The highly contagious flu called SARS with airborne mechanism of contamination. The disease is caused by influenza viruses A, B and C. influenza is characterized by rapid exceeding of the epidemiological threshold in all age groups.
Features of influenza are the short incubation period, rapid Cycling course, the severity of naturalnego and intoxication syndromes, as well as the defeat mainly epithelial lining the mucosa of the upper DP (respiratory tract).
The lower DP are involved in the inflammatory process in severe and/or complicated course of influenza. In this case, the disease often progresses with days (respiratory failure), hemorrhagic syndrome, bacterial complications (most often bacterial pneumonia), in extremely severe cases, vascular collapse, pulmonary edema and brain.
The flu is a viral disease, so antibiotics for the flu without complications of bacterial flora, not appointed. Moreover, early incorrect prescription of antibiotics for viral infections will not only facilitate the patient’s condition, but can even trigger the development tank.complications.
In this regard, it is important to remember that in order to prevent complications, and to prevent contamination after contact with patients, antibiotics are not used. The flu, in the first two or three days of the disease is necessary to use antiviral drugs (Zanamivir, Rimantadine, Oseltamivir, etc.) and the interferon (Viferon in candles). Antiviral drugs are prescribed for five days: Viferon from five to ten days.
Antibiotics for colds and flu are assigned only in case of secondary bacterial complications such as pneumonia, sinusitis, frontal sinusitis, otitis, streptococcal tonsillitis, etc., the list of indications for antibiotic use include acute against the background of influenza, COPD (chronic obstructive pulmonary disease), as well as the development of bacterial sepsis.
The main complication of influenza is pneumonia. It can be
Antibiotics are indicated only if there is a bacterial component.
For primary viral pneumonia, which developed on the background of influenza, characterized by the development at 1-3 days of the disease. It should be noted that the vast majority of lethal influenza pneumonia are not associated with late bacterial infection, namely virus invasion of the lungs.
The risk group primary pneumonia include: children, pregnant women, patients with diseases of the SSS or immunodeficient conditions.
The main primary symptom of pneumonia is a cough with scanty sputum and blood streaks. Massive hemoptysis is a rare and is a bad prognostic sign.
Also appears days, tachycardia, tachypnea, cyanosis. Pleural pain is uncommon.
In severe cases, the disease is complicated by DIC syndrome and renal failure.
Viral-bacterial pneumonia may develop by the end of the first week of the disease.
For characterized by productive cough with considerable purulent expectoration, sometimes bloody sputum, chills, pleural pain. Also marked days and cyanosis.
Clean bacterial pneumonia, may develop in the second week of illness. This complication is not uncommon. Specific, that prior to the occurrence of bacterial pneumonia marked a period of greatly improved health. In the future, begins the so-called “second wave” of fever and chills, associated with productive cough (purulent sputum, sometimes streaked with blood), chest pain.
Sometimes, pneumonia superimposed on the flu symptoms, without improvement.
In influenza complicated by bacterial pneumonia may be applied:
- beta-lactams (inhibitorsdisease penicillins, cephalosporins of third or fourth generation);
- macrolides (for non-severe for and contraindications to the appointment beta-lactams);
- fluoroquinolones (levofloxacin, ciprofloxacin is used in severe).
For initial therapy it is preferable to use beta-lactams. In severe you must assign parenteral cephalosporins (Ceftriaxone, ceftazidime, Cefotaxime). In mild and moderate (without complications and in the absence of background confounding pathologies –diabetes, immunodeficiency) possible use inhibitorsdisease penicillins or cephalosporins oral (Flemoklav Solutab, Augmentin, Suprax, Zinnat).
In severe disease, high risk of complications or failure of therapy with beta-lactams is recommended to use fluoroquinolones. However, when prescribing these medications must remember that they are not assigned to 18-ti years. Exceptions may be cases of severe pneumonia in patients older than 16 years, in the absence of alternatives.
Also, fluoroquinolones are not prescribed to women, pregnant baby breastfeeding, patients with severe pathologies of kidney and liver, patients with inflammation of tendons after taking-generation fluoroquinolone antibacterial drugs in history.
When mild or moderate current may be administered macrolides. These drugs are the most low-toxic and well carried by the antibiotics. Macrolides, and beta-lactams, may be administered for the treatment of bacterial complications of SARS in pregnant women.
Under heavy or moderate infection with high-risk pregnancies, all recommended antibiotics be administered parenterally. It is possible to use sequential therapy. That is, when the dynamics is expressed through 42 hours after the onset of persistent clinical improvement, is the transition to oral CP-VA.
For the treatment of bacterial complications of ARVI in children, the recommended beta-lactams (penicillins and cephalosporins) and macrolides.
With mild course of infection to patients, who for years did not receive a penicillin, can be given medication amoxicillin (Amasin, flemoksin soljutab, etc.). In other instances, starting therapy is preferable to start with inhibitorsdisease version of amoxicillin or cephalosporins. Can also be used macrolides.
The drug is a Dutch farm.campaign Astellas. Available in the form of soluble table. 20-five pieces in the package. The cost per package 0.125, 0.25, 0.5 and 1 g – 240, 290, 370 and 470 million, respectively.
Flemoksin soljutab relates to antibacterial preparations with wide spectrum antimicrobial action of bactericidal nature. Active component Flemoxin is a semi – synthetic penicillin: amoxicillin. The tool is highly effective against the major bacterial pathogens of respiratory tract infections. Note, however, that the amoxicillin is completely destroyed In bacterial-lactamases, therefore, for the treatment of diseases caused by bacteria producing these enzymes, it is necessary to prescribe amoxicillin+clavulanate acid. Inhibitorsdisease version of an antibacterial drug is resistant to enzyme inactivation and is effective against beta-lactamaseproducing strains.
The resorption has a high bioavailability, is rapidly and completely absorbed when administered orally. Eating does not affect the extent of absorption of SR-VA.
Bactericidal concentration in the blood plasma is reached in two hours. The body of the antibiotic is excreted by the kidneys, mainly unchanged.
It should be noted that the resorption of gematoplatzentarnyi able to overcome the barrier. In this regard, despite the fact that amoxicillin has no teratogenic effects on the fetus and is approved for treatment of pregnant women use the drug only valid on prescription.
It is also necessary to consider that the drug is excreted in breast milk, therefore, can be recommended for temporary suspension of breastfeeding.
A limitation to the use of an antibacterial drug are allergic reactions to drugs are a class of beta-lactams, lymphoproliferative disease, gastrointestinal pathology, and mononucleosis.
Flemoksin soljutab is made in the form of soluble tablets. It can be taken in pill form with water, diluted with twenty milliliters of water to obtain a syrup or a hundred milliliters to form a slurry.
For children under one year of age, the dose of SR-VA for the day is calculated according to the thirty – sixty mg/kg dose divided into two or three times.
Children 1 to 3 years the resorption of the administered 0.125 g three times a day or 0.25 every 12 hours.
With 3 to 10 years – for two hundred and fifty milligrams every eight hours or 0.375 twice a day.
After 10 years appoint five to seven hundred and fifty milligrams twice a day or 0.35-0.5 g every eight hours.
A standard course of therapy is 5 to 7 days.
The resorption usually well tolerated and seldom produces undesirable effects from the treatment. The most common side effects are Allergy to the drug, disorders of the gastrointestinal tract, dysbacteriosis and a thrush.
Is Dutch farm.campaign Astellas. Antibacterial drug comes in the form of capsules, soluble tablets (Solutab form) and suspension for children. Cost:
- six capsules of 0.4 g – 740 rubles;
- seven table. 0.4 grams – 900 RUB.;
- suspension 100 mg per 5 ml – 606 rubles.
Antibacterial drug belongs to semisynthetic cephalosporins of the 3rd gen. with broad spectrum bactericidal action on pathogenic microorganisms. The main component of CP-VA – cefixime, resistant to enzymatic inactivation by beta-lactamases of gram – and gram+ pathogens.
Many staphylococci, enterococci and clostridia are resistant to cefixime.
Restriction of antimicrobial drug are:
- diseases of the kidney associated with reduction in creatinine clearance below sixty milliliters per minute;
- individual intolerance to beta-lactam agents;
- pseudomembranous colitis in anamnesis;
- age less than 12 years for capsules and for at least 6 months for the suspension and soluble pills.
Cefixime is not teratogenic and is included in the list of antibiotics allowed during pregnancy, however, be administered the drug should be exclusively your doctor. If necessary, use of antibiotic while breastfeeding, you may need to temporarily suspend breastfeeding.
Patients over 12 (including adults), Suprax administered in a daily dose of 0.4 grams at once or divided into two doses.
From 6 months to 12 years daily dose is calculated at 8 mg/kg. the Drug is also taken at once or divided into two doses.
Adverse reactions to cefixime are rare. Most often lead to dysbacteriosis, thrush, allergies and gastrointestinal disorders.
The article was prepared:
Infectious disease physician Chernenko A. L.
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