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

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.

A Rare Case of Spontaneous Empyema by Clostridium perfringens

Empyema caused by clostridial infections is rare especially in the absence of invasive thoracic procedures. We present the case of an 81-year-old man without a history of preceding trauma who presented with shortness of breath and nonproductive cough and grew Clostridium perfringens only in the pleural cavity. He was predisposed to the infection due to his swallowing dysfunction. He was treated with penicillin and chest tube placement for drainage and subsequently improved.