Acute Bronchitis In Children Research Articles

Алгоритм диференційованого вибору лікарських засобів при терапії гострого простого бронхіту у дітей

Purpose — to develop and study the effectiveness of the author's algorithm of differential choice as regards medicines in the inpatient therapy for acute bronchitis in children. Patients and methods. On the basis of correlation analysis and sequential Wald's analysis, the algorithm of differential choice of medicines (recombinant interferon alpha-2β; probiotical agent Bacillus subtilis; bacterial lysates OM-85; Ivy extract) which are to be used in management of children with acute simple bronchitis (ASB) was developed. The differential administration of medicines for management of ASB in children was shown to lead to the faster resolution of catarrhal and inflammatory syndromes, as well as contribute to the restoration of non-specific immunity indicators. The results of introduction of the algorithm of doctor's actions into healthcare practice have demonstrated that the estimated effectiveness of usage and likelihood of acquiring the final result are equal to 75–86%. Conclusions. Features of functioning of the system of non-specific respiratory tract defense in children of 1 to 6 years old with ASB, their clinical and anamnestic characteristics, as well as dynamics of ASB course according to BSS justify the necessity to reinforce standard inpatient therapy of ASB. The administration of recombinant interferon, probiotical agents, bacterial lysates and Ivy extract for children of 1to 6 years old with ASB in order to restore non-specific immunity was pathogenetically justified based on proved clinical and immunologic effectiveness along with their influence on major clinical signs of acute bronchitis according to Bronchitis severity score (BSS).

EXPERIENCE IN MANAGING ACUTE BRONCHITIS IN CHILDREN IN OUTPATIENT SETTINGS

There are presented data of a prospective three-year follow-up study of patients with acute bronchitis (OB) at the pediatric site. The calculated population prevalence rate of acute bronchitis in children amounted to 74-96/ 1000 children. The tactics of various methods of the treatment of acute acute bronchitis (acute bronchitis) and acute obstructive bronchitis (OOB) in two adjacent pediatric areas were evaluated. The authors found no significant differences in the duration of arresting wheezing and dyspnea in simple bronchitis with antibiotics as compared with saline inhalations in two compared groups. According to the criterion “disappearance of wheezing” there was shown the efficacy of a 3% solution of sodium chloride (the main group) if compared with the use of antibiotic and berodual in the comparison group. Antibacterial therapy was required in 15% of cases for children suffered from acute bronchitis with concomitant urinary tract infections, acute otitis media, chlamydia and mycoplasmal infection.

Inappropriate Antibiotic Prescribing for Acute Bronchitis in Children and Impact on Subsequent Episodes of Care and Treatment.

To examine whether inappropriate antibiotic treatment for an initial bout of acute bronchitis in childhood affects patterns of future healthcare utilization and antibiotic prescribing. We conducted a retrospective analysis of children with at least 1 acute bronchitis episode, defined as the 14-day period after an acute bronchitis visit, born in 2008 and followed through 2015 in a nationally representative commercial claims database. We predicted the likelihood of returning for a subsequent acute bronchitis episode, and being prescribed an antibiotic as part of that episode, as a function of whether or not the child was prescribed an antibiotic as part of the first acute bronchitis episode controlling for patient, provider and practice characteristics. Children prescribed an antibiotic as part of their initial acute bronchitis episode were more likely both to have a subsequent acute bronchitis episode (hazard ratio = 1.23; 95% confidence interval: 1.17-1.30) and to be prescribed an antibiotic as part of that second episode (hazard ratio = 2.13; 95% confidence interval: 1.99-2.28) compared with children who were not prescribed as part of their first episode. Children diagnosed with asthma were more likely to experience a second visit for acute bronchitis, but less likely to receive an antibiotic as part of that second episode. Inappropriate antibiotic prescribing for a child's initial acute bronchitis episode of care predicted likelihood of subsequent acute bronchitis episodes and antibiotic prescriptions. Providers should consider the downstream effect of inappropriate antibiotic prescribing for acute bronchitis in childhood.

Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children - The BSS-ped.

Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children - The BSS-ped.

Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children – The BSS-ped

Background:There are no validated standardised clinical procedures for severity measurement of acute bronchitis in children. The “BSS-ped”, a short version of the physician-rated assessment scale BSS (Bronchitis Severity Scale), can fill this gap, if it is valid.Objective:To examine the scale´s validity.Methods:Investigations were planned according to classical clinical-psychometric validity criteria including a formal competence evaluation of the scale´s authors and statistical analyses of data from 78 patients aged 1-6 and diagnosed with “acute bronchitis”. Cross-validation was provided by analysis of data from 70 children with matching age, sex and diagnosis. All children were examined three times (day 0, 3-5 and 7) using the BSS-ped in addition to other clinical and psychometric monitoring procedures.Results:The evidently high level of expertise of the scale’s authors substantiates pronounced content validity and relevance of the BSS-ped and its items. The validity criterion, i.e. to reflect the unidimensional severity of acute bronchitis and its change using the BSS-ped score, was fulfilled. There were substantial correlations with other scales measuring the current health-related quality of life, as well as satisfaction and success of treatment. Severity change prognoses for acute bronchitis under placebo and an active substance were correct. The BSS-ped was found to be a feasible instrument because it can be repeated at short intervals (minute range) without any special technical aids or extended training.Conclusion:The BSS-ped is a valid procedure for measuring the severity of acute bronchitis in children.

Exposure to traffic-related air pollution and acute bronchitis in children: season and age as modifiers

BackgroundAcute bronchitis (AB) is one of the principal causes of childhood morbidity. Increasing number of studies has shown that air pollution is an important environmental contributor of respiratory disease. However,...

ЕРs7630 – current weapon against «old» disease

The article gives an overview of recent scientific works devoted to the unresolved problems of diagnosis, treatment and prognosis of acute bronchitis in children. The authors cover etiological, pathogenetic, diagnostic and therapeutic approaches of this nosology. A concise overview provide insight into the most recent results of highly reliable studies and meta-analyzes on the efficacy and safety of Pelargonium sidoides extract (EPs7630) – the drug Umkalor in the treatment of acute bronchitis in pediatric practice.

Современные подходы к лечению острых бронхитов у детей

Современные подходы к лечению острых бронхитов у детей

Scientific substantiation of the model of the drugs' recommended list development for pharmacotherapy of acute bronchitis in children of early age

Важливим напрямом реалізації державної політики кожної країни є забезпечення виконання соціальних стандартів галузі охорони здоров'я, зокрема в аспекті фармацевтичного забезпечення декретованих категорій населення безоплатними препаратами у межах регламентованого переліку.Мета. Розробка методики формування рекомендованого переліку основних лікарських засобів для дітей раннього віку та опрацювання її на прикладі фармакотерапії хворих на гострий простий бронхіт.Методи. У ході дослідження використано системний, аналітичний методи аналізу, а також метод вирішення завдань багатокритеріальної оптимізації та метод аналізу ієрархій.Результати. На підставі систематизації одержаних результатів нормативно-правових, маркетингових та фармакоекономічних досліджень лікарських засобів обґрунтовано та розроблено модель формування Рекомендованого основного та додаткового переліків препаратів для фармакотерапії гострого простого бронхіту у дітей раннього віку, що складається з семи послідовних етапів. Відповідно запропонованої моделі до складу Рекомендованого основного переліку найбільш ефективних та економічно доступних препаратів увійшло 24 торгових найменування, зокрема 13 антибактеріальних, 1 противірусний, 2 імуномодулюючих та 8 муколітичних найменувань лікарських засобів. Питома вага препаратів вітчизняного виробництва у зазначеному переліку складає 20,8 %.Висновки. Запропонований склад Рекомендованого основного переліку препаратів у подальшому сприятиме формуванню локальних формулярних і страхових переліків лікарських засобів для фармакотерапії дітей раннього віку у межах амбулаторно-поліклінічних закладів охорони здоров'я. Разом з тим, даний Перелік є основою для прогнозування перспективної потреби в необхідних лікарських засобах та розрахунку обсягів реімбурсації їх вартості для дітей до 3-х років хворих на гострий простий бронхіт, що сприятиме заощадженню бюджетних коштів

Cross-sectional evaluation of the Bronchitis Severity Score in Egyptian children: A move to reduce antibiotics.

Despite evidence of limited benefit of antibiotics in acute bronchitis, most paediatric patients are prescribed them. To assess the validity of the Bronchitis Severity Score (BSS) in assessing the clinical response to treatment of acute bronchitis, and determine whether clinical data and basic laboratory measurements can be used to guide antibiotic prescription. We enrolled 200 patients (age range 6 months - 12 years) with clinically diagnosed acute bronchitis. They were divided into three groups according to age. All patients were evaluated three times during the bronchitis episode (days 0, 5 and 7). The primary outcome measurement was the change in the BSS from day 0 to day 7. On the initial visit, the mean (standard deviation (SD)) BSS was 8.36 (2.6), indicating moderate severity of bronchitis. The mean BSS decreased to 4.03 (2.3) on day 5 and to 2.36 (1.45) on day 7. Initial blood tests showed anaemia (80%), leucocytosis (6%), bandaemia (3%) and lymphocytosis (52%). Only four patients were positive for C-reactive protein, while the erythrocyte sedimentation rate was elevated in 98% of cases. There were significant correlations between bandaemia, fever grade (p<0.001) and white blood cell count with clinical variables such as the presence of secretions on chest auscultation (p<0.05) and toxic facies on general examination (p<0.05). Acute bronchitis in children is a self-limiting disease that does not require routine administration of antibiotics. The BSS is a simple and practical clinical scoring system that is useful in evaluating disease severity and monitoring disease resolution in acute bronchitis.

Effect of diurnal temperature range on the outpatient visits for acute bronchitis in children: a time-series study in Hefei, China

ObjectivesTo determine the relationship between diurnal temperature range (DTR) and outpatient visits for childhood acute bronchitis (AB) in Hefei, China, to analyze whether DTR effect was delayed, and to explore the susceptible populations. Study designAn ecological study. MethodsA Poisson generalized linear regression model combined with a distributed lag non-linear model was used to analyze the relationship between DTR and childhood AB from Hefei, China during 2010–2013, after adjusting for long-term trend and seasonality, mean temperature and relative humidity. ResultsAn adverse effect of DTR on childhood AB was observed, and the impact of DTR was greatest at three days lag, with a 1.0% (95% confidence interval = 0.5–1.6%) increase of AB cases per 1 °C increment of DTR. Female children and children aged 0–4 years appeared to be more vulnerable to DTR effect than other children. ConclusionsOur study suggests that large DTR may increase the incidence of childhood AB in Hefei, particularly for those who are female and young. Caregivers and health practitioners should be made aware of the potential threat posed by large DTR.

Polymorphism of the genes of pro-and anti-inflammatory cytocins and acute bronchitis in children

Certain role in the development of respiratory diseases is played by cytokines that possess both pro-and anti-inflammatory activity, and the balance of these factors influences the course of the disease. As shown by studies in recent years, the negative influence of environmental factors, as a rule, implemented against the background of the individual genetic predisposition in virtually any known to date pathology. Objective research: to identify molecular genetic risk factors for the development of acute bronchitis and community-acquired pneumonia in children on the basis of the analysis of polymorphisms of pro- and anti-inflammatory interleukins. A complex clinicallaboratory and instrumental examination of 110 children aged 6 to 15 years with acute bronchitis (the main group) was carried out. The control group included 163 conditionally healthy children of the same age. Significant differences were revealed by the polymorphism of the TNFA gene, which has pro-inflammatory properties. At the same time, analysis of the frequency allocation of alleles and genotypes of polymorphism (-174)C/G of IL6 and + 3953C/T gene IL1B did not reveal significant differences with the control. The results of the study can be used in the development of prognostic markers of acute pathology in children and optimization of treatment tactics and preventive measures with an individual approach for each patient.

Ефективність використання Траумелю С у комплексному лікуванні гострого бронхіту у дітей

Ефективність використання Траумелю С у комплексному лікуванні гострого бронхіту у дітей

Acute Bronchiolitis in Children. Current Approaches to Diagnosis and Therapy

The article is dedicated to the problem of acute bronchitis in children. The relevance of this problem is obvious: according to conservative estimates, more than 150 million cases of bronchiolitis are registered annually. 7–13% of these cases require hospital treatment and 1–3% — hospitalization in an ICU. The most common etiologic factor is the virus — respiratory syncytial (the vast majority of cases — 90%); rhinovirus and influenza viruses A and B, parainfluenza, adenovirus, coronavirus, metapneumovirus, and human bocavirus are also important agents. A number of factors can cause the evolution of bronchiolitis in 0–2-years-old children. Premature infants, children with bronchopulmonary dysplasia, bottle-fed children, and patients with congenital malformations and immunodeficiencies undergo bronchiolitis especially hard. Specialists of the Professional Association of Pediatricians — The Union of pediatricians of Russia — have formulated and summarized fundamental criteria for the diagnosis, treatment and further management algorithms for patients with this pathology in accordance with the principles of evidence-based medicine.

Ингаляционные формы амброксола в терапии секреторно-эвакуаторных нарушений респираторного тракта при острых бронхитах у детей

Мукотропная терапия детей в возрасте от 1 года до 5 лет с острым бронхитом при помощи препарата Лазолван®, раствор для ингаляций и перорального применения, или сиропа для перорального применения Лазолван®, 15 мг/5 мл, является высокоэффективным и безопасным методом ликвидации секреторно-эвакуаторных нарушений респираторного тракта. При наличии возможности проведения ингаляционной терапии эффективным методом выбора при сохраненном высоком профиле безопасности являются ингаляции препарата Лазолван®, раствор для ингаляций и перорального применения посредством небулайзера. Более быстрое снижение клинической тяжести острых бронхитов у детей, получавших ингаляции Лазолвана®, связано с ускоренным восстановлением нарушенных секреторно-эвакуаторных механизмов бронхиального дерева.

Сравнение эффективности и безопасности фито- и антибиотикотерапии при лечении острого бронхита у детей: результаты многоцентрового двойного слепого рандомизированного клинического исследования

Although viruses cause most cases of acute bronchitis, antibacterial drugs are still widely used to treat children with such diseases; this results in development of antibiotic resistance. Therefore, one of the key objectives of clinical medicine is now an effort to reduce unreasonable use of antibacterial agents. A multicenter double blind randomized clinical trial (E-BRO-PCT) involved 182 2-6-years-old children and was aimed at assessing effectiveness and safety of phytotherapy (the syrup characterized by a fixed combination of thyme herb and ivy leaf extracts) of acute bronchitis. Patients were divided into groups according to the type of therapy: phyto-, antibacterial or multimodal therapy. The level of procalcitonin (PCT) – a bacterial inflammation marker – was measured retrospectively in the blood samples of all the children obtained at inclusion to the study. Therapy effectiveness was assessed by means of overall assessment of response to treatment on day 7. The share of children with low PCT and positive response to phytotherapy was comparable to the share of children subjected to antibiotic therapy. This is also true for all the patients included in the study regardless of the PCT level. Phyto- and antibacterial therapy featured a comparable safety profile; however, according to the researchers, the former one came out slightly better. Results of this study convincingly demonstrate that phytotherapy is an effective and well-tolerated type of treatment of acute bronchitis in children.

Pelargonium sidoides extract for treating acute respiratory tract infections

Pelargonium sidoides (P. sidoides), also known as Umckaloabo, is a herbal remedy thought to be effective in the treatment of acute respiratory infections (ARIs). To assess the efficacy and safety of P. sidoides for the treatment of ARIs in children and adults. In April 2013 we searched MEDLINE, Journals@Ovid, The Cochrane Library, Biosis Previews, Web of Science, CINAHL, CCMed, XToxline, Global Health, AMED, Derwent Drug File and Backfile, IPA, ISTPB + ISTP/ISSHP, EMBASE, Cambase, LILACS, PubMed component "Supplied by Publisher", TRIPdatabase, the publisher databases: Deutsches Ärzteblatt, Thieme, Springer, ScienceDirect from Elsevier. We conducted a cited reference search (forward) in Web of Science of relevant papers for inclusion. In addition we searched the study registries ClinicalTrials.gov, Deutsches Register klinischer Studien DRKS (German Clinical Trials Register), International Clinical Trials Registry Platform (ICTRP) - WHO ICTRP, Current Controlled Trials and EU Clinical Trials Register. Double-blind, randomized controlled trials (RCTs) examining the efficacy of P. sidoides preparations in ARIs compared to placebo or any other treatment. Complete resolution of all symptoms was defined as the primary outcome; in addition, we examined resolution of predefined key symptoms. At least two review authors (AT, JG, WK) independently extracted and quality scored the data. We performed separate analyses by age group and disease entity. Subanalysis considered type of preparation (liquid, tablets). We examined heterogeneity using the I(2) statistic. We calculated pooled risk ratios (RR) using a fixed-effect model if heterogeneity was absent (I(2) < 5%; P > 0.1), or a random-effects model in the presence of heterogeneity. If heterogeneity was substantial (I(2) > 50%; P < 0.10), a pooled effect was not calculated. Of 10 eligible studies eight were included in the analyses; two were of insufficient quality. Three trials (746 patients, low quality of evidence) of efficacy in acute bronchitis in adults showed effectiveness for most outcomes in the liquid preparation but not for tablets. Three other trials (819 children, low quality of evidence) showed similar results for acute bronchitis in children. For both meta-analyses, we did not pool sub totals due to relevant heterogeneity induced by type of preparation.One study in patients with sinusitis (n = 103 adults, very low quality of evidence) showed significant treatment effects (complete resolution at day 21; RR 0.43, 95% confidence interval (CI) 0.30 to 0.62). One study in the common cold demonstrated efficacy after 10 days, but not five days (very low quality of evidence). We rated the study quality as moderate for all studies (unvalidated outcome assessment, minor attrition problems, investigator-initiated trials only). Based on the funnel plot there was suspicion of publication bias.There were no valid data for the treatment of other acute respiratory tract infections. Adverse events were more common with P. sidoides, but none were serious. P. sidoides may be effective in alleviating symptoms of acute rhinosinusitis and the common cold in adults, but doubt exists. It may be effective in relieving symptoms in acute bronchitis in adults and children, and sinusitis in adults. The overall quality of the evidence was considered low for main outcomes in acute bronchitis in children and adults, and very low for acute sinusitis and the common cold. Reliable data on treatment for other ARIs were not identified.

Air pollutants, genes and early childhood acute bronchitis

BackgroundStudies have reported gene-by-environment interaction for chronic respiratory conditions but none on acute illnesses in children. We investigated, longitudinally, whether genotype modifies the relationship of environmental exposures (second-hand tobacco smoke, polycyclic aromatic hydrocarbons, particulate matter <2.5μm (PM2.5)) with acute bronchitis in children below two years. MethodsA random sample of 1133 children, born between 1994 and 1998, in two districts of the Czech Republic, was followed-up from birth, of which 793 were genotyped. Pediatric records were abstracted for respiratory illnesses. Second-hand tobacco smoke exposure from household members was obtained through questionnaires and verified using urine cotinine. Air monitoring provided estimates of ambient polycyclic aromatic hydrocarbons and PM2.5. Additionally, we collected information on a range of potential confounders including breastfeeding history, indoor fuel use, other children in household, maternal characteristics, ambient temperature etc. DNA was extracted from tissues taken from the middle of the placenta, opposite the umbilical cord. We examined six single nucleotide polymorphisms (GSTM1, GSTP1, GSTT1, CYP1A1 MspI, EPHX1 exon 3 and 4) and one (EPHX1) diplotype. To investigate effect measure modification we constructed logistic regression models using generalized estimating equations (for repeated observations) stratified by genotypes. ResultsThe EPHX1 low activity diplotype consistently imparts greater susceptibility to bronchitis from second-hand tobacco smoke, polyclic aromatic hydrocarbons (PAH) and PM2.5. Each of these three classes of exposure also showed elevated risk for bronchitis in the presence of either one or two histidines at exon 3 and exon 4 of EPHX1. Additional effect modifiers include CYP1A1 and GSTT1. ConclusionSeveral xenobiotic metabolizing genes may modify the impact of second-hand tobacco smoke and ambient air pollutants, polycyclic aromatic hydrocarbons and PM2.5, on acute bronchitis in preschool children.

Treatment of acute bronchitis with EPs 7630: Randomized, controlled trial in children and adolescents

The aim of this trial was to investigate the efficacy and tolerability of EPs 7630, a herbal drug preparation from Pelargonium sidoides, in children and adolescents suffering from acute bronchitis, outside the strict indication for antibiotics. A total of 220 patients with acute bronchitis were randomized and given either verum containing EPs 7630 (1-6 years/>6-12 years/>12-18 years: 3 × 10/3 × 20/3 × 30 drops/day) or matching placebo for 7 days. The main outcome measure was the change in the total score of bronchitis-specific symptoms (BSS) from day 0 to day 7. The decrease in the BSS total score was significantly higher for EPs 7630 compared to placebo (change day 0-day 7: 4.4 ± 1.6 vs 2.9 ± 1.4 points; P < 0.0001). Improvements were most pronounced for 'coughing' and 'rales at auscultation'. Tolerability was similarly good in both groups. EPs 7630 proved to be an efficacious and well-tolerated option for the treatment of acute bronchitis in children and adolescents outside the strict indication for antibiotics.

Encouraging results for herbal treatment of acute bronchitis in children and adolescents

Kamin W, Maydannik V, Malek FA, Kieser M. Efficacy and tolerability of EPs 7630 in children and adolescents with acute bronchitis: a randomized, double‐blind, placebo‐controlled multicenter trial with a herbal drug preparation from Pelargonium sidoides roots. Int J Clin Pharmacol Ther 2010; 48: 184–91.