Acute respiratory diseases (ARI) are a large group of infections that have much in common in pathogenesis and transmission routes: we are talking mainly about airborne infections, although the contact (through dirty hands) transmission pathway plays an equally important role. This term is used to combine acute nonspecific infections, regardless of their localization - from rhinitis to pneumonia. However, as a clinical diagnosis of acute respiratory infections, it requires interpretation: there should be an indication either of an organ lesion (otitis media, bronchitis, pharyngitis, etc.), for which a spectrum of pathogens is known, or of a possible etiology of the disease (viral, bacterial acute respiratory infections). Since up to 90% of acute respiratory infections are caused by respiratory viruses and influenza viruses, in the absence of signs of a bacterial infection, the term "acute respiratory viral infection" (ARVI) and the appointment of antiviral therapy are justified.

According to the authors of a series of studies carried out under the auspices of WHO, in different countries– both developed and developing – children early age annually carry 5-8 acute respiratory infections, and in rural areas they get sick less often than in cities, where a child can carry 10-12 infections per year. Children who in early childhood are less likely to come into contact with sources of infection and therefore get sick less during this period “get the missing infections” in primary school. The statement of this fact, of course, should not be the cause of the development of fatalism in relation to SARS - children should be tempered and, if possible, protected from sources of infection, fully fed and treated for diseases (chronic tonsillitis, allergies), against which ARI develops especially often. At the same time, it is necessary to protect sick children from unnecessary therapeutic interventions in every possible way, since acute respiratory infections are the reason for unreasonable treatment and the most common cause of side effects of drugs.

Antivirals

Strictly speaking, antiviral therapy is indicated for any respiratory viral disease. Unfortunately, the antiviral agents at our disposal often do not give a pronounced effect, and the ease of most episodes of acute respiratory viral infections, limited to 1-3 feverish days and catarrhal syndrome for 1-2 weeks, does not justify chemotherapy. But in more severe cases, especially with influenza, antiviral agents have some effect and should be applied more widely than is considered appropriate today.

The main rule for the use of antiviral chemotherapy drugs is their appointment in the first 24-36 hours of the disease; at a later date, their effect is not visible. The main anti-influenza agent, which also acts on a number of other viruses, is rimantadine, which suppresses the reproduction of all strains of type A influenza. Rimantadine also inhibits the reproduction of respiratory syncytial (RS) and parainfluenza viruses. Recommended; 5-day course at the rate of 1.5 mg / kg / day in 2 doses for children 3-7 years old; 50 mg 2 times for children 7-10 years old - 3 times a day - over 10 years old. At an early age, rimantadine is used in the form of algirem (0.2% syrup): in children 1-3 years old, 10 ml; 3-7 years - 15 ml: 1st day 3 times, 2-3rd days - 2 times, 4th - 1 time per day. The effectiveness of rimantadine increases when taken with no-shpa (drotaverine) orally, at a dose of 0.02-0.04 g in children 4-6 years old and 0.04-0.1 g in patients 7-12 years old, especially in violation of heat transfer (cold extremities, marbling of the skin).

Arbidol has a similar antiviral effect, which inhibits the fusion of the lipid envelope of influenza viruses with the membrane of epithelial cells. It is also an interferon inducer. This low-toxic drug can also be prescribed for moderate acute respiratory viral infections from the age of 2: children 2-6 years old, 50 mg per dose, 6-12 years old, 100 mg each, over 12 years old, 200 mg per dose 4 times a day. Both rimantadine and arbidol reduce the febrile period by an average of 1 day in both influenza A2, mixed infections, and non-influenza ARVI.

Ribavirin (ribamidil, virazole) is an antiviral drug that was originally used (mainly in the USA) as having activity against the RS virus in bronchiolitis in the most severe patients with an unfavorable premorbid background (premature, with bronchopulmonary dysplasia). The drug is used for this purpose in the form of continuous (up to 18 hours a day) inhalations through a special inhaler at a dose of 20 mg/kg/day; due to the high price and side effects in Europe, it is practically not used. It also turned out that this drug is active against influenza viruses, parainfluenza, herpes simplex, adenoviruses, as well as coronavirus - the causative agent of severe acute respiratory syndrome (SARS). For influenza in adolescents over 12 years of age, it is used orally at a dose of 10 mg / kg / day for 5-7 days. For SARS, ribavirin is given intravenously.

Progress in the treatment of influenza caused by both type A and type B viruses may be due to the use of the neuraminidase inhibitors oseltamivir-tamiflu and zanamivir-relenza. These drugs, when taken early, reduce the duration of fever by 24-36 hours and have a preventive effect, but there is little experience of their use in children (from 12 years old) in Russia, and they are practically not written about in reference books of recent years. Relenza is used as an inhaled powder (in the USA from age 7) - 2 inhalations (5 mg each) per day with an interval of at least 2 hours (on the 1st day) and 12 hours (from the 2nd to the 5th day treatment). Tamiflu (75 mg capsules and 12 mg/ml suspension) in adults and children over 12 years old is used 75 mg once a day for 5 days 2 times a day, 15-23 kg - 45 mg 2 times a day, 23-40 kg - 60 mg 2 times a day). This drug is the only one to which H5N1 avian influenza is susceptible, and a number of countries are currently stockpiling it in case of an epidemic, which seems to limit its use to relatively small production (Hoffmann-La Roche, Switzerland, produces 7 million doses of Tamiflu per year).

Used topically (in the nose, in the eyes) preparations florenal 0.5%, oxolinic ointment 1-2%, bonafton, lokferon and others have some antiviral activity; they are indicated, for example, in adenovirus infection. Although their effect is difficult to assess, the low toxicity justifies the use of these agents.

The proteolytic processes that occur during the synthesis of viral polypeptides, as well as the fusion of viruses with cell membranes, are capable of inhibiting aprotinins - contrical, gordox, etc., as well as amben. These drugs can be used for severe forms respiratory infections with high inflammatory activity, usually with signs of DIC (as inhibitors of fibrinolysis) and microcirculation disorders. Amben is a part of hemostatic sponges. Kontrykal is used at a dose of 500-1000 IU / kg / day. Used in adults, olifen and erisod, which are part of the preparations of this group, have not yet been tested in children.

Interferons and their inductors have universal antiviral properties, inhibiting the replication of both RNA and DNA, while simultaneously stimulating the immunological reactions of the macroorganism. Early use of interferons can, if not interrupt the course of infection, then mitigate its manifestations.

Native leukocyte interferon α (1000 IU / ml - 4-6 times a day in the nose in a total dose of 2 ml on the 1st-2nd day of illness) is less effective than recombinant interferon preparations. Of the latter, the use of influenza - interferon α-2β (10,000 IU / ml) with thickeners is promising; it is administered in the form of drops in the nose - 5 days, children under one year old - 1 drop 5 times a day (single dose 1000 IU, daily dose - 5000 IU), children from 1 to 3 years old 2 drops 3-4 times a day (single dose 2000 IU, daily - 6000-8000 IU), from 3 to 14 years - two drops 4-5 times a day (single dose - 2000 IU, daily - 8000-10 000 IU). The introduction of parenteral interferon preparations, practiced, for example, for the treatment of chronic hepatitis, is hardly justified in the vast majority of respiratory infections. However, a number of studies have shown the effectiveness of rectal suppositories viferon - interferon α-2β + vitamins E and C for influenza and ARVI. 7 years - they are prescribed 2-3 times a day for 5 days. Viferon is also used prophylactically - in frequently ill children.

Laferon - interferon α-2β powder - is used in the form of nasal drops, and in children over 12 years of age it is administered intramuscularly at 1-3 million IU.

In addition to arbidol, a number of drugs are used as interferon inducers. Amixin (tiloron) won the greatest popularity among children over 7 years old - it is administered at the first symptoms of acute respiratory infections or flu orally after meals, 60 mg 1 time per day on the 1st, 2nd, and 4th day from the start of treatment. Children's Anaferon - homeopathic doses of affinity-purified antibodies to interferon α, it is used 1 tablet every 30 minutes for 2 hours, then 3 times a day, however, there is little convincing evidence of its effectiveness.

In children with acute respiratory viral infections, it is often necessary to treat a primary herpesvirus infection that occurs as severe febrile stomatitis. Children with atopic dermatitis often develop Kaposi's eczema, a herpesvirus infection of the affected skin that is also severe. In older children, ARVI is the most common cause reactivation of herpes viruses in the form of specific rashes on the lips, wings of the nose, less often on the genitals. This infection responds well to treatment with acyclovir - it is used at 20 mg / kg / day in 4 doses, in severe cases - up to 80 mg / kg / day or intravenously at 30-60 mg / kg / day. Valaciclovir does not require fractional administration, its dose for adults and adolescents over 12 years of age is 500 mg 2 times a day.

For the treatment of acute respiratory viral infections, a much larger number of drugs are used in practice, including those of plant origin (adaptogens, dietary supplements, tinctures, etc.). There are no data on the effectiveness of the vast majority of them, but side effects are often encountered.

Antibacterial agents

Bacterial acute respiratory infections in children, as in adults, are relatively few, but they pose the greatest threat in terms of the development of serious complications. Making a diagnosis of bacterial acute respiratory infections at the bedside of an acutely ill child presents great difficulties due to the similarity of many of their manifestations with those in acute respiratory viral infections (fever, runny nose, cough, sore throat), and express methods of etiological diagnosis are practically inaccessible. And the detection of a microbial pathogen in the material of the respiratory tract does not yet speak of its etiological role, since most bacterial diseases are caused by pathogens that constantly grow in the respiratory tract.

Under these conditions, of course, the doctor, at the first contact with the child, tends to overestimate the possible role of the bacterial flora and use antibiotics more often than necessary. Our data show that in Moscow antibiotics are prescribed by 25% of children with acute respiratory viral infections, in some cities of Russia this figure reaches 50-60%. The same trend is typical for other countries: antibiotics for ARVI are used in children in 14-80% of cases. Figures close to our data are given by authors from France (24%) and the USA (25%). In developing countries, antibacterial drugs for ARI are also overused, although this process is constrained by their lower availability. In China, 97% of children with acute respiratory infections who seek medical help receive antibiotics. Obviously, with a viral etiology of the disease, antibiotics are at least useless and, most likely, even harmful, since they disrupt the biocenosis of the respiratory tract and thereby contribute to the colonization of their unusual, often intestinal, flora.

Antibiotics in children with ARVI more often than in bacterial diseases cause side effects - various rashes and other allergic manifestations. During bacterial processes in the body, a powerful release of a number of mediators (for example, cyclic adenosine monophosphate) occurs, preventing the manifestation of allergic manifestations. With viral infections, this does not happen, so allergic reactions are realized much more often.

Another danger of excessive use of antibiotics is the spread of drug-resistant strains of pneumotropic bacteria, which is observed in many countries of the world. Obviously, the unjustified use of antibiotics leads to unnecessary costs for treatment.

The influence of antibiotics on the development of the child's immune system should not be ignored. The predominance of the immune T-helper response type 2 (Th-2), characteristic of the newborn, is inferior to the more mature T-helper response type 1 (Th-1), largely under the influence of stimulation with endotoxins and other products of bacterial origin. Such stimulation occurs both during a bacterial infection and during SARS, since a viral infection is also accompanied by increased (albeit non-invasive) reproduction of pneumotropic flora. Naturally, the use of antibiotics weakens or completely suppresses this stimulation, which, in turn, contributes to the preservation of the Th-2-directed immune response, which increases the risk of allergic manifestations and reduces the intensity of anti-infective protection.

Indications for antibiotic treatment of acute respiratory infections

The recommendations of the professional societies of pediatricians in most countries emphasize the importance of avoiding the use of antibacterial agents in children with uncomplicated respiratory viral infection. The recommendations of the US Academy of Pediatrics emphasize that antibiotics are not used not only for uncomplicated SARS, but also mucopurulent rhinitis is also not an indication for antibiotics if it lasts less than 10-14 days. The French consensus allows the use of antibiotics for ARVI only in children with a history of recurrent otitis media, in babies under the age of 6 months, if they attend a nursery and in the presence of immunodeficiency.

The recommendations of the Union of Pediatricians of Russia indicate that in uncomplicated acute respiratory viral infections, systemic antibiotics in the vast majority of cases are not indicated. This document lists the manifestations of the disease observed in the first 10-14 days that cannot justify the administration of antibiotics.

The question of prescribing antibiotics in a child with ARVI arises if he has a history of recurrent otitis media, an unfavorable premorbid background (severe malnutrition, congenital malformations) or if there are clinical signs of immunodeficiency.

The following are signs of a bacterial infection that require antibiotic treatment:

• purulent processes (sinusitis with swelling of the face or orbit, lymphadenitis with fluctuation, paratonsillar abscess, descending laryngotracheitis);
• acute tonsillitis with inoculation of group A streptococcus;
• anaerobic angina - usually ulcerative, with a putrid odor;
• acute otitis media confirmed by otoscopy or with suppuration;
• sinusitis - while maintaining clinical and radiological changes in the sinuses after 10-14 days from the onset of SARS;
• respiratory mycoplasmosis and chlamydia;
• pneumonia.

More often than these obvious foci, the pediatrician sees only indirect symptoms of a probable bacterial infection, among which persistent (3 days or more) febrile temperature, shortness of breath in the absence of obstruction (respiratory rate above 60 per 1 min in children 0-2 months old) are most often detected. , more than 50 in 1 min at the age of 3-12 months and more than 40 - in children 1-3 years old), asymmetry of auscultatory data in the lungs. Such symptoms make it necessary to prescribe an antibiotic, which, if the diagnosis is not confirmed during a subsequent examination, should be immediately canceled.

For the initial treatment of bacterial acute respiratory infections, a small set of antibiotics is used. With otitis and sinusitis, to suppress the main pathogens - pneumococcus and Haemophilus influenzae, amoxicillin is prescribed orally 45-90 mg / kg / day. In recent antibiotic-treated children, amoxicillin/clavulanate 45 mg/kg/day is used to suppress the growth of probably resistant Haemophilus influenzae and Moraxella in these patients.

Acute tonsillitis requires a differential diagnosis between adenoviral tonsillitis, infectious mononucleosis and streptococcal tonsillitis. Viral angina is characterized by cough, catarrhal syndrome, for streptococcal - no cough, for mononucleosis - blood changes. Antibiotics (penicillin fau, cephalexin, cefadroxil) are indicated for streptococcal tonsillitis; the use of amoxicillin is undesirable, since in mononucleosis it can cause toxic rashes. Although adenoviral tonsillitis does not require an antibiotic, the presence of severe leukocytosis (15-25x10 9 / l) and an increase in the level of C-reactive protein justify their use in many cases.

Bronchitis is usually a viral disease that does not require antibiotic treatment. The exception is bronchitis caused by mycoplasma, when they are detected, the use of macrolides (azithromycin, midecamycin, etc.) is indicated. Clinical signs of mycoplasmal bronchitis are:

• age (preschool and older);
• high temperature without severe toxicosis;
• an abundance of crepitant wheezing (as in bronchiolitis in infants);
• wheezing asymmetry;
• dull "dry" catarrh of the upper respiratory tract;
• hyperemia of the conjunctiva ("dry conjunctivitis");
• local enhancement of the broncho-vascular pattern on the radiograph.

The choice of antibacterial agents for the initial treatment of community-acquired pneumonia is also not very large, since most of the “typical” pneumonias are caused by pneumococcus or Haemophilus influenzae (the exception is the first months of life, when staphylococci and intestinal flora can be the causative agent), while “atypical” forms are treatable macrolides. The choice of starting antibiotic for pneumonia is determined taking into account the likely causative agent of the disease.

With typical pneumonia (febrile, with a focus or homogeneous infiltrate), the following are used:

• E. coli, staphylococcus aureus) - amoxicillin / clavulanate inside, intravenously; cefuroxime, ceftriaxone or cefazolin + aminoglycoside intravenously, intramuscularly;
• 6 months-18 years: mild (the most likely pathogens are pneumococcus, H. influenzae) - amoxicillin inside; severe (the most likely pathogens are pneumococcus, in children under 5 years old - H. influenzae type b) - cefuroxime, ceftriaxone or cefazolin + aminoglycoside intravenously, intramuscularly.

With atypical (with inhomogeneous infiltrate) pneumonia:

• 1-6 months (the most likely pathogens are C. trachomatis, U. urealyticum, rarely P. carinii) - macrolide, azithromycin inside, co-trimoxazole;
• 6 months-15 years (the most likely pathogens are M. pneumoniae, C. pneumoniae) - macrolide, azithromycin, doxycycline (> 12 years) orally.

Pathogenetic methods of treatment

These methods include interventions used in acute laryngitis and obstructive forms of bronchitis.

Acute laryngitis, croup are conditions that require assessment of the degree of stenosis, as judged by the intensity of inspiratory chest indrawings, pulse rate and respiration. Croup of the 3rd degree requires urgent intubation, croup of the 1st and 2nd degree is treated conservatively. A patient with laryngitis does not receive antibiotics, according to the world consensus, the most effective is the introduction of dexamethasone intramuscularly 0.6 mg/kg, which stops the progression of stenosis. Further treatment is continued with inhaled steroids (metered or through a nebulizer - pulmicort) in combination with antispasmodics (salbutamol, berotek, berodual in inhalations).

Stenosis of the larynx can be caused by epiglottitis (in its etiology, the main role belongs to H. influenzae type b) - it is characterized by high temperature and increased stenosis in the supine position; the appointment of an antibiotic (cefuroxime, ceftriaxone) in this case is mandatory.

Difficulty breathing and expiratory dyspnea are often observed with bronchiolitis and obstructive bronchitis, as well as with an asthma attack on the background of SARS. Because bacterial infection is rare in such cases, antibiotics are not warranted. Treatment - inhalation of sympathomimetics (in young children it is better in combination with ipratropium bromide) and the use of steroids in refractory cases - makes it possible to cope with obstruction in 1-3 days.

Symptomatic therapy for acute respiratory infections

As indicated above, ARI is the most common reason for the use of drugs, in particular symptomatic drugs, which occupy most of the pharmacy shelves. It is important, however, to clearly understand that the mere presence of this or that symptom should not be the basis for intervention, it is necessary first of all to assess to what extent this symptom disrupts life and whether the treatment will turn out to be more dangerous than the symptom.

Fever accompanies most acute respiratory infections and is a protective reaction, so reducing its level with antipyretics is justified only in certain situations. Unfortunately, many parents and doctors consider fever the most dangerous manifestation of the disease and strive to normalize the temperature at all costs. According to our research, 95% of children with acute respiratory viral infections receive antipyretics, including 92% of children with subfebrile temperature. Such tactics cannot be considered rational, since fever, as a component of the body's inflammatory response to infection, is largely protective.

Antipyretics do not affect the cause of fever and do not reduce its duration, they increase the period of virus isolation in acute respiratory infections. In most infections, the maximum temperature rarely exceeds 39.5 °. This temperature does not pose any threat to a child older than 2-3 months; usually, in order to improve well-being, it is enough to lower it by 1-1.5 °. Indications for temperature reduction:

• Previously healthy children over the age of 3 months - with a temperature> 39.0 ° -39.5 °, and / or with discomfort, muscle aches and headache.
• Children with a history of febrile convulsions, with severe heart and lung diseases, as well as from 0 to 3 months of life - at a temperature> 38 ° -38.5 °.

The safest antipyretic for children is paracetamol, its single dose is 15 mg/kg, the daily dose is 60 mg/kg. Ibuprofen (5-10 mg/kg per dose) has more side effects (with a similar antipyretic effect), it is recommended to use in cases where an anti-inflammatory effect is required (arthralgia, muscle pain, etc.).

In acute respiratory infections in children, acetylsalicylic acid (aspirin) is not used - in connection with the development of Reye's syndrome, metamizole sodium (analgin) inside (danger of agranulocytosis and a collaptoid state), amidopyrine, antipyrine, phenacetin. Nimesulide is hepatotoxic; unfortunately, his children's forms were registered in Russia, although they are not used anywhere else in the world.

Treatment of a runny nose with vasoconstrictor drops improves nasal breathing only in the first 1-2 days of illness, with longer use they can increase the runny nose, and also cause side effects. At an early age, due to pain, only 0.01% and 0.025% solutions are used. Convenient (after 6 years) nasal sprays that allow even distribution of the drug at a lower dose (for the nose, vibrocil). But most effectively cleans the nose and nasopharynx, especially with thick exudate, saline solution (or its analogues, including a home-prepared salt solution: add salt at the tip of a knife to 1/2 cup of water) - 2-3 pipettes in each nostril 3-4 times a day in the supine position with the head hanging down and back. Orally administered cold remedies containing sympathomimetics (phenylephrine, phenylpropanolamine, pseudoephedrine) are used after 12 years; from 6 years, fervex is prescribed for children that does not contain these components. Antihistamines, including the second generation, effective in allergic rhinitis, WHO does not recommend the use of acute respiratory infections.

The indication for the appointment of antitussives (non-narcotic central action - glaucine, butamirate, oxeladin) is only a dry cough, which usually quickly becomes wet with bronchitis. Expectorants (their cough-stimulating action is similar to that of emetics) are of dubious effectiveness and can cause vomiting in young children, as well as allergic reactions, up to anaphylaxis. Their appointment is more a tribute to tradition than a necessity, expensive remedies from this group have no advantages over conventional galenic ones, WHO generally recommends limiting yourself to "home remedies".

Of the mucolytics, acetylcysteine ​​is the most active, but with acute bronchitis in children, there is practically no need for its use; carbocisteine ​​is prescribed for bronchitis - based on its beneficial effect on mucociliary clearance. Ambroxol with thick sputum is used both inside and in inhalations. Aerosol inhalations of mucolytics are used for chronic bronchitis; aerosol inhalations of water, saline, etc., are not indicated for acute respiratory infections.

With a long-lasting cough (whooping cough, persistent tracheitis), anti-inflammatory drugs are indicated: inhaled steroids, fenspiride (erespal). Soothing lozenges and sprays for pharyngitis usually contain antiseptics, they are used from 6 years old; starting from the age of 30 months, a topical antibiotic fyuzafungin is used, produced in an aerosol (bioparox) and used both nasally and orally.

Still popular in Russia for bronchitis, mustard plasters, jars, hot plasters in children should not be used; with acute respiratory infections, there are rarely indications for physiotherapy. Surprising is the popularity of halochambers, the purpose of which is "inhalation of salt vapor", as in a salt mine. But in a salt mine, the patient is not affected by salt (which does not belong to volatile substances), but by clean air, free from dust and other allergens; in addition, they are not there for 15 minutes. Halochamber treatment is not in the consensus for asthma either, yet many clinics spend huge sums of money to build them.

The funds indicated in this section, with a few exceptions, cannot be considered mandatory for ARVI; moreover, we often encounter side effects resulting from such treatment. Therefore, it should be a rule to minimize drug loads in cases of non-severe ARVI.

The problem of acute respiratory infections in childhood remains relevant not only because of their prevalence, but also due to the need to revise and optimize treatment tactics. The accumulated data show that the approaches prevailing in the practice of pediatricians at least do not contribute to the formation of the child's immune system, so the revision of tactics should be primarily aimed at modifying the therapeutic activity, in particular, at reducing the cases of unjustified prescriptions of antibacterial and antipyretic drugs.

Literature

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3. Ministry of Health of the Russian Federation, Russian Academy of Medical Sciences, Research Institute of Influenza. Standardized principles for the diagnosis, treatment and emergency prevention of influenza and other acute respiratory infections in children. St. Petersburg, 2004.
4. Union of Pediatricians of Russia, International Foundation for Maternal and Child Health: Scientific and practical program “Acute respiratory diseases in children. Treatment and prevention". M., 2002.
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V. K. Tatochenko, doctor of medical sciences, professor
NTsZD RAMS, Moscow

It is hardly possible to find a person who has not suffered at least once in his life an acute respiratory disease. We experience the disease habitually with drugs and the resulting complications. But the symptoms of acute respiratory infections and acute respiratory viral infections in children are much more disturbing, and every parent tries to do everything so that the disease quickly recedes.

Medical illiteracy often does not allow us to distinguish between a cold and the flu, especially when it comes to our babies. Unlike us, they are not yet able to talk about their pain, discomfort. But depending on how quickly the parents reveal the signs of the disease, the effectiveness of the treatment and the recovery time will depend.

Parents need to know what the symptoms of SARS are in order to detect the disease in a timely manner

The World Health Organization has established more than 250 types of respiratory infections.

1. Acute respiratory viral infections: influenza, parainfluenza, adeno-, rota-, corona-, rhino-, paraviruses, etc. Influenza occurs due to a virus of the same name, the rest of the respiratory infections are called SARS.
2. Bacterial infection, the same rhinopharyngitis, rhinitis, bronchitis, tracheitis, pneumonia and others are caused by streptococcal, staphylococcal, pneumococcal and other bacilli.
3. Mycoplasma are caused by microbes.
4. Unspecified types include atypical infection.

Diagnosis of all types of infectious respiratory diseases is difficult due to the similarity of symptoms, and a professional doctor establishes a diagnosis of ARVI, undertaking treatment for the signs of the disease. To distinguish acute respiratory infections, that is, a cold from the flu, you need to know the sequence of onset of symptoms at the last.

Advantages of breastfeeding in acute respiratory infections and acute respiratory viral infections in children

ARVI infection occurs by air through the cough, sneezing of the patient. Babies who are on breastfeeding, up to 6 months of age, they practically do not get ARVI. The reason for this is the composition of mother's milk. It contains a unique set of useful components: vitamins, minerals, trace elements and enzymes that protect a small organism from any kind of infection. Artificial babies, unfortunately, are defenseless against the attacks of microbacteria, viruses and can become infected under any conditions. Therefore, an important and main point of parents is to protect the health of their beloved child and regular visits to the pediatrician.

Signs of acute respiratory infections and acute respiratory viral infections in children

Influenza is manifested by the suddenness of symptoms. First of all, pathogens affect the mucous membrane of the nose, larynx, respiratory canals. Therefore, there is perspiration, sore throat. You can determine by the child if he refuses to drink, eat.

With the flu, the temperature rises quite sharply

The next stage is the introduction of the virus into the epithelium of cells and spread throughout the body through the blood. Intoxication occurs, causing headache and dizziness, aching joints. Given the fact that the child cannot talk about it, you need to pay attention to the following points:

• the baby does not sleep well, restless sleep, interrupted by crying, whims;
• the baby's skin becomes pale, the area around the nose and lips turns blue;
• the child's voice becomes hoarse;
• runny nose occurs.

It is impossible not to notice the high temperature, so it is necessary to measure it regularly.

ARI is caused by bacteria that every person has in the body. Their activation can be provoked by:

• hypothermia;
• protracted, chronic diseases;
• draft, cold air.

In a child, the disease manifests itself through:

• runny nose;
• sneezing
• hoarseness of voice;
• swollen lymph nodes.

If the child's immunity is too suppressed, the temperature rises and complications are possible, but such cases are rare and the common cold disappears with adequate treatment without consequences.

Treatment of acute respiratory infections and acute respiratory viral infections in children

Acute respiratory disease disappears after 7 days, maximum after 10, the main thing is to take adequate treatment and regimen.

• In case of a runny nose, use vasoconstrictors that open the way to free breathing and minimize the risk of mucus stagnation - Aquamaris, Salin, etc. These drugs are designed specifically for babies in the form of drops, nasal sprays. You can use them for no more than 3 days.
• The child's cough in the first 3 days is dry (unproductive), then sputum begins to be expectorated. In these cases, parents can only give warm drinks: milk, herbal tea with honey, lemon, cocoa butter, decoction of chamomile, linden flowers, raspberries. Medications only as prescribed by a doctor.
• Dryness in the throat, perspiration is treated with available means: rinsing with soda solution (for 1 glass of warm water, half a teaspoon of soda and salt). Older children can be given lozenges with a softening effect with menthol, lemon balm, as well as antitussive sprays.

Runny nose in children can be treated with AquaMaris

What to give a child at the first sign of SARS

Treatment of acute respiratory viral infection requires an individual approach. For appointments, the doctor needs to collect a complete history and study the symptoms, to which therapy will be directed. It includes exposure to influenza drugs of the following series:

• Antiviral, as well as immunomodulatory, stimulating the body's production of its own interferon - Kagocel, Viferon, Kipferon.
• Antipyretics - Ibuprofen and its derivatives.

• Antihistamines for vasodilation - Diazolin, Suprastin, etc.
• Bronchodilators, antispasmodics, painkillers are also prescribed, but therapy should only be prescribed by an experienced specialist.

What to do with SARS in a child

Regardless of whether the baby has an acute respiratory disease or the flu, there are a number of mandatory measures that alleviate the condition of the child.

1. Bed rest. The child should be at rest and save the already meager reserves of protective forces. It is required to protect him from visiting strangers. If the baby has pain in the eyes, photophobia, lacrimation, close the curtains, turn off the luminous devices.
2. Drink. Water, compotes, herbal teas, juices, fruit drinks are a great way to cleanse the body of toxins caused by the decay products of viruses and parts of healthy cells. Also, water regulates heat transfer and moisturizes dry, inflamed respiratory mucosa, helps to thin sputum and expectorate mucus.
3. Regular airing of the child's room. In stagnant, dry air, the supply of oxygen dries up, because of which the condition of the sick child worsens. There is also a rapid growth of infection in the atmosphere, and viruses again penetrate the body, again affecting the internal organs.

The onset of SARS in a child: how to stop

Drinking plenty of fluids is the main source of your baby's recovery. Any infection is dehydration of the body, and as we know, dryness of the mucous membrane, intoxication occurs. If the baby is sick, apply it to the chest more often. Give older children fruit drinks, compote, warm water, raspberry decoctions.

Bed rest in the treatment of SARS is extremely important

Important: regardless of whether the parents know the exact diagnosis or not, it is necessary to call an ambulance at the first sign of an infectious disease. Self-medication can lead to the development of complications and dangerous consequences.

Red cheeks in a child with ARVI signal a high temperature, which at first should not be knocked down. But if it grows beyond the mark of 38.5 degrees, before the ambulance arrives, apply a napkin with cool water to the wrist and ankles. You can also wipe the entire body with a solution of vinegar.

In a child with SARS, the eye festered - there is an attachment of a bacterial infection that affects the mucous conjunctiva. This symptom is a frequent companion of colds in babies, since the virus easily moves over the surface. Babies rub their eyes and nose and involuntarily spread the infection. If a child’s eyes turn sour during ARVI, complex treatment is necessary with the use of antiviral rectal suppositories, washing the mucous membrane of the eyes with special solutions, Okomistin drops containing the antimicrobial miramistin.

Prevention of SARS in children

Measures to prevent respiratory infections are an essential part of keeping a child healthy. In order for the baby not to be exposed to frequent colds, it is necessary to strengthen his immunity. Children under 1 year old can be massaged, hardened in a mild form - water the legs either with cold or warm water.

• With a surge in influenza epidemics, it is categorically not to let infected people into the house, and even healthy, but strangers.
• Before communicating with the baby, parents must wash their hands, face, remove outer clothing.
• Don't force your child to eat. Swallowing with sore throat and perspiration is not pleasant to anyone. Weld Easy chicken bouillon, porridge, mashed potatoes and give the baby only when he wants it.
• If there is a person with flu in the house, immediately apply immunomodulatory suppositories - Viferon, Kipferon.

Is the child sick? Don't Panic, Get Started

The first signs of SARS in a child: what to do? The main thing - do not panic and take effective treatment prescribed by the pediatrician. A viral infection should not be frightening, thanks to infection, the baby's body receives a dose of antigens that enhance the immune response, which will subsequently make it easy to endure the disease or bypass it.

Frequent acute respiratory infections - a manifestation of acute respiratory diseases with a frequency of about once a month. The need to avoid drafts, dress warmly, take various medications - this can hardly please your child who wants to play and grow on a par with their peers. These symptoms don't just happen. And if your son or daughter suffers from 6 or more colds every year, you should contact a specialist to find the causes and get rid of them.

Children suffering from respiratory diseases several times a year belong to a special group of “CHID” (frequently ill children) and are subject to special control by pediatricians. The critical frequency of diseases is determined by the age of the child and is:

• from 4 times - for children under the age of 1 year;
• from 6 times - for children aged 1 to 3 years;
• from 5 times - for children aged 3 to 5 years;
• from 4 times - for children over the age of 5 years.

In some cases, up to 8 acute respiratory infections per year are considered the norm, if the disease in children is mild, without high fever and acute characteristic symptoms.

Often the cause of acute respiratory infections is contact with sick children in preschool institutions (kindergartens, circles, etc.), which, on the one hand, is unpleasant, but on the other hand, is a necessary condition for the formation of the child's immune system.

Child immunity

Immunity is the more stable, the more often it meets with various infections and defeats them. That is, this system human body- trained. Moreover, it develops not only as a result of past illnesses, but also in other ways:

• food. Proper nutrition that your child receives not only contributes to the development of his body and the formation of new cells, tissues, growth of the baby, but also helps the cells of the immune system. With food, children must necessarily receive the necessary vitamins - C, A, E, B. They are found in meat, fish, eggs, dairy products, animal liver, nuts, legumes, brightly colored vegetables and fruits (carrots, tomatoes, apricots , pumpkin, etc.);
• healthy sleep and physical activity. Remember that the sleep period in young children is at least 10 hours (even more at an early age). And for schoolchildren - at least 8 hours. Sleep periods should be combined with periods of physical activity, walks in the fresh air. Winter sports and swimming are especially beneficial for strengthening the immune system;
• hardening. Numerous hardening methods can be found on the Internet yourself, but it is better to consult a pediatrician. Remember that it is necessary to start hardening in the warm season, so that the child's body has time to get used to and adapt. This should be done gradually so as not to provoke a cold;
• osteopathic and manual procedures. Massage and osteopathy help maintain the overall tone of the body, and therefore contribute to the development of the immune system.

Maximum efficiency is observed with a complex effect on the body: a balanced diet, physical activity, hardening, osteopathy and massage. Try to pay as much attention as possible to the health of the child and strengthening his immunity, and you will soon forget about frequent colds.

Diagnosis and symptoms of acute respiratory infections

All types of acute respiratory infections are characterized by the same signs - the so-called symptoms of intoxication:

• elevated temperature. The temperature may not be very high. But even deviations from the norm by a few tenths of a degree should not be taken as something normal. In children, even small deviations can be quite difficult and have unpleasant consequences;
• tearfulness. Often the child feels discomfort, some pain, but cannot express it in words. ARI can manifest itself in restless behavior, causeless crying and whims, refusal to eat;
• stool disorders. Diarrhea usually occurs in infants under 1 year of age, but may occur with ARI in older children;
• cough and runny nose. Although these indicators may not be very pronounced, against the background of other symptoms, they indicate a possible acute respiratory disease in a child.

In many cases, the disease can proceed without fever. Then inflammatory processes in the mucous membranes (laryngitis) will clearly warn about it. Because of it, children have a dry cough already in the first stages of the disease. In babies younger than 1 year old, the symptoms of the disease can also be expressed in the appearance of the so-called croup - an inflammatory edema of the larynx directly above the vocal cords. This leads to pain when swallowing, a violation of the swallowing reflex, refusal to eat.

The complexity of the croup is that the edema usually appears at night. Difficulty breathing, restlessness in sleep, barking cough, blue lips caused by lack of oxygen will help determine its appearance. A child younger than one year old can turn completely blue due to croup - the result of the same hypoxia. For children, it is of particular danger, since disturbances in blood circulation and the supply of oxygen to brain cells can cause their irreversible change, which will entail not only a progressive cold, but also possible other disorders in the child's body.

At the first sign of a respiratory infection, parents need to take emergency measures:

• call a doctor or an ambulance;
• if possible, calm the child by taking him in his arms, shaking him;
• warm the baby by moving him to a warm room - for example, a bathroom with hot water;
• make steam inhalations - with clean water or a weak alkaline solution ( mineral water, a solution of baking soda);
• give the child a plentiful alkaline drink (mineral water without gas or a solution of soda - a third of a teaspoon per glass of warm water).

Also, respiratory infections and diseases can manifest themselves in a severe runny nose without coughing and fever. In this case, a runny nose can keep a child from several days to several weeks. It is characterized in the first stages of the disease by watery secretions, which later - with the development of the disease - turn into mucous and mucopurulent.

Although the cold itself, carried by a child, in most cases does not pose a critical danger to his life and health, unpleasant consequences can be caused by complications:

• convulsions that occur at elevated temperatures;
• croup and bronchitis, which can cause various chronic respiratory diseases;
• otitis and sinusitis arising from the spread inflammatory diseases on the ear and paranasal sinuses.

Osteopathic causes of frequent acute respiratory infections in children

From the point of view of osteopathy, the causes of frequent acute respiratory infections are a violation of the blood flow to the brain, which leads to the appearance of symptoms and the development of the disease, often with complications. The fact is that the brain, like the heart (as well as other internal organs), pulsates, filling with blood and receiving from it the oxygen necessary for normal operation cells. Together with the brain, the bones of the skull, as well as the brain membranes (shells), also make micropulsations. The latter are in equilibrium due to their uniform tension, which can be disturbed by external influences. For example, a head injury.

Usually, frequent colds are not associated with injuries and injuries received by the child, and they can be the cause. The equilibrium tension of the membranes is disturbed, due to which the microvibrations of the skull bones are partially or completely blocked. As a result, this leads to a violation of the blood supply to the brain, its partial hypoxia.

The causes of frequent manifestations of acute respiratory infections can be not only injuries, but also other disorders that may not be felt even by the child himself. Therefore, it is important that consultations and examinations with an osteopath become regular. Try to provide the specialist with the most complete information about the health of children, disorders in their body, possible hereditary diseases, etc.

The most accurate history in the vast majority of cases contributes to the rapid search for causes and their elimination. According to its results, the osteopathic doctor prescribes treatment, which may be different - depending on the nature and complexity of the disease and its root causes, the anatomical features of the child.

The course usually includes a set of procedures that can be carried out with long breaks (from several weeks to several months). Osteopathic treatment courses can be repeated at certain intervals (it is determined by the doctor) to prevent recurrence of the disease and compensate for disorders in the child's body.

How osteopathy treats frequent acute respiratory infections in a child

The osteopathic treatment of regularly manifesting acute respiratory infections in a child includes several different methods that can be used individually or in combination, as well as combined with other methods of treatment and prevention. The search for the cause begins with a thorough examination of the body, which helps to identify violations in muscle development, skeletal bones, and blood circulation.

Most often, the root causes lie in the cervical region and the head of the patient. The manual impact of a specialist is carried out in parallel on several body structures - the skull, cervical regions, spine, chest muscles, etc. Thus, the specialist simultaneously eliminates mechanical blockages for the normal functioning of muscles, joints, the circulatory system of the body and restores the intracranial balance of the meninges.

The child's body is a self-regulating system that is quite capable of coping with frequent acute respiratory infections and other manifestations of immunity problems. But only on condition that external or internal factors will not interfere with it. The latter just include problems with the muscles, joints, spine and brain. Cranial osteopathic techniques are not so much a treatment in themselves, but rather help the body to get rid of diseases and their consequences on their own.

In parallel with the osteopathic treatment of frequent acute respiratory infections, other methods of treatment (including medications) can be used to get rid of the painful and unpleasant symptoms of acute respiratory infections.

Frequent colds in a child are effectively treated with osteopathic methods. At the same time, a general improvement of the body is observed, since cranial techniques help to improve the adaptive ability of the body to environmental conditions.

Osteopathy and vaccinations

Many parents note the fact that after vaccinations designed to strengthen the immune system, the child often begins to feel worse - he gets sick for a long time and hard. It is believed that preventive vaccinations do not pose a danger to the human body if it is in full health. Unfortunately, today completely healthy children are rather an exception. But you should not completely refuse vaccinations - because of the danger of damage to the body by complex and dangerous infections.

After vaccinations, it is recommended to contact an osteopathic specialist to help correct the negative consequences of their impact, which affect, first of all, compression of the intracranial cavity and impaired intracerebral circulation.

Prevention of frequent frequent acute respiratory infections

Your child will feel much better if you keep a close eye on his health, regularly referring to specialists. An osteopathic doctor in the treatment of acute respiratory infections is an important element of success. He will not only help eliminate the symptoms and normalize the functioning of the body, but also advise effective methods for preventing the occurrence of colds and viral diseases.

In addition to general strengthening procedures, it is recommended to periodically carry out preventive osteopathy, which will allow you to correct the negative consequences that have accumulated in the body and eliminate diseases on early stages their occurrence.

Frequent acute respiratory infections will no longer be a problem for you and, first of all, for your child.

ARI (acute respiratory infections, acute respiratory infections, colds) do not manifest themselves immediately, the first signs in babies may be anxiety, refusal to eat, bad dream. And only later there are such signs of the disease as a runny nose, sneezing, fever, cough. And here you can not do without a doctor. After all, colds with improperly organized and inadequate care, including self-medication, often lead to the formation of a group of frequently ill children, the development of chronic foci of infection, diseases of the gastrointestinal tract, kidneys, favor the formation of allergic diseases and delay psychomotor and physical development.

Error one: in the treatment of acute respiratory infections and acute respiratory viral infections, the desire to "bring down" the temperature. An increase in body temperature (hyperthermia, fever) can occur against the background of acute infectious diseases (ARI, pneumonia, intestinal infections, and a number of others), with dehydration, overheating, damage to the central nervous system, etc. Therefore, before the start of the decrease in temperature, it is necessary to establish the cause that caused its increase. This will help the doctor. In addition, it must be remembered that lowering the temperature improves well-being, but does not affect the cause of the disease. High temperature is primarily a protective reaction, and lowering its level is far from always justified. Many viruses and bacteria stop multiplying at temperatures above 37–38 ° C, with fever, absorption and digestion of bacteria increase, lymphocytes are activated - blood cells involved in the fight against infectious agents, the formation of antibodies is stimulated - protein substances that neutralize the action of microorganisms; a number of protective substances, including interferon, a protein that has an antiviral effect, are released only at temperatures above 38 ° C. Therefore, doctors strongly recommend not to use antipyretics if the child's temperature does not exceed 38.5 ° C. In this situation, it is usually enough to improve heat transfer: open the child, wipe it with water at room temperature, let the water dry without dressing the baby (heat transfer increases during evaporation), put a damp cold towel on the forehead. At present, wiping with vodka is not recommended, because. absorption of alcohol is possible (especially in young children) and poisoning of the child's body up to the development of a coma. However, parents need to clearly know the situations when, before the doctor arrives, the child needs to be given an antipyretic:

• initially healthy children older than 2 months at a temperature above 38.5 ° C (in the armpit), younger than 2 months - above 38 ° C;
• at temperatures above 38 ° C for children with perinatal lesions of the central nervous system, congenital heart defects with circulatory disorders, hereditary metabolic anomalies;
• at a temperature above 38 ° C for children who have previously had convulsions against a background of fever;
• at any temperature, accompanied by pain, pallor, severe malaise, impaired consciousness.

It must be remembered that antipyretics do not affect the cause of fever and its duration, in addition, they increase the period of virus isolation in acute respiratory infections. To reduce the temperature in a child, it is possible to recommend drugs based on paracetamol (act 2-3 hours) or ibuprofen (act up to 6 hours, have a fairly pronounced anti-inflammatory effect, but more often give side effects - abdominal pain, nausea, vomiting, impaired stool, bleeding ); but analgin(causes severe damage to the hematopoietic system) and aspirin(can cause Reye's syndrome - severe damage to the liver and brain) by decision of the Pharmaceutical Committee of the Russian Federation are not shown to children under 16 years of age! Children are also contraindicated amidopyrine, antipyrine and phenacetin due to their adverse effect on the hematopoietic system, frequent allergic reactions, the likelihood of provocation of a convulsive syndrome. A second dose of antipyretic drug should be given only after a new increase in temperature to the level indicated above, but not earlier than four hours later - this reduces the risk of overdose.

Error two: regular intake of antipyretics. Long-term regular use (2-4 times a day) of antipyretics should be avoided due to the danger side effects and possible difficulty in diagnosing bacterial complications (otitis media, pneumonia, etc.). If you regularly give your child antipyretics, you can create a dangerous appearance of well-being! With such a "course" tactics, the signal about the development of a complication (pneumonia or other bacterial infection) will be masked and, accordingly, time will be missed to start its treatment. Therefore, to give a second dose of antipyretic should be only with a new rise in temperature. The simultaneous appointment of an antipyretic drug and an antibiotic makes it difficult to assess the effectiveness of the latter.

Error three: uncontrolled use of medicinal herbs. Medicinal herbs (phytotherapy) are widely used in the treatment of acute respiratory infections. Since ancient times, people have been treated with herbs and have accumulated a large amount of knowledge about their properties. This experience is important to use wisely. With acute respiratory infections, the doctor may recommend fees based on chamomile, calendula, sage, eucalyptus, etc. (for gargling, inhalation, oral administration). However, the use of medicinal herbs must be approached with caution: one must remember the dose and not forget about contraindications. It is simply dangerous to prescribe “herbs” to your child without understanding their action. With extreme caution, phytotherapy should be used by people with allergies and children under 12 years of age, in whom the use of any medicinal herbs is possible only after consulting a doctor.

Mistake four: the desire to dress warmer at a temperature. A child with a fever should not be dressed warmer than usual. The processes of heat generation and heat loss are interconnected, they help maintain a constant body temperature. "Wrapping up" a child against the background of increased heat generation leads to a violation of heat transfer, which contributes to a sharp deterioration in the general condition, up to loss of consciousness from overheating. With an increase in body temperature, everything must be done to ensure that the body has the opportunity to lose heat: clothing should be loose and light.

Mistake five: fear of hypothermia of the child. A sick child needs fresh air. It is necessary to ventilate the room as often as possible (it is possible in the absence of a child), regularly (2 times a day) carry out wet cleaning. Frequent ventilation facilitates breathing, reduces runny nose. In the room where the child is located, there should be a constant temperature (20–22 ° C) and optimal humidity (60%).

Mistake six: taking antibiotics for any acute respiratory disease. As you know, most acute respiratory infections (90% or more) are caused by respiratory viruses (they are often called ARVI - acute respiratory viral infections), bacterial acute respiratory infections are few. Viruses, unlike bacteria (single-celled microorganisms), are very simple and are not cells, they cannot live and reproduce on their own and do this only inside other organisms (including humans), or rather, inside cells. Antibiotics have no effect on viruses, moreover, they not only do not prevent bacterial complications, such as pneumonia (lung inflammation), otitis media (middle ear inflammation), sinusitis (inflammation of the paranasal sinuses), but also, by inhibiting the growth of normal microflora, open the way to colonize the respiratory tract with antibiotic-resistant microorganisms. The irrational use of antibiotics in ARVI often leads to negative consequences - an increase in the number of drug-resistant microorganisms, the development of dysbiosis (changes in the composition of the microflora) of the intestine, and a decrease in the child's immunity. Uncomplicated SARS do not require antibiotics. They are indicated only for bacterial complications, which can be determined (as well as select the appropriate antibacterial drug) only by a doctor. Preference is given to penicillins ( amoxicillin, synonym flemoxin), not used biseptol(the causative agents of bacterial acute respiratory infections have become resistant to it). One of the ways to limit the excessive use of general antibacterial agents in acute respiratory infections is the use of drugs that act locally and suppress the pathogenic flora in the mucous membrane of the respiratory tract, with little or no effect on the entire body ( bioparox- used in children older than 30 months).

Error seven: treatment of the common cold with acute respiratory infections with vasoconstrictor drugs until "recovery". Vasoconstrictor drugs ( Nazivin,naphthyzinum,otrivin,galazolin etc.) only temporarily facilitate nasal breathing, but do not eliminate the causes of the common cold. In addition, they can only be used for the first three days, with longer use they can even increase the runny nose and cause side effects, up to atrophy (thinning with subsequent dysfunction) of the nasal mucosa. It should also be remembered that vasoconstrictor drops from the nasal cavity in children can be quickly absorbed into the bloodstream and have a general effect on the body, leading to increased heart rate, increased blood pressure, headache, and general anxiety. The question of their use and dosage is decided only after consultation with a doctor. For washing the nose in children, it is recommended to use isotonic solutions ( saline,aquamaris, physiomer). They are prepared from sea water, sterilizing it and bringing the salt content to an isotonic concentration (corresponding to the concentration of salts in the blood). The drugs help to normalize the fluidity and viscosity of mucus. It is believed that the salts and microelements contained in sea water (calcium, potassium, magnesium, iron, zinc, etc.) contribute to an increase in the motor activity of cilia, which remove bacteria, dust, etc. from the nasal cavity, and activate regenerative, wound healing processes in cells of the nasal mucosa and normalization of the function of its glands. Washing is carried out 4-6 times a day (if necessary, more often) alternately in each nasal passage.

Error eight: reception medicines for "treatment of cough" (antitussive, expectorant, thinning sputum). Cough is a protective reaction aimed at removing foreign particles (viruses, bacteria, etc.) from the respiratory tract, and its suppression does not lead to a cure. Antitussives ( glaucine, libexin, butamirate etc.) are shown to reduce dry, frequent cough, leading to vomiting, sleep and appetite disturbance (excruciating, debilitating cough), which is very rarely observed in acute respiratory infections. More often, a cough with acute respiratory infections quickly enough (within 3-5 days) turns into a wet one, and then taking antitussives is simply contraindicated, as it prevents the outflow of sputum. Expectorants - drugs, often of plant origin, that facilitate the release of sputum when coughing. In acute infections, there is no need for their use, they are indicated only for chronic processes. Especially carefully expectorants are used in young children, tk. overstimulation of the vomiting and cough centers in the medulla oblongata, which are nearby, can lead to aspiration (vomit entering the respiratory tract). The question of the use of mucolytics (sputum thinners), such as bromhexine, ambroxol, acetylcysteine, is decided only by a doctor. They are used in the presence of thick, viscous, difficult to separate sputum.

Mistake nine: taking antihistamines. Antihistamines play an important role in the treatment of allergic diseases, which is determined by the key role of histamine (a biologically active substance released during allergies) in the formation of clinical manifestations of allergy. In particular, these drugs are highly effective for rhinitis (runny nose) of an allergic nature (second-generation drugs are mainly used - cetirizine (zyrtec), loratadine (claritin), fexofenadine (telfast). Currently, most doctors are inclined to reduce the drug load in acute respiratory infections, including the refusal to use antihistamines, since there is no evidence of the need for their use. Preparations of this group are prescribed for acute respiratory infections only for children with allergic diseases.

Mistake ten: physiotherapy, incl. "home remedy". Mustard plasters, jars, burning plasters and rubbing in children should not be used. Their effectiveness has not been proven, moreover, they are painful, dangerous with burns, and can lead to the development of allergic reactions. Also, the effectiveness of chest irradiation (heating) has not been proven, and visits to the clinic for a course of physiotherapy are dangerous in terms of re-infection.

Mistake eleven: desire to force-feed the child. In sick children during acute respiratory infections, the secretion of digestive juices decreases, changes in intestinal motility appear. Poor appetite is a natural reaction of the body to a disease, since all its resources are directed to fighting the infection, and the digestion of food is a rather energy-intensive process. If the baby refuses to eat, it should not be forced (this can lead to vomiting), you need to feed several times a day small portions of easily digestible food (scrambled eggs, chicken broth, low-fat yogurt, baked fruit). At the same time, it is important to give a child a lot of fluids: warm tea with honey (only for children over 1 year old in the absence of allergies), jam, lemon, cranberry or lingonberry juice, dried fruit compote, alkaline mineral water without gas (you can use milk), fruit juices or plain water. General rule lies in the fact that the body should not be overloaded, and the child's nutrition should be of the proper density, liquid or semi-liquid; the patient is prescribed food in small portions, taking into account, of course, the taste of the baby. However, spicy foods, hard-to-digest foods, and canned foods should be avoided.

Mistake twelve: a sick child should be in bed. The baby's regimen should correspond to his condition: bed - in severe cases, semi-bed (with alternating moderately active wakefulness and rest in bed, as well as obligatory daytime sleep) - when the condition improves, and normal - 1-2 days after the temperature drops.

Mistake thirteen: the use of self-medication, neglect of the doctor's advice when the child's condition changes. It must be remembered that the manifestations of SARS can be signs of more serious diseases, such as tonsillitis, scarlet fever and a number of other infections. With sore throat and fever, diphtheria and meningitis (inflammation of the meninges) can begin, in which delay in diagnosis and treatment can be fatal! It is not easy to make a correct diagnosis in these cases. Therefore, at the first signs of the disease, it is necessary to consult a doctor who will prescribe the appropriate treatment. All therapeutic measures are carried out only by appointment and under the supervision of a doctor!

To date, a fairly common pathology is acute respiratory infections in children, the symptoms and treatment of which can be established by a specialist. Moreover, a child can be cured not only with antibiotics, which are by no means a panacea against this disease, but also with folk remedies. The belief that antibiotics can fix health problems is a gross misconception, because they should be used only as a last resort if previous methods have not worked.

ARI is a disease that is much more common in a child's chart than other ailments. This term by doctors means that the patient has a temperature, nasal congestion and cough. The term itself stands for acute respiratory disease. Such ailments are transmitted by airborne droplets. When an infection enters the body, irritation of the respiratory tract begins. Refer to acute respiratory diseases adenovirus infections, influenza and others. Often, viruses act as a source, it is this factor that automatically translates the pathology from acute respiratory infections into acute respiratory viral infections. The latter stands for acute respiratory viral infections.

But due to the fact that the irritant of the body that causes the disease is a virus, the difference between ARVI and ARI is practically not noticeable, and many of these 2 terms are considered synonymous. Before proceeding with the treatment of the disease, it is necessary to determine its stage and form. The irritant, namely whether it was an infection or a virus, also depends on what approach will be used in the treatment and examination.

Symptoms of the disease

In order to begin treatment of the disease, it is necessary to undergo an examination by a specialist, and, according to the instructions received, conduct a course of recovery. But first you need to diagnose an ailment that makes itself felt only after 4 days after infection.

ARI symptoms in children are manifested as follows:

• the child completely loses his appetite;
• the general condition worsens significantly and a feeling of malaise appears;
• sleep problems appear.

If the baby has similar signs, this is a sure bell that notifies you of an infection in the body and the need for treatment. A few days later, other signs appear:

• runny nose;
• cough;
• the child begins to sneeze often;
• in addition to everything, headaches appear;
• general weakness is observed;
• due to inflammation of the mucosa, pain in the throat appears;
• the temperature rises.

If the treatment of acute respiratory infections in children is started on time, then the symptoms will begin to disappear much faster, although a cough may remain until the moment of recovery. But he will accompany the disease for no longer than 7 days.

In more rare cases, other pathologies may be observed:

• pain in the abdomen;
• blood vessels burst in the eyes;
• lymph nodes are enlarged;
• joints and muscles begin to ache.

It is imperative to show the child to the doctor if even the slightest signs of acute respiratory infections are detected.

In most cases, a specialist for diagnosis needs to get urine, blood and a smear from the mucous membrane for analysis. After receiving the results, drugs are prescribed.

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How to treat ARI?

Treatment methods for the disease in an adult and a child are very similar. In order to facilitate the child's recovery period, you can use and folk remedies, which will also be approved by a doctor. For children, the dosage of drugs is prescribed less than for an adult. That is why you should not resort to treating a child on your own based on your own experience. The volume of the drug taken is affected not only by the age of the patient, but also by his physical data, especially weight.

You should not make decisions about treatment on your own, because this can negatively affect the health of the baby. Moreover, self-medication can lead to the development of more acute diseases. An incorrectly prescribed course of recovery can leave an imprint on the general condition, especially on the immune system.

To combat acute respiratory diseases, antiviral drugs are used that will help the child's body cope with the disease much faster.

If the patient has a strong cough, then drugs are prescribed that help relieve irritation from the mucous membrane of the throat. It is this that contributes to the desire to cough. But it is important to determine what type of cough. Since with a dry and phlegm cough, you will have to take completely different drugs.

Given that one of the signs of an infection in the body is fever, and this is a departure from the norm, it must be brought down to an acceptable level. Therefore, the child must also take antipyretics. It is not recommended to give the baby aspirin - this is a rather strong drug that can harm a fragile child. immune system. But since an increase in temperature may indicate the body's struggle against infection, substances must be taken with caution. And mostly they are only used as a last resort at very high temperatures. Permissible rise to 38 degrees, at a higher temperature, you need to start knocking down.

Without fail, for respiratory diseases, sprays with drops are also used. They allow you to remove congestion in the nose and facilitate the breathing process. To raise the child's immunity, it is necessary to introduce the intake of vitamins into the course of treatment. And the best option would be natural sources, which include fresh fruits and vegetables. If the season does not imply their availability, then in the pharmacy you can buy the necessary vitamin specifically for children. It can be lollipops, askorbinka or others. If the course of treatment does not bring appropriate results, and relief does not occur, then antibiotic therapy is introduced.