Effectiveness of protected aminopenicillins in treatment of non-social pneumonia in children

Author(s):  
Е.Е. Краснова ◽  
В.В. Чемоданов ◽  
Е.Г. Кузнецова

Пневмония – острое инфекционно-воспалительное заболевание легких преимущественно бактериальной этиологии, характеризующееся выраженной в разной степени дыхательной недостаточностью, токсическими и респираторными нарушениями, локальными физикальными симптомами, а также инфильтративными изменениями на рентгенограмме. Заболеваемость внебольничными пневмониями повышается в октябре-декабре, достигая максимума в январе-апреле, коррелируя с сезонным повышением уровня острых респираторных вирусных инфекций. Схожесть симптомов дебюта пневмонии с проявлениями острых респираторных вирусных инфекций может привести к несвоевременной ее диагностике и, как следствие, к отсроченному началу лечения. Поэтому в период сезонной заболеваемости респираторными инфекциями должна повышаться настороженность врачей-педиатров в отношении внебольничной пневмонии. Антибактериальная терапия оказывает решающее влияние на прогноз пневмонии, поэтому при достоверном диагнозе или у больного в тяжелом состоянии с вероятным диагнозом ее следует начать незамедлительно. Выбор антибиотика в каждом случае внебольничной пневмонии проводят индивидуально с учетом природной активности препаратов в отношении предполагаемого возбудителя и их возможной приобретенной резистентности, тяжести и течения заболевания, наличия у пациента противопоказаний к использованию тех или иных антибиотиков. В статье приводятся сведения о диагностических критериях внебольничных пневмоний. Рассмотрены вопросы антибактериального лечения типичной нетяжелой пневмонии у детей разных возрастных групп амоксициллином с клавулановой кислотой и показана его эффективность. Результаты проведенного исследования позволяют заключить, что пероральное использование одного курса защищенного аминопенициллина эффективно при лечении типичной внебольничной нетяжелой пневмонии у детей разного возраста, о чем свидетельствует ликвидация основных клинических проявлений болезни в короткие сроки. Pneumonia is an acute infectious and inflammatory lung disease of predominantly bacterial etiology, characterized by respiratory failure, toxic and respiratory disorders, local physical symptoms, and infiltrative changes on the roentgenogram. The incidence of community-acquired pneumonia increases in October-December, reaching a maximum in January-April, correlating with the seasonal increase in the level of acute respiratory viral infections. The similarity of the symptoms of the onset of pneumonia with the manifestations of acute respiratory viral infections can lead to its untimely diagnosis and, as a consequence, to a delayed start of treatment. Therefore, during the period of seasonal morbidity with respiratory infections, the alertness of pediatricians in relation to community-acquired pneumonia should increase. Antibiotic therapy has a decisive influence on the prognosis of pneumonia, therefore, with a reliable diagnosis or in a patient in serious condition with a probable diagnosis, it should be started immediately. The choice of antibiotic in each case of community-acquired pneumonia is carried out individually, taking into account the natural activity of the drugs in relation to the alleged pathogen and their possible acquired resistance, the severity and course of the disease, the patient's contraindications to the use of certain antibiotics. The article provides information on the diagnostic criteria for community-acquired pneumonia. The issues of antibacterial treatment of typical non-severe pneumonia in children of different age groups with amoxicillin with clavulanic acid are considered and its effectiveness is shown. The results of the study allow us to conclude that the oral use of one course of protected aminopenicillin is effective in the treatment of typical community-acquired non-severe pneumonia in children of different ages, as evidenced by the elimination of the main clinical manifestations of the disease in a short time.

2020 ◽  
Author(s):  
Christin L Deal ◽  
Timothy J Thauland ◽  
Rebecca Signer ◽  
Stanley F Nelson ◽  
Hane Lee ◽  
...  

Viral respiratory infections are the most common childhood infection worldwide. However, even common pathogens can have significant consequences in the context of patients with primary immunodeficiency diseases. More than half or viral infections annually are due to rhinovirus/enterovirus strains. Most clinical manifestations of viral infection are mild. However 3% of cases result in hospitalization in patients who have no other known risk factors. These patients may have an inborn error of immunity, a genetic susceptibility to viral infections. Here we present the case of an adult male who suffered respiratory viral infections his whole life and developed chronic, inflammatory damage to sinuses and lungs as a consequence. Genomic sequencing identified compound heterozygous variants in the IFIH1 gene, encoding the protein Melanoma Differentiation Association Protein 5 (MDA5), a RIG-I-like cytoplasmic sensor of RNA intracellular infections. We show a dominant negative effect on these variants on the level of interferon-induced expression of MDA5 protein. This work supports that loss-of-function variants in IFIH1 affect the sensing of viral infections. Underlying genomic variants may dictate the point at which recurrent, respiratory viral infections leave commonplace experience and incur lasting damage.


Author(s):  
I. V. Bakshtanovskaya ◽  
T. F. Stepanova ◽  
G. V. Sharukho ◽  
A. N. Letyushev ◽  
K. B. Stepanova ◽  
...  

The aim of this work was to identify the causative agent of community-acquired pneumonia and coinfection using PCR study of biomaterial from patients.Materials and methods. PCR testing of 268 samples from 258 patients was carried out to identify RNA/DNA of viral and bacterial pathogens of respiratory infections.Results and discussion. In 43.3 % of samples SARS-CoV-2 RNA was detected, in 4.5 % – RNA/DNA of acute respiratory viral infections pathogens, in one sample – DNA of Mycoplasma pneumoniae. Co-infection was detected only in patients of the anti-tuberculosis dispensary (SARS-CoV-2 and Mycobacterium tuberculosis). In the examined patients with pneumonia, SARS-CoV-2 RNA was significantly more often detected in biomaterial from the lower respiratory tract (52 %) than in respiratory smears (8.5 %). In the first week from the onset of the disease, 19.2 % of positive samples were found, in the second – 56.5 %. 


2006 ◽  
Vol 5 (2) ◽  
pp. 119-126
Author(s):  
Ye. I. Kondratieva ◽  
L. A. Matveeva ◽  
Ye. Yu. Tyuteva ◽  
N. A. Ryzhakova ◽  
A. A. Terentieva ◽  
...  

The aim of the research was the investigation of prophylactic using the drug «Cycloferon». Influence of Cycloferon on acute respiratory viral infection and flu and on their clinical manifestations as well as on local immunity condition was assessed. We examined 124 children aged from 4 to 18 years. It was revealed that duration of acute respiratory viral infections as well as flu decreased and local immunity of the upper respiratory ways increased considerably in children taking Cycloferon. The abovementioned changes were observed both just after the treatment and in the follow-up period.


Author(s):  
Evgeniia Dmitrova ◽  
◽  
Oleksandr Smiyan ◽  
Viktoria Holubnycha ◽  
Kateryna Smiian ◽  
...  

Introduction. Acute respiratory infections are the most common infectious diseases worldwide among children of different age groups. Materials and methods. 59 children between the ages of 3 and 7 participated in the study. The first group included 22 patients with an acute respiratory viral infection, the second one consisted of 23 patients with acute respiratory viral infections associated with adenoid vegetation, and 14 apparently healthy children were included in the control group. Immunology research was conducted during the acute period of the disease. Statistical processing of received data was done with the standard statistical software EZR 1.41. Results. After the research, most of the patients with acute respiratory viral infections were identified an actual increase in CD3+, CD4+, CD8+, CD22+- cells and IgA, IgM in the blood serum. Simultaneously, in patients with acute respiratory viral infections associated with adenoid vegetation during the acute period, the increase in total lymphocytes was identified due to CD4+, CD8+, CD22+ cells and IgG. A comparative analysis of the study results of both groups of patients showed that children from the second group had a significantly higher level of CD3+- cells, while the CD22+- lymphocytes, IgA, IgM and IgG were significantly lower from the similar indicators of the first group. Conclusions. The acute period of the disease in children with acute respiratory viral infections, associated with adenoid vegetation, had an imbalance in both the cell and the immune system's humoral component


2018 ◽  
pp. 14-16 ◽  
Author(s):  
S. B. Krutikhina ◽  
E. A. Yablokova

Acute respiratory viral infections (ARVI) are leading in the structure of the general morbidity of the population. To date, more than 200 viruses that affect the respiratory tract and ENT organs are known [1]. The reservoir of ARVI pathogens is only human, the highest incidence is observed in the cold season [8]. It is also possible to infect several ARVI pathogens together, which is accompanied by a severe course of the disease and the addition of bacterial complications [6, 7]. To date, prevention and treatment of ARVI, both in adults and children, is one of the important tasks facing the medical community [1, 2]. The etiotropic therapy of most ARVI has not been developed, and the use of interferon preparations and interferon synthesis inducers has not proved their clinical efficacy [11]. As an alternative, bioregulatory agents that have proven their safety and clinical efficacy can be used [12]. The article presents numerous studies of clinical efficacy and safety of the bioregulatory drug Engystol in different age groups.


2020 ◽  
pp. 23-34
Author(s):  
O. A. Gizinger

The term «acute respiratory viral infections» refers to a group of diseases whose etiological agents are respiratory viruses, mainly affecting the epithelium of the upper respiratory tract. The article presents the results of studying the effectiveness of the drug Nobazit® in 32 patients with body temperature > 37.5 °C having at least one catarrhal symptom (cough, rhinitis, or sore throat) and one symptom of intoxication (chills, sweating, malaise, weakness, or headache) who consulted a doctor within the first 48 hours from the onset of symptoms of an acute respiratory viral infection. The use of the drug Nobazit® (enisamium iodide) allowed to reduce the severity of clinical manifestations, eliminate lymphopenia, normalize factors of innate and adaptive immunity, and restore the receptor landscape of peripheral blood lymphocytes. The registered clinical and immunological efficacy of the drug Nobazit® allows recommending its inclusion in the complex therapy of acute respiratory infections.


2018 ◽  
pp. 146-149
Author(s):  
W. M. Delyagin

The incidence of acute respiratory infections (ARI) of the upper respiratory tract in children of the first 3 years of life can reach 3796.29: 1,000. Pre-school children from organized groups register up to 6–10 episodes of ARI annually, and 7–12 in primary school children. The frequency of bacterial complications (otitis, sinusitis, tracheobronchitis, pneumonia) in different age groups and socioeconomic conditions is 10–60%, which requires the appointment of antibiotics. In the case of a severe course of complications, with previously prescribed drugs of the 1st line, an unfavorable premorbid background the treatment with cefixime is preferable.


2021 ◽  
Vol 6 (4) ◽  
pp. 90-97
Author(s):  
D. Yu. Ivanov ◽  
O. M. Drozdova

Aim. To study the incidence of acute respiratory infections (ARI) in medical staff of dental clinics.Materials and Methods. We performed a descriptive, retrospective epidemiological study of ARI incidence by means of conducting an anonymous survey of 1,081 dentistry practitioners (358 in specialised dental clinics and 723 employees of polyclinics) in Kemerovo (2020). ARI included COVID-19, community-acquired pneumonia, and other common respiratory viral infections. The questionnaire included 12 questions about ARI, age, gender, working experience, and position.Results. The incidence of ARI in dentistry practitioners in specialised dental clinics was 2.6-fold higher as compared with those working in polyclinics [379.52 per 1,000 (95% CI = 327.10-434.11) and 146.19 per 1,000 (95% CI = 120.56-174.93), respectively, p = 0,00001], regardless of age. Prolonged and close contact with the patients along with an intensive use of aerosol-generating technologies were associated with a 2.3-fold times higher incidence of ARI in dental therapists in comparison with dental surgeons. Female dentists suffered from ARI 1.8-fold more frequently than males [410.91 per 1,000 (95% CI = 352,18-471,58) and 228.07 per 1,000 (95% CI = 127.40-358.36), p = 0,01] but most women worked as dental therapists that could confound such association. ARI incidence was not associated with age, work experience, and position (p = 0.22).Conclusion. Dentistry practitioners working in specialised clinics more frequently experienced ARI than those working in polyclinics. Dental therapists were at higher risk of ARI in comparison with dental surgeons, potentially due to the active use of aerosol generating technologies and prolonged close contact with the patients during treatment. Other factors were not among the major determinants of ARI incidence in dentistry practitioners.


2021 ◽  
Vol 1 (11) ◽  
pp. 29-33
Author(s):  
V. V. Nikiforov ◽  
N. V. Orlova ◽  
V. V. Lomaychikov

Acute respiratory viral infections (ARVI), including influenza, remain the most common infectious diseases. In the context of COVID‑19 pandemic, there is a need for differential diagnosis of respiratory syndrome. The clinic of ARVI, depending on the pathogen, may have its own characteristics. Influenza and COVID‑19 have common pathways of transmission of the pathogen and similar symptoms, so the optimal differential diagnosis is the use of test systems for both viruses. Against the background of influenza and other acute respiratory infections, complications from various organs and systems can develop. The article discusses in detail the issues of the clinical course of ARVI, differential diagnosis, modern approaches to therapyand prophylactic. Complications of influenza from the cardiovascular system are considered in detail. The data of our own observations on the risk of developing acute coronary syndrome in persons who have undergone COVID‑19 are presented. Prevention of the development of complications of influenza and other acute respiratory infections is the early appointment of antiviral therapy. Numerous studies confirm the effectiveness of interferon inducers in the treatment of influenza and other ARVI. The article presents the results of clinical studies confirming the effectiveness of therapy with the interferon inducer Kagocel. Against the background of its use, a decrease in the severity of clinical manifestations, a reduction in the duration of the disease, and the prevention of complications were noted. In studies, the drug has shown a high level of safety. The article discusses studies on the effectiveness of chemoprophylaxis of influenza and other acute respiratory infections.


Author(s):  
Cecilia Johansson ◽  
Freja C. M. Kirsebom

AbstractViral respiratory infections are a common cause of severe disease, especially in infants, people who are immunocompromised, and in the elderly. Neutrophils, an important innate immune cell, infiltrate the lungs rapidly after an inflammatory insult. The most well-characterized effector mechanisms by which neutrophils contribute to host defense are largely extracellular and the involvement of neutrophils in protection from numerous bacterial and fungal infections is well established. However, the role of neutrophils in responses to viruses, which replicate intracellularly, has been less studied. It remains unclear whether and, by which underlying immunological mechanisms, neutrophils contribute to viral control or confer protection against an intracellular pathogen. Furthermore, neutrophils need to be tightly regulated to avoid bystander damage to host tissues. This is especially relevant in the lung where damage to delicate alveolar structures can compromise gas exchange with life-threatening consequences. It is inherently less clear how neutrophils can contribute to host immunity to viruses without causing immunopathology and/or exacerbating disease severity. In this review, we summarize and discuss the current understanding of how neutrophils in the lung direct immune responses to viruses, control viral replication and spread, and cause pathology during respiratory viral infections.


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