Application of a herbal preparation in the therapy of acute tonzillopharyngitis in children

Introduction. Tonsillopharyngitis often accompanies the course of acute respiratory infections in children (up to 12-15%). The use of systemic antibacterial drugs for viral etiology of the disease has not been shown, therefore, the interest of researchers in the use of herbal products is increasing. In numerous clinical trials conducted around the world, the liquid extract of the roots of Pelargonium sidoides EPs® 7630 has been shown to be effective and safe in the treatment of acute respiratory infections, acute tonsillopharyngitis, rhinosinusitis, acute bronchitis in adults and children.Objective of the study: assessment of the efficacy and safety of the drug EPs® 7630 (Umckalor) in acute tonsillopharyngitis of non-streptococcal etiology in children 2-6 years old on an outpatient basis.Materials and methods. A prospective analysis of cases of treatment with Umckalor for acute tonsillopharyngitis of non-streptococcal etiology against the background of acute respiratory infection in children 2-6 years old (n = 23, group 1) was carried out.The comparison group (2) consisted of children receiving standard therapy (n = 22). Systemic antibiotics and antiviral drugs were not used in all patients. The study was conducted over 6 months (2019-2020). The research results were processed using the Statistica 7.0 software (StatSoft, USA).Results and discussion. Therapy with Umckalor in children with acute tonsillopharyngitis contributed to the elimination of the main clinical symptoms of the disease on the 4th day of treatment (efficiency was 69.9%, p < 0.05). The most persistent symptom was hyperemia of the tonsils and oropharynx. The period of convalescence occurred 2 days earlier than in the children of group 2 (p < 0.05). Umckalor was well tolerated, no side effects of the drug were identified.Conclusions. The drug Umckalor can be recommended for monotherapy for 7 days in patients with acute non-streptococcal tonsillopharyngitis on an outpatient basis with mild and moderate disease.

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Recurrent bronchitis as a clinical variant of functional changes of the respiratory system in children

Pediatrician (St Petersburg) ◽

10.17816/ped8544-48 ◽

2017 ◽

Vol 8 (5) ◽

pp. 44-48 ◽

Cited By ~ 2

Author(s):

Zoia V. Nesterenko

Keyword(s):

Connective Tissue ◽

Clinical Symptoms ◽

Respiratory Infections ◽

Acute Bronchitis ◽

Preschool Age ◽

Careful Examination ◽

Bronchial Obstruction ◽

Connective Tissue Disorders ◽

Functional Changes ◽

Close Relationship

Background. The high prevalence of acute respiratory infections in children, recurrent episodes of acute bronchitis remain to be one of the hot topics of pediatrics. The causes of recurrent exacerbations of bronchitis in children, despite the numerous research works on this issue, are not completely clear. Aim: to study the features of the clinic in children with recurrent bronchitis. Methods. There were 58 patients aged 3 to 12 years with recurrent bronchitis. A study demonstrated the close relationship between recurrent episodes of acute bronchitis not only with pre-preschool and preschool age (when bronchopulmonary tissue is not completely differentiated), with the influence of negative environmental factors, with bacterial, viral infection, but also with signs of connective tissue disorders (CTD) in them. Results. Revealing connective tissue insufficiency explains the causes of disorders of bronchial cartilage and connective tissue, that lead to the development of bronchial dyskinesia thus exacerbating the vulnerability of immature bronchopulmonary tissue along with autonomic dysfunction, typical for CTD. Involvement of several organs and systems in the CTD process changes the course of clinical symptoms of recurrent bronchitis. Probably by the main differentiation of tissues of organs at this age, including connective tissue, can be explained the fact that in 2/3 of the children observed by the age of 7 the manifestations of exacerbations of the disease ceased. In the half of the patients with recurrent episodes, who had bronchial obstruction in the first year of life, a allergy history, paroxysms of respiratory dyspnoea after an additional examination, – asthma was diagnosed; in one patient an aneurysm of the lung vessels was revealed. Conclusions. Basing on the conducted study, the use of the term “recurrent bronchitis” is advisable in children of the first seven years of life. In patients with continuing episodes of bronchitis bronchopulmonary pathology should be excluded; in patients with allergy history and symptoms of bronchial obstruction, spasmodic cough in previous episodes of bronchitis asthma should be excluded. The presence of symptoms of connective tissue disorders in children with recurrent bronchitis requires a careful examination of patients for the detection of comorbid diseases.

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Chronic Periodontitis and Acute Respiratory Infections: A Nationwide Cohort Study

Applied Sciences ◽

10.3390/app11209493 ◽

2021 ◽

Vol 11 (20) ◽

pp. 9493

Author(s):

Jae-Hong Lee ◽

Seong-Nyum Jeong

Keyword(s):

Cohort Study ◽

Chronic Periodontitis ◽

Respiratory Infections ◽

Smoking Status ◽

Acute Bronchitis ◽

National Sample ◽

Population Based ◽

Acute Respiratory Infections ◽

Acute Tonsillitis ◽

Sociodemographic Variables

Chronic periodontitis (CP) may increase the risk of exacerbation of and hospitalization for respiratory infections. The aim of the present study was to determine whether CP is associated with acute respiratory infections by analyzing a population-based longitudinal database from the National Health Insurance Service—National Sample Cohort. Univariate and multivariate logistic regression analyses were conducted to assess the association between CP and acute respiratory infections, including acute nasopharyngitis, acute pharyngitis, acute tonsillitis, acute laryngitis and tracheitis, acute bronchitis, and acute bronchiolitis, while adjusting for the confounding effects of sociodemographic variables (sex, age, household income, and smoking status) and comorbidities (diabetes mellitus). Among 545,416 recruited participants, 98,490 (18.1%) had CP. Multivariate analysis, adjusted for sociodemographic variables and comorbidities, showed that except influenza and pneumonia, total acute respiratory infections (odds ratio (OR), 1.33; 95% confidence interval (CI), 1.28–1.38; p < 0.001), acute upper respiratory infections (OR, 1.26; 95% CI, 1.22–1.29; p < 0.001), and acute lower respiratory infections (OR, 1.23; 95% CI, 1.20–1.26; p < 0.001) were significantly associated with CP. The findings of the current cohort study suggest an association between CP and acute respiratory infections. Particularly, CP seems to increase the risk of acute upper and lower respiratory infections.

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Place of combination drugs in the therapy of acute bronchitis in children

Medical Council ◽

10.21518/2079-701x-2020-10-42-47 ◽

2020 ◽

pp. 42-47

Author(s):

N. G. Kolosova ◽

I. V. Grebeneva ◽

V. D. Denisova ◽

E. M. Maksimova

Keyword(s):

Respiratory Tract ◽

Respiratory Infections ◽

Acute Bronchitis ◽

Influenza Viruses ◽

Human Bocavirus ◽

Acute Respiratory Infections ◽

Protective Function ◽

Nonproductive Cough ◽

Combination Drugs ◽

Tract Infections

Acute respiratory tract infections accompanied by cough play a significant role in respiratory pathology in childhood. The incidence of acute respiratory infections among children is 4–5 times higher than among the adult population and accounts for more than 90% of all infectious and parasitic diseases registered in Russia. The highest rates of acute respiratory infections are observed among children of preschool age, especially in the first three years of life. As in adults, children’s cough, described as a symptom of «upper respiratory infection» or «acute bronchitis», is the most commonly diagnosed acute manifestation in primary care. These 2 diagnoses represent 75% of all cough cases. The most common etiological agents in acute bronchitis are respiratory viruses: adenovirus, influenza viruses and parainfluenza viruses, respiratory syncytial virus, rhinovirus, human Bocavirus, Coxsackievirus, herpes simplex virus, etc. Drug therapy for coughing is prescribed when there is a nonproductive cough that does not perform its protective function, meaning it does not contribute to the purification of the respiratory tract, and is aimed at dilution of sputum, reducing its adhesiveness (viscosity) and thus increase the effectiveness of coughing. The main groups of mucoactive drugs that are usually considered in this case are mucolytics, mucoregulators, mucokinetics, expectorants, and combination drugs. Combination drugs created to eliminate various elements of pathogenesis of respiratory diseases, accompanied by a nonproductive cough and bronchoobstruction, deserve close attention due to the possibility of using several active substances in fixed drug combinations with accurate dosages and proven clinical effectiveness, reducing the number of simultaneously taken drugs, reducing the risk of developing undesirable events. Oral administration of combined medicines becomes especially important in conditions when inhalation therapy is impossible.

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Pneumonia and respiratory tract infections

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0081 ◽

2017 ◽

pp. 621-628

Author(s):

Adamantia Liapikou ◽

Antoni Torres

Keyword(s):

Clinical Symptoms ◽

Respiratory Infections ◽

Functional Decline ◽

Primary Source ◽

Acute Bronchitis ◽

Altered Mental Status ◽

Community Acquired Pneumonia ◽

Antimicrobial Treatment ◽

Poor Functional Status ◽

Tract Infections

Acute lower respiratory infections, such as acute bronchitis and pneumonia, are a leading cause of death worldwide and a primary source of morbidity and mortality in older adults. Clinically, elderly patients with community-acquired pneumonia often have non-specific clinical symptoms, altered mental status, or subtle functional decline, making an accurate diagnosis and early antimicrobial treatment difficult, and further worsening the prognosis. Older frail patients living in nursing homes have a high frequency of aspiration pneumonia caused by gram-negative bacilli and anaerobic pathogens. Over the last few years there has been a controversy over whether the higher mortality of pneumonia is due to inappropriate therapy or the poor functional status of these patients. Prevention strategies of respiratory infections in older people include the prevention and management of aspiration, reduction in the use of neuroleptic medication, influenza vaccination, and possibly the use of the newer antiviral drugs.

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Human Coronaviruses HCoV-NL63 and HCoV-HKU1 in Hospitalized Children with Acute Respiratory Infections in Beijing, China

Advances in Virology ◽

10.1155/2011/129134 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Li-Jin Cui ◽

Chen Zhang ◽

Ting Zhang ◽

Rou-Jian Lu ◽

Zheng-De Xie ◽

...

Keyword(s):

Clinical Symptoms ◽

Respiratory Infections ◽

Hospitalized Children ◽

Acute Respiratory Infections ◽

Rt Pcr ◽

Nucleoprotein Gene ◽

Phylogenetic Studies ◽

Syncytial Virus ◽

Human Coronaviruses ◽

Beijing China

The human coronaviruses (HCoVs) HCoV-NL63 and HCoV-HKU1 are two recently discovered coronaviruses that circulate widely and are associated with acute respiratory infections (ARI). We detected HCoV-NL63 and HCoV-HKU1 in specimens collected from May 2008 to March 2010 from patients with ARI aged <7.75 years of age attending the Beijing Children's Hospital. Thirty-two (8.4%) and 57 (14.9%) of 382 specimens tested positive for HCoV-NL63 and HCoV-HKU1, respectively, by real-time RT-PCR. Use of a Luminex xTAG RVP Fast kit showed that coinfection with respiratory syncytial virus and parainfluenza 3 virus was common among patients infected with either virus type. In HCoV-HKU1-infected patients, the predominant clinical symptoms were cough, fever, and expectoration. In HCoV-NL63-infected patients they were cough, fever, and rhinorrhea. Phylogenetic studies showed that the HCoV-HKU1 nucleoprotein gene was relatively conserved compared to NCBI reference sequences, while the 1ab gene of HCoV-NL63 showed more variation.

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Prevention of dysbiosis and antibiotic-associated diarrhea in children with acute respiratory infections after antibiotic therapy

Russian Medical Inquiry ◽

10.32364/2587-6821-2021-5-11-712-720 ◽

2021 ◽

Vol 5 (11) ◽

pp. 712-720

Author(s):

L.N. Mazankova ◽

◽

S.G. Perlovskaya ◽

M.D. Ardatskaya ◽

A.A. Korsunskiy ◽

...

Keyword(s):

Fatty Acids ◽

Antibiotic Therapy ◽

Respiratory Infections ◽

Short Chain Fatty Acids ◽

Short Chain ◽

Acute Respiratory Infections ◽

Antibiotic Associated Diarrhea ◽

Group 3 ◽

Group 2 ◽

Group 1

Aim: to develop a method of dysbiotic abnormality prevention after antibiotic therapy (ABT) in early childhood. Patients and Methods: the study enrolled 90 children aged 12–60 months who were admitted to the hospital with complicated acute respiratory infections (ARIs) and received ABT. The children were randomized into three groups (each comprised of 30 children). The children received either a probiotic with Lactobacillus rhamnosus GG and Bifidobacterium BB-12 (group 1) or a cytomucoprotector, gelatin tannate (group 2) to prevent antibiotic-associated diarrhea (AAD). Group 3 children received ABT only. To assess microbiocenosis, short-chain fatty acids (SCFAs) in stool were measured by gas-liquid chromatography. Results: AAD was reported in 23.3% of group 1 children, 17% of group 2 children, and 46.7% of group 3 children (p=0.03). In group 2, the duration of diarrhea was significantly lower. Baseline stool concentration of SCFAs was 2.5-times lower compared to normal ranges. Further reduction in the total absolute level of SCFAs was reported in group 3 after treatment. An increase in total SCFA level, a significant increase in the relative amounts of acetic acid, and a reduction in propionic acid and (to a lesser degree) butyric acid were reported in groups 1 and 2 compared to group 3. Conclusions: an improvement in stool SCFA levels was reported in group 1 and 2 children who received probiotics or cytomucoprotector. Incorporation of these medications and ABT in the complex treatment for ARIs in children stabilized metabolic activity of microbiota through preserving the pool of indigenous microorganisms producing butyrate. KEYWORDS: antibiotic, antibiotic-associated diarrhea, acute respiratory viral infections, microbiota, short-chain fatty acids, probiotic, gelatin tannate. FOR CITATION: Mazankova L.N., Perlovskaya S.G., Ardatskaya M.D. et al. Prevention of dysbiosis and antibiotic-associated diarrhea in children with acute respiratory infections after antibiotic therapy. Russian Medical Inquiry. 2021;5(11):712–720 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-712-720.

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Outpatient Management of Acute Respiratory Infections in Children

Педиатрическая фармакология ◽

10.15690/pf.v18i5.2298 ◽

2021 ◽

pp. 363-370

Author(s):

Radima A. Mukozheva ◽

Tatyana V. Kulichenko ◽

Tatyana V. Vilchanskaya ◽

Mariya A. Lazareva ◽

Olga V. Romanova ◽

...

Keyword(s):

Viral Infection ◽

Russian Federation ◽

Antibacterial Therapy ◽

Respiratory Infections ◽

Acute Bronchitis ◽

Community Acquired Pneumonia ◽

Outpatient Clinics ◽

Acute Respiratory Infections ◽

Acute Respiratory Viral Infection ◽

Tract Infections

Background. Antimicrobial resistance is one of the most crucial problems in human health care worldwide. The main cause of this crisis is the excessive and misuse of antibacterial drugs (ADs). The highest rate of improper antibiotics' prescriptions in pediatric practice is observed at treatment of respiratory tract infections in outpatient clinics. Objective. The aim of the study is to analyze the clinical practice of management of patients with acute respiratory infections (ARI) and the use of ADs in children's outpatient clinics across the regions of Russian Federation. Methods. Multicenter retrospective study was conducted. All ARI cases documented in 969 medical records (form 112/y) of children born in 2015–2017 yy. in 16 regions of Russian Federation (selected randomly) were analyzed. Results. Acute viral infection was diagnosed in 79.6% cases of referencing to doctor with ARI symptoms. Systemic ADs were prescribed in 23% cases of ARI. Antibacterial therapy was received by 14% of children diagnosed with acute respiratory viral infection, 35% with acute laryngotracheitis, 80% with acute bronchitis, 76% with acute rhinosinusitis, 94% with ARI associated with otitis media, 52% with tonsillopharyngitis, and 100% with community-acquired pneumonia. Amoxicillin (35%), amoxicillin/clavulanic acid (24%), azithromycin (20.2%) were prescribed most often. Parenteral administration of ADs was prescribed in 3.9% of cases, mostly for children with community-acquired pneumonia. Prescribed antibacterial therapy was unreasonable in 84% of analyzed cases. Polypragmasy occurred in 50.5% of cases. Clinical protocols violations were mostly common for management of patients with laryngotracheitis and tonsillopharyngitis. Conclusion. There is favorable trend towards the decrease in ADs prescribing frequency in outpatient clinics for children with ARI. Thus, polypragmasy and irrational choice of antibacterial therapy frequency remains quite high.

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Improving antibiotic prescribing for acute bronchitis in the ambulatory setting using a multifaceted approach

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.164 ◽

2021 ◽

pp. 1-3

Author(s):

Philip Chung ◽

Regina Nailon ◽

M. Salman Ashraf ◽

Scott Bergman ◽

Teresa Micheels ◽

...

Keyword(s):

Primary Care ◽

Respiratory Infections ◽

Acute Bronchitis ◽

Outpatient Setting ◽

Ambulatory Setting ◽

Antibiotic Prescribing ◽

Acute Respiratory Infections ◽

Multifaceted Approach ◽

Primary Care Clinics ◽

Absolute Reduction

Abstract Antibiotics are frequently prescribed inappropriately for acute respiratory infections in the outpatient setting. We report the implementation of a multifaceted outpatient antimicrobial stewardship initiative resulting in a 12.3% absolute reduction of antibiotic prescribing for acute bronchitis in primary care clinics receiving active interventions.

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Clinical presentation of flu coinfections in children

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-11-665-669 ◽

2020 ◽

Vol 4 (11) ◽

pp. 665-669

Author(s):

S.V. Nikolaeva ◽

◽

D.V. Usenko ◽

S.V. Shabalina ◽

Yu.N. Khlypovka ◽

...

Keyword(s):

Hospital Admission ◽

Clinical Presentation ◽

Clinical Laboratory ◽

Respiratory Infections ◽

Clinical Manifestations ◽

Infusion Therapy ◽

Acute Respiratory Infections ◽

Group 2 ◽

Syncytial Virus ◽

Group 1

Aim: to identify the clinical laboratory features of coinfection with flu and other respiratory viral infections. Patients and Methods: case records (inpatient files) of 139 children aged 2 months — 18 years who were admitted to Moscow hospitals from October 2017 to February 2020 with the clinical manifestations of acute respiratory infections (ARI) were analyzed. All children were divided into two groups. Group 1 included children with coexisted flu and other ARI (n=31). Group 2 included children with flu alone (n=108). The etiology of ARI was discovered by polymerase chain reaction (oral or nasal smears and/or discharge, sputum) and enzyme immunoassay (antibodies to herpesvirus type 1, 2, and 6, cytomegalovirus, Epstein-Barr virus, Chlamydia, and Mycoplasma). Results: respiratory syncytial virus and rhinovirus were the most common viruses coexisted with flu (8/31 and 5/31, respectively). The onset of ARI occurred 2.60±1.6 days before hospital admission in group 1 and 3.35±1.72 days before hospital admission in group 2 (p>0.05). In group 1, febrile temperature lasted for 4.72±1.25 days that is almost 2 days longer than in group 2 (p<0.01). The rate of complications in coinfection with flu and ARI vs. flu alone was different, i.e., acute (catarrhal, medium) otitis was diagnosed in 35.5% and 8.3.% (p<0.01), respectively, acute sinusitis in 12.9% and 8.3%, respectively, and pneumonia in 22.6% and 7.4%, respectively. Conclusion: in children, coinfection with flu and other respiratory virus is generally more severe as demonstrated by higher temperature, more severe intoxication symptoms, more common complications (e.g., otitis, sinusitis, pneumonia etc.), and a greater need in infusion therapy. Co-infected children are admitted to hospital more rapidly and stay in hospital for a longer period. KEYWORDS: acute respiratory infections, flu, rhinovirus, children, fever, intoxication, severity. FOR CITATION: Nikolaeva S.V., Usenko D.V., Shabalina S.V. et al. Clinical presentation of flu coinfections in children. Russian Medical Inquiry. 2020;4(11):665–669. DOI: 10.32364/2587-6821-2020-4-11-665-669.

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Are functional gastrointestinal disorders a clinically significant comorbid factor for acute respiratory infection in children?

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2020-48-020 ◽

2020 ◽

Vol 48 (4) ◽

pp. 231-239

Author(s):

E. R. Meskina ◽

M. K. Khadisova

Keyword(s):

Clinical Symptoms ◽

Respiratory Infections ◽

Past History ◽

Functional Gastrointestinal Disorders ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Resistance Index ◽

Gastrointestinal Disorders ◽

Acute Respiratory Infections ◽

Tract Infections

Rationale: Functional gastrointestinal disorders (FGID) are highly prevalent in children worldwide. Current concept of FGID pathophysiology implies contributions from various mechanisms. Information in the role of acute respiratory infections in the development of FGID in children is lacking.Aim: To determine the prevalence of FGID in children hospitalized to the department of infectious diseases with acute respiratory tract infections (ARTI) and their association with demographic, medical biological factors and clinical manifestations.Materials and methods: We performed observational and cross-sectional study with continuous patient sampling. The study included 180 ARTI patients, whose mothers agreed to fill in the proposed questionnaire of 41 items. The diagnosis of FGID during in-hospital stay was made based on clinical data in accordance with the Rome criteria IV (2016) and by standard collection of the information from the parents. The stool characteristics were assessed with the Bristol scale. The rate of recurrent ARTI was assessed by the resistance index of above 0.5. We considered clinical symptoms of ARTI at the admittance, the rates of bacterial complications and the need in antibacterial treatment.Results: The prevalence of FGID in hospitalized children with ARTI below 4 years of age (n = 134) was 35.1% (95% confidence interval [CI]) 27.0– 43.9); they had higher rates of functional diarrhea (14.9%, 95% CI 9.4–22.1) and constipation (14.2%, 95% CI 8.8–21.3). Among those above 4 years of age (n = 46), FGID were diagnosed in 50% (95% CI 34.9–65.1) of the cases; with most frequent symptoms being abdominal pain (39.1%, 95% CI 25.1–54.6) and irritable bowel syndrome (10.8%). Irrespective of their age, the children with FGID had higher rates of ARTI recurrence (by 34.0%, 95% CI 20.0–48.1; relative risk 1.98, 95% CI 1.47–2.69; odds ratio 4.13, 95% CI 2.18–7.85) and intestinal infections in their past history, compared to those without any gastrointestinal symptoms during the index hospitalization. In children with FGID, ARTI were more frequently complicated by otitis and they had higher requirement in antibiotics. The mothers of the infants and toddlers with FGID had lower educational level (smaller proportion of those with high school education) and were less satisfied with their home and living conditions, whereas their fathers were older and more frequently employed in vehicle operations and less frequently were occupied in communication-related professions.Conclusion: Acute respiratory infections, especially recurring, may plaу a significant role in the development and maintenance of FGID in children. Further studies are necessary, which may result in useful information for the development of tailored strategies to treatment and prevention.

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