Effectiveness of Antibacterial Therapy in Treatment of Children with Infectious-Associated Relapsing Obstructive Bronchitis

The study deals with investigating the value of chronic foci of upper respiratory tract infection in the development of bronchial obstruction in children with infectious-associated relapsing obstructive bronchitis (ROB). We also studied the effectiveness of the use of antibacterial therapy with cefpodoxim in the treatment of children with infectious-associated ROB. Material and methods. 33 children aged from 2 to 5 years were under the supervision. Their diagnosis was infectious-associated recurrent obstructive bronchitis, which during the objective study became chronic focus infection of upper respiratory tract. We studied the data of disease records, and clinical manifestations of the disease. There was an objective examination performed, supplemented with tympanic membrane examinations mit otoskope Heine mini 3000. If necessary children consulted ENT doctor, and roentgenography sinuses were made. Results and discussion. As a result of the examination, we could evaluate the presence of chronic foci of infection in the upper respiratory tract. The bacteriological research of smears of throat and nose was also conducted. If a child had chronic foci of infection or pathogenic microorganisms were detected in the bacteriological examination, he/she was prescribed a course of antibiotic therapy with cefpodoxim. In previous studies this drug was effective to the main bacterial pathogens of respiratory infections. Cefpodoxim was appointed by the rate 8 mg / kg / day for a 14 day period. Such a long course therapy was elected due to low ability of antibiotics to penetration in chronic focus infection. The frequency of bronchial obstruction attacks before and after the course of antibiotic therapy was investigated in the course of treatment. Among chronic inflammatory diseases of upper respiratory tract in children that were under the supervision, we often recorded chronic inflammation lymphatic rings (tonsillitis, adenoiditis), found in all children with chronic foci of infection upper respiratory tract. The second were chronic inflammation sinuses – sinusitis. The chronic sinusitis was not defined as an independent disease, and was detected in the part of children with chronic tonsillitis. All 33 children with nasopharynx were allocated with 46 bacterial strains. 20 children (60.60%) were allocated with one pathogen, 13 patients (39.40%) had a combined allocation of several pathogens (mixt-infection). Staphylococcus aureus had the first place among detected pathogens. At the same time, taking in the account that this microorganism is a conditional pathogen, it was seen as a potential reason of respiratory tract lesions only in the presence of clinical manifestations of inflammation. The second and third place took Streptococcus pyogenes and Moraxella catarrhalis that are typical pathogens of upper respiratory tract infections. Conclusions. Having analyzed the frequency of bronchial obstruction attacks over a year after beginning the therapy in children who had antibiotic therapy, it was established that if during the year before the antibiotic therapy the average number of episodes exacerbation of ROB was 6.42 ± 0.19, then after a course of Cefpodoxim it got down to 4.06 ± 0.15, p <0.01.