Acute Bronchitis In Children And Adults - Causes, Symptoms And Treatment Of Acute Bronchitis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-17 02:10

Causes, symptoms and treatment of acute bronchitis

Content:

• Symptoms of acute bronchitis
• Causes of Acute Bronchitis
• Acute bronchitis in children
• Treatment of acute bronchitis

The problem of acute bronchitis has not been finally solved even by the modern achievements of medical science. All the same, new cases of the disease continue to be registered, 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, there are still difficulties with the complete disposal of patients from acute bronchitis. As a result, the chronization of the process or its transition to more severe forms and bronchopneumonia. Therefore, the discussion of the features of bronchitis will never lose its relevance.

Symptoms of acute bronchitis

The clinical manifestations of the disease are characterized by a fairly good specificity. Correctly carried out differential diagnosis of complaints, symptoms and data of an objective examination of the patient helps to establish the correct diagnosis within a few minutes.

Acute bronchitis can be evidenced by:

1. Dry cough. Typical for the initial stages of the inflammatory process in the bronchi. Its duration can be different and depends on many reasons. In typical cases, a dry cough in acute bronchitis lasts 4-5 days and is triggered by inhalation of air. Its particular harshness is noted at drops in high and low temperatures;
2. Moist cough. The appearance of a wet cough in acute bronchitis marks the second phase of the inflammatory process in the bronchi. At the same time, during an attack of coughing, transparent mucous or yellowish-green sputum is coughing up. This cough lasts about a week and occurs spontaneously as sputum accumulates in the bronchi, especially in the morning;

3. Hyperthermic reaction. It usually proceeds as a subfebrile temperature (about 38 ° C). The presence of its higher numbers should always be alarming in relation to pneumonia;
4. General weakness, sweating and malaise. They belong to the signs of intoxication and are expressed the more, the more active the inflammatory process in the bronchial tree;
5. Shortness of breath and decreased physical activity. They join as the respiratory failure progresses and always indicate a severe course of bronchitis or its complications;
6. Wheezing on auscultation of the lungs. In the initial stages of the process, they are usually dry, rough against the background of hard breathing. As you cough up phlegm during coughing, the heard wheezing becomes moist, large and medium bubbly. The appearance of small bubbling or crepitant rales should always be alarming in relation to pneumonia.

The central symptom of acute bronchitis is cough. The diagnosis of the disease is built around this symptom. The acute process is characterized by a sudden onset and complete resolution of symptoms within 2 to 3 weeks. Otherwise, we have to talk about a recurrent or chronic process.

Causes of Acute Bronchitis

In the occurrence of acute bronchitis, the main role belongs to the microbial factor and the individual characteristics of the bronchial tree of each person.

The causative factors of acute bronchitis include:

1. Cold and general hypothermia. Against their background, the protective properties of the body are sharply reduced;
2. Bacterial infections: staphylococci, streptococci, pneumococci, haemophilus influenzae, maroxella and other pathogens;
3. Viral infections. Any respiratory viruses (influenza, parainfluenza, adenovirus, respiratory syncytial virus) can cause damage to the bronchial mucosa. In this case, pathogenic bacteria are activated on the damaged epithelium;
4. Immunodeficiency states of primary and secondary origin;
5. Long bronchial tree with a thin lumen. This interferes with the normal drainage of sputum, which results in inflammation of the sputum with any infection.

Acute bronchitis in children

The child's body is considered initially more susceptible to the possibility of developing any form of bronchitis.

This is due to the anatomical and physiological features:

1. Imperfection of the immune mechanisms of antimicrobial protection;
2. Anatomical features of the bronchial tree in children, which create an obstacle to the outflow of sputum;
3. Imperfection of mucociliary clearance. The result of this feature is a tendency to increased production of sputum with the inability of the cilia on the surface of the cylindrical epithelium of the mucous membrane to remove it;
4. Constant contact of the child with bacterial and viral pathogens circulating in children's groups;
5. Increased reactivity of the smooth muscle components of the bronchial wall, which leads to their spasm and narrowing of the airway lumen.

Usually, bronchitis in childhood is longer and more severe than in adults. The younger the child is, the more dangerous bronchitis becomes. This is due to its frequent transition to an obstructive form or a long, recurrent course of up to 3 or 5 years, until persistent changes in the immune system and anatomical features of the bronchi occur.

As for the clinical features of bronchitis in children, there are also certain differences from adults. In children, not only coughing, but also symptoms of intoxication comes to the fore. At the same time, the child becomes lethargic, has a high temperature, refuses to play, eat and drink. In the most severe cases, with signs of bronchial obstruction, severe shortness of breath occurs with difficulty breathing and bubbling, wheezing rales. Children of older age groups encounter such a course of bronchitis much less often.

Treatment of acute bronchitis

Current trends in the treatment of acute bronchitis do not differ much from those that were adopted earlier. Only the views on the methods of supplying drugs to the inflamed bronchi have changed. If earlier the main emphasis was on taking pills and injections, today inhalation is used for these purposes. The creation of special devices (nebulizers) made it possible to grind liquid dosage forms to the smallest dispersed particles, which allows them to penetrate into the lumen of the smallest structures of the bronchial tree.

For therapeutic purposes, the following groups of drugs are used:

1. Expectorants. These can be sputum disintegrants (ACC - acetylcysteine), drugs that enhance the work of the mucociliary apparatus (lazolvan, bromhexine, flavamed) or herbal preparations (pectolvan, plantain syrup, span, alteika);
2. Cough medicines (sinekod, stopusin, bro-zedex, trifed). They are prescribed in the first stage of acute bronchitis to relieve hacking dry cough. Do not use them for wet coughs;
3. Bronchodilators are drugs for expanding the bronchial lumen. Indicated only if there are symptoms of bronchial obstruction. Used aminophylline, theophylline, salbutamol, ventolin, flexotide. Only aminophylline can be administered intravenously. Do not be afraid to use the listed funds even in pediatric practice only because of the possibility of addiction or side effects. Sometimes, even a single inhalation of them on a nebulizer almost completely eliminates the symptoms of bronchial obstruction;
4. Detoxification therapy (infusion, vitamin preparations). It is more often prescribed for young children, but it can also be indicated for adults.
5. Antibiotics for acute bronchitis. The expediency of prescribing antibiotics for acute bronchitis occurs in case of obvious problems with the immune system, high body temperature, pronounced signs of intoxication or respiratory failure, expectoration of mucopurulent sputum, prolonged course of bronchitis, with bronchitis in young children. Everything is decided individually and only by the attending physician. In all doubtful cases, it is better to prescribe a prophylactic dose of sparing antibiotics than to wait for the patient's condition to worsen.

The main groups of antibacterial drugs are given in the form of a table:

Group of drugs	Representatives	Application features
Semisynthetic aminopenicillins	Unprotected: ospamox, flemoxin, gramox, amoxicillin	First-line drugs with a wide spectrum of action against the causative agents of bronchitis. Protected drugs are more resistant to the action of microbial beta-lactamases. They are used both in pediatrics and in adults. There are all forms of release, which allows you to change the methods of administration of drugs in different phases of the course of the disease.
	Protected: amoxiclav, augmentin, flemoklav
Cephalosporins	Cefazolin, cefotaxime, ceftriaxone (loraxon, medaxone, emsef), cefoperazone, cefixime, cefuroxime (zinacef), cefepime (maxipime)	Antibacterial agents with a fairly strong antimicrobial effect. They are prescribed as drugs of choice, both alone and in combination with other antibiotics. Available only in one dosage form (tablets or powder for injection), with the exception of cefuroxime.
Macrolides	Clarithromycin (Macropen, Klacid, Fromilide), Spiramycin (Rovamycin)	They create a very high concentration in bronchial mucus. They act not only on the usual, but also on atypical pathogens of bronchitis. Available exclusively in tablet forms.
	Azithromycin (sumamed, zomax, azivok, zotsin)	An excellent alternative to any antibacterial drug if it is ineffective or intolerant. It is taken once a day. All dosage forms exist. There are no restrictions for admission in pediatric practice. It can be used as the drug of choice for bronchitis.
Fluoroquinolones	Ciprofloxacin, Levofloxacin (Lefloxin, Glevo), Gatifloxacin (Gatigem, Gatimax), Moxifloxacin (Avelox)	In most cases, it is indicated for severe bronchitis, both alone and in combination with aminopenicillins or cephalosporins. They have a strong effect and a broad antibacterial spectrum. Contraindicated for use in pediatric practice.
Aminoglycosides	Amikacin, gentamicin	There are exclusively tablet forms. Quite good and fairly broad antibacterial effect allows them to be used as a primary or alternative drug for bronchitis

List of antibiotics: Antibiotics for bronchitis in adults and children

Antibiotic therapy for bronchitis is a specific section in the treatment of this disease. Only a specialized specialist can prescribe a specific antibiotic and its dosage. Uncontrolled intake of such drugs can result in serious consequences and the development of resistance of microorganisms to antibacterial agents. This will complicate the course of the disease and complicate the subsequent selection of an effective antibiotic.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".