
  • The baby is preterm, weak, under the age of three.

Many parents who opposed the child was placed in the hospital for treatment, - they say, he's more than picked up the infection than cure. These fears are unfounded, but still, if the child is very poor, it is better to entrust to specialists.


List of antibiotics for bronchitis in children

Antimicrobial therapy does not negate the other therapeutic measures, but complements them. We still have to comply with bed rest, drink more fluid to do the procedure and take expectorant drugs.

For the treatment of bronchitis in children the following groups of antibiotics:

  • Aminopenicillin;
  • Cephalosporins;
  • Macrolides.

Drugschoices are a Amoxiclav and Augmentin, about the merits of which we described above. In case of intolerance to penicillins will gain cephalosporins: Cephalexin, Cefuroxim, Cefaclor. The treatment of infantile bronchitis with them, especially long, need to accompany the reception of live bacterial cultures (Acipol, Bifidumbacterin, Linex, Bifiform) and vitamin C IV.

Macrolides can save you from a lingering, chronic and atypical bronchitis (Macrolide, Sumamed, Rulid). These antibiotics are good because they penetrate well in all body fluids, including, in the bronchial secretion, which can influence the causative agents of bronchitis most quickly and efficiently.

Modern antibiotics for children are available in accessible and convenient form: in the form of syrups and chewable tablets with a fruity taste. This greatly facilitates the treatment of bronchitis in young patients.


Treatment of bronchitis with antibiotics during pregnancy

The most unpleasant and dangerous that you can imagine during pregnancy is a sudden serious disease, for treatment which medication may be needed to harmful to future child. If a pregnant woman diagnosed with bronchitis, you need to take all measures in order to strengthen her immune system and help to cope with the disease themselves. There are also specific Immunostimulants that protect the fruit itself and have a local impact, for example, rectal and vaginal suppositories Viferon. They are administered depending on what physiological hole closer to the placenta.

If the bronchitis could not stop using symptomatic and immune-stimulating treatment, it is wiser still to use antibiotics, rather than to prevent intoxication and a high leukocytosis at the expectant mother. These factors will affect the fetal development of even more negative than modern antibiotics. Do not forget about the fact that the diaphragm of the pregnant woman squeezed the growing fetus, and this makes it difficult expectoration of bronchial mucus and facilitates, thereby, the growth of the bacteria in the bronchi.

Treatment of bronchitis during pregnancy the following:

  • In the first trimester, when laid all the major systems and organs of the future child, treatment with antibiotics is highly undesirable. But if they can not do, the doctor usually prescribes Amoxicillin flemoksin or another drug from the group aminopenicillins.
  • In the second and third trimester , antibiotics can be prescribed cephalosporin and macrolides;
  • Absolutely impossible to treat bronchitis in pregnant tetracycline andfluoroquinolones;
  • Local antibacterial treatment can be carried out using inhaler Bioparoks – is a modern antibiotic which acts directly on the source of the disease and does not harm the unborn baby.

10 rules of treatment bronchitis antibiotics

In conclusion, let us return to the beginning of our conversation and we emphasize again that to take antibiotics for bronchitis should only be the case if it is really necessary. The appointment of a drug if not a bacterial sputum culture, at least a basic blood test must be submitted. And if there is leukocytosis, and increased number of segmented and band segments of white blood cells and erythrocyte sedimentation rate over 20 mm/h, then the treatment of bronchitis with antibiotics is advisable. But if the cause of the bronchitis is uncomplicated viral infection (as is often the case), a reception of antibacterial drugs pointless and harmful.

  1. Keep a record of which antibiotics you took earlier, and you should report that doctor! The same rule applies to children, parents must provide the pediatrician accurate information about all antibacterial drugs that he was treated to the first visit to this doctor, and whether these remedies were effective, what side-effects they caused, was allergic to them. Objective data on the tolerance on the frequency of use of antibiotics will allow the doctor to select a drug for the treatment of bronchitis, which is most likely to help the patient and will not cause negative effects.

  2. Do not ask the doctor prescribing antibiotics and don't take them yourself! We're in a hurry to quickly recover and think of advertising of drugs it is possible to gather all the necessary information. So when the doctor with bronchitis recommend to put the mustard and drink the tea with honey, we fretful frown and I think that this unqualified expert "old school", which runs from us as soon as possible to get rid of. Then we come to the pharmacy, where the pharmacist helpfully offers a wide range of modern, cool, strong (and of course more expensive) drugs. The result of such treatment is not always a victory over the bronchitis, but almost always we get dysbiosis, allergies and tolerance to antibiotics.

  3. Ask bacteriological analysis of sputum in the absence of improvements! If after 3-5 days since the beginning of neat andtimely taking a prescribed antibiotic in health have not shown any positive changes, be sure to tell your doctor and ask to have your sputum for bacterial culture. Maybe you have an atypical form of bronchitis, or it is caused by bacteria that are resistant to the selected drug.

  4. Strictly follow the dosage, frequency and time of antibiotics! If you are prescribed to take the medicine three times a day, this does not mean that you need to drink a pill during Breakfast, lunch and dinner, or before/after a meal. For the effective treatment of bronchitis with antibiotics is necessary to maintain constant therapeutic blood concentration of the drug. Therefore, if you are prescribed a triple reception means intermittently 8 hours if the four-time – with breaks 4 hours if twice – 12 hours, and if single, then you need to take the pill every day at the same time.

  5. Do not drop the treatment immediately after you feel better! The duration of treatment bronchitis antibiotics depend on the type of drug, and can range from 3 to 14 days, often 5-7 days. These terms are taken not from the ceiling, and are the results of clinical studies on numerous control groups of patients. "Medolechenie"diseases even worse than"retreatment," that is, unnecessary use of antibiotics. What happens in the body of the patient, antimicrobial therapy is interrupted halfway? There remains a colony of bacteria, it is not killed, but merely maimed antibiotic, and familiar with the principle of its action. These agents will survive and pass to his descendants the hereditary genetic information, which in future, a person can develop multi-resistant, untreatable infection.

  6. Avoid treatment interruptions and inconsistent substitutions of antibiotics! Always purchase as many packages of the drug, as you need to pass the full course of treatment bronchitis antibiotics. Absolutely unacceptable the situation, when the right time is pills just do not have the hand and the patient misses taking medicine or takes on the pharmacy of the assigned analogue of the drug because tablets were not on sale. The analogue may be a different composition or dosage of active substance! In extreme cases, call your doctor and consult regarding the selection of the replacement.

  7. Do not change the dosage! Some people in the treatment of bronchitis with antibiotics see signs of Allergy or severe side effects (nausea,vomiting, diarrhea, weakness, dizziness) but nothing to say the doctor, and instead stoically endure suffering just reduce the dosage of the drug, hoping in this way to reduce the severity of unpleasant symptoms. You can't do it in any case! Read about the consequences in section 5. Increase the dosage of antibiotics to cure bronchitis as soon as possible is also impossible, because then certainly not escape the side effects and harmful effects on kidneys and liver.

  8. Take antibiotics correctly! If the instructions say that the medicine need to drink 20 minutes before meals, during meals or an hour after eating, this practice is recommended because each type of antibiotics you need certain conditions for optimal suction and the blood flow. Can also be special instructions about how to take the drug (to swallow the pill or capsule whole, chew, dissolve, hold under tongue) than it is to drink (only water or any other liquid), and how much water need to be taken with the medicine. These recommendations also need to comply with as there are antibiotics, irritating the digestive tract.

  9. Do not neglect supportive therapy! Long-term treatment of bronchitis with antibiotics is almost always accompanied by prophylactic intake of vitamins, probiotics, and fungicides, because without these measures it is difficult to maintain the body's healthy microflora. Disregard the advice of a physician or banal desire to save money can result in a prolonged disorder of the digestive system, stomatitis, beriberi, vaginal candidiasis (thrush) and other unpleasant symptoms. Therefore, it is better to buy and drink any recommended medicine.

  10. Follow any special diet! It is no secret that some very tasty and nourishing food (meats, fried foods, confectionery) represent a heavy burden on the liver. But in the period of treatment bronchitis antibiotics so she has a hard time. About alcohol and say nothing – it not only overloads the kidneys, but also comes with most of the antibiotics in a dangerous interaction. Try during the illness to be as restrained in eating, eat more healthy and easy food (cereals, soups, vegetables) and drink at least two liters of pure water per day. Be healthy!