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Causes, symptoms and treatment of acute bronchitis

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The problem of acute bronchitis is not completely solved even with modern achievements of medical science. Still continue to register new cases, both among adults and among children. Despite the ease of diagnosis of the disease and the presence of a powerful Arsenal of drugs to combat it, still there are difficulties with the full disposal of patients from acute bronchitis. As a result, chronic process or its more severe form, and bronchopneumonia. Therefore, the discussion of the peculiarities of bronchitis will never lose its relevance.


Symptoms of acute bronchitis

Clinical manifestations of the disease are characterized by fairly good specificity. Properly conducted differential diagnosis of complaints, symptoms and data of objective research of the patient helps establish the correct diagnosis within a few minutes.

To indicate acute bronchitis can:

  • Dry cough. Characteristic of the initial stages of the inflammatory process in the bronchi. Its duration may be different and depends on many factors. In typical cases of dry cough in acute bronchitis lasts 4-5 days and is triggered by inhalation of air. Special his nadeznosti observed at the extremes of high and low temperatures;

  • Wet cough. The emergence of a productive cough with acute bronchitis, marks the second phase of the inflammatory process in the bronchi. Thus during the attack of cough, expectorated a transparent slimy or yellowish-green sputum. Such a cough lasts for about a week and occurs spontaneously as the accumulation of phlegm in the bronchi, especially in the morning;

  • Hyperthermic reaction. Usually proceeds as subfebrile temperature (about 38°C). The presence of higher numbers should always guard against pneumonia;

  • General weakness, sweating, and malaise. Are signs of intoxication and expressed the more, the more active inflammatory process in the bronchial tree;

  • Shortness of breath and reduced physicalactivity. Join with the progression of respiratory failure and always indicate severe bronchitis or complications;

  • Wheezing auscultation. In the initial stages of the process they are usually dry and rough against the background of harsh breathing. As the expectoration of sputum during a cough listen to the wheezing become wet it is large and srednepuzyrchatye. The appearance of finely krepitiruyuschie or wheezing should always guard against pneumonia.

  • The Central symptom of acute bronchitis is a cough. Around this symptom is based diagnosis of the disease. Acute process characterized sudden onset and complete resolution of symptoms over 2-3 weeks. Otherwise, we have to talk about retidiviruuschem or chronic process.


    Causes of acute bronchitis

    In the event of acute bronchitis, the main role of the microbial factor and the individual features of the bronchial tree of each person.

    As causal factors of acute bronchitis include:

    1. Colds and the common cold. On the background of sharply reduced protective properties of the organism;

    2. Bacterial infection: staphylococci, streptococci, pneumococci, Haemophilus influenzae, coli, Moraxella and other pathogens;

    3. The viral infection. Any respiratory viruses (influenza, parainfluenza, adenovirus, respiratory syncytial virus) can cause damage to the bronchial mucosa. At the same time on damaged epithelium aktiviziruyutsya pathogenic bacteria;

    4. Immunodeficiency States primary and secondary origin.

    5. Long bronchial tree with his thin clearance. It interferes with the normal drainage of the mucus that ends their inflammation in any contact with infection.

    Acute bronchitis in children

    The child's body is considered to be initially more receptive to the possibility of the development of any form of bronchitis.

    This is due to anatomical and physiological features:

    1. The imperfection of the immune mechanisms of antimicrobial protection;

    2. Anatomical features of the bronchial tree in children, creating obstacles to the outflow of a sputum;

    3. Imperfection mukotiliarnogo clearance. The result of this particular is becoming a tendency to increased formation of phlegm in the inability of the cilia on the surface of the cylindrical epithelium of the mucous withdraw it ;

    4. Constant contact of the child with bacterial and viral pathogens circulating in children's groups;

    5. The increased reactivity of the smooth muscle component of the bronchial wall, which causes spasm and narrowing of the lumen of the respiratory tract.

    Usually, bronchitis in children is more durable and heavier than in adults. The younger the child, the more dangerous it becomes bronchitis. This is due to his frequent passage in the form of obstructive or prolonged, relapsing course up to 3 or 5 years, until a persistent adjustment of the immune system and the anatomical features of the bronchial tubes.

    With regard to the clinical features of bronchitis in children, there are also some differences from adults. Children has not only cough, but the symptoms of intoxication. The child becomes lethargic, high temperature, refuses to eat and drink. In the most severe cases, with symptoms of bronchial obstruction occurs, severe shortness of breath with difficulty breathing and gurgling, whistling rales. Children of older age groups with the course of bronchitis face much less.


    Treatment of acute bronchitis

    Modern trends in the treatment of acute bronchitis not particularly different from those that were adopted earlier. Only changed views on ways of summing up the drugs to the inflamed bronchi. If earlier the basic attention was given to pills and injections, today for these purposes, used inhalation. Creating special devices (nebulizers) made it possible to grind liquid dosage forms to the smallest dispersed particles, allowing them to penetrate into the lumen of the smallest structures of the bronchial tree.

    With the purpose of treatment using such groups of drugs:

    1. Expectorants. It may be a shortening of sputum (NAC – NAC), drugs that enhance the work mukotiliarnogo apparatus (Lasolvan, Bromhexine, flamed) or herbal preparations (best, plantain syrup, prospan, alteyka);

    2. Drugs for cough (pour, spray Aqua Maris., bro-zedex, trayfed). They are assigned in the first stage of acute bronchitis for the relief of dry hacking cough. It is not necessary to apply them with a wet cough;

    3. Bronchodilators – drugs to expansion of bronchial lumen. Shown only in the presence of symptoms of bronchial obstruction. Used aminophylline, theophylline, salbutamol, ventolin, flixotide. Intravenous aminophylline may be administered only. Do not be afraid to use any of these means even in the pediatric practice only because of the possibility of addiction or side effects. Sometimes, even a single inhalation of them nebulizer almost completely eliminate the symptoms of bronchial obstruction;

    4. Detoxification therapy (infusions, vitamin preparations). Often assigned to young children, but can be displayed and adults.

    5. Antibiotics for acute bronchitis. The appropriateness in the prescription of antibiotics for acute bronchitis occurs when the apparent problems with the immune system, high body temperature, severe signs of intoxication or respiratory failure, the expectoration Muco-purulent expectoration, protracted course of bronchitis, bronchitis in children. Everything is solved individually and only to the attending physician. In all doubtful cases it is better to prescribe a prophylactic dose sparing of antibiotics than to wait for the weight of the patient.

    The major groups of antibacterial drugs is given in the form of a table:

    Antibacterial agents with strong antimicrobial effects. Assigned as drugs of choice, both independently and in combination with other antibiotics. Available only in the form of some dosage forms (tablets or powder for injection) with the exception of cefuroxime.

    Group of drugs

    Representatives

    Application features

    Semisynthetic aminopenicillin

    Unprotected: ospamox, flemoksin, geramox, amoxicillin

    The first-line drugs with broad spectrum of activity against pathogens of bronchitis. Protected drugs are more resistant to microbial beta-lactamase. Used in Pediatrics and adults. There are all forms of release that allows you to change the ways of introduction of drugs in different phases of the disease.

    Protected: Amoxiclav, Augmentin, flemoklav

    Cephalosporins

    Cefazolin, Cefotaxime, Ceftriaxone (noraxon, madkson, emcef), cefoperazone, cefixime, cefuroxime (zinacef), cefepime (maxipim)

    Macrolides

    Clarithromycin (macropen, klacid, fromilid), spiramycin (rovamycin)

    Create a very high concentration in bronchial mucus. Are not only in usual but also in atypical pathogens for bronchitis. Available only in tablet form.

    Azithromycin (Sumamed, zomax, aziwok, satin)

    A great alternative to any antimicrobial drug in case of its inefficiency or intolerance. Taken once a day. There are all dosage forms. No limit for admission to paediatric practice. It is acceptable to use as the drug of choice for bronchitis.

    Fluoroquinolones

    Ciprofloxacin, levofloxacin (replacin, glevo), Gatifloxacin (gatejel, gfimax), moxifloxacin (Avelox)

    In most of the cases shown in severe bronchitis, both independently and in combination with aminopenicillins or cephalosporins. Possess potent and broad antibacterial spectrum. Contraindicated for use in pediatric patients.

    Aminoglycosides

    Amikacin, gentamicin

    There are only a tablet form. Good and wide enough antibacterial effect allows you to use them as a primary or alternative drug for bronchitis


    List of antibiotics: Antibiotics for bronchitis in adults and children


    Antibacterial therapy for bronchitis is a specific section in the treatment of this disease. Assign to a specific antibiotic and its dosage can only a subject matter expert. Uncontrolled use of such drugs can result in severe effects and development of resistance of microorganisms to antibacterial agents. This will aggravate the disease and will hinder the subsequent selection of an effective antibiotic.