Antibiotics for bronchitis in children

Antibiotics for bronchitis are often prescribed for children, and this raises a lot of questions from parents. After all, the Internet is replete with information that, as a rule, viruses are the cause of bronchitis, and antibiotics are designed to fight bacteria.

Indeed, antibiotics need to treat bacterial infections, and antiviral drugs help to defeat viral infections. All this is true, but with regard to bronchitis, everything is not so simple. Let's try to figure out whether a child needs antibiotics for bronchitis, is their use justified, can they cure this disease?

Bronchitis - Viral or Bacterial?

To answer the question whether antibiotics are needed in the treatment of childhood bronchitis, you need to know what kind of "pests" provoke this dangerous disease. In 50-60% of all episodes of childhood bronchitis, the disease is provoked by viruses: rhinovirus, adenovirus, and more often than others - the influenza virus. What happens next is not difficult to imagine. The immune defense of the child's body is destroyed and very favorable conditions are created for the vital activity of pathogenic bacteria. So the disease "flows" into the category of bacterial, secondary bacterial infection joins the primary viral infection.

In 20% of cases, bronchitis is of bacterial origin. A child gets sick when all kinds of "cocci" - staphylococcus, streptococcus, Pseudomonas aeruginosa, Haemophilus influenzae, moraxella penetrate into his body (in the respiratory tract in particular). In about 15% of cases, bronchitis is caused by fungi, and about 5% of cases are caused by the so-called atypical organisms - chlamydia, mycoplasma. These "pests" are insidious - they are interesting forms of life, a cross between bacteria and viruses. Such bronchitis is overgrown with the adjective "atypical".

Choice of drugs for treatment

Since almost any bronchitis can sooner or later be retrained into a bacterial form, antibiotics are the most common remedy for the disease. This is the position of official medicine. She somewhat contradicts the opinion of doctor Yevgeny Komarovsky, beloved by mothers. He claims that 99.9% of bronchitis is viral and insists on treatment without antibiotics.

However, on a call, not Komarovsky will come to your home, but a doctor from your polyclinic, and his position will be closer to the traditional one. Consider her.

Excellent, if the exact causative agent of the disease is known for certain, this will give the doctor the opportunity to prescribe a targeted effective antibiotic. Hemophilus influenzae, for example, is afraid of penicillins, and "Erythromycin" does not act on it at all. Macrolides of the new generation are fatal for Moraxella, and she is indifferent to most of the representatives of a number of penicillins. Atypical chlamydia and the like do not like antibiotics from the tetracyclines group. The most capricious are pneumococci, they are resistant to a large list of antibiotics, so it is very difficult to cure bronchitis caused by such microorganisms.

When choosing an antibiotic for treating a child, one should also take into account that a gentle antibiotic is preferable for a child's body, which has a minimum of side effects. The form of the disease cannot be ignored either. The most common choice of pediatricians is broad-spectrum antibiotics.

In acute viral bronchitis, antibiotics are not prescribed at all. The child's body can cope with such an infection on its own or with the support of special therapy based on antiviral drugs.

When detecting acute bronchitis, in which bacteria, atypical chlamydia, or chronic bronchitis are to blame, prescribing antibiotics is sometimes an important component of adequate treatment.

Obstructive brochitis, which is also called purulent, is most often treated with antibacterial drugs.

In the next video, you can see how to treat acute bronchitis without resorting to serious medications.

The doctor will never prescribe antibiotics to a child for the prevention of chronic bronchitis, because for this purpose, such powerful drugs are not given. Antibiotics are not needed for allergic bronchitis, by the way, this form of disease occurs more often in children than we, parents, are used to thinking.

With traechobronchitis (a disease in which both the mucous membranes of the bronchi and the membranes of the trachea are affected), and exacerbation of bronchial asthma, the issue of prescribing antibiotics is solved in the same way as in acute bronchitis, i.e. solely at the discretion of the physician.

In general, according to established practice, doctors prescribe antibiotic therapy for bronchitis only in 10% of cases of all diseases. The remaining 90% are treated with expectorant, mucolytic, antiviral, antihistamines.

And in the next video, Dr. Komarovsky will tell you how to treat bronchitis in a child.

Indications for use

Bronchitis is not such a harmless disease as it might seem at first glance. It is often complicated by pneumonia (inflammation of the lungs) and bronchiolitis (inflammation of the small bronchi). The most dangerous is bronchitis for babies from birth to one year. At this age, according to statistics, more than 200 babies from a control group of 100,000 babies die from bronchitis and its complications.

The reason is that the disease develops very quickly at this age, and there is no time to select alternative drugs. The only sensible solution is antibiotics. They try to treat small children under one year old with bronchitis in stationary conditions, where it is possible to monitor the child's condition around the clock. It is important not to miss the onset of complications.

Most often, children from 1 to 5 years old suffer from bronchitis. Younger schoolchildren aged 7 to 9 years get sick less often, but they have a higher risk of developing chronic bronchitis.

Having weighed the possible risks to the life and health of the child, it becomes clear why doctors "respect" antibiotics in the treatment of bronchitis.

There are several important nuances in which the doctor, even with an unburdened form of bronchitis, will still be inclined to prescribe antibiotics to the child:

If the child has a history of birth trauma, developmental defects.
If, with bronchitis, a child has bright pronounced signs of respiratory failure.
If in the sputum of the patient, impurities of pus are clearly distinguishable.
If the high temperature (above 38 degrees) lasts for more than three days.
If a child with bronchitis has noticeable manifestations of severe intoxication. This may indicate the bacterial origin of the disease, because intoxication is the poisoning of the baby's body with the waste products of harmful bacteria.

Children are usually prescribed antibiotics of three groups - penicillins, macrolides and cephalosporins.

Moreover, in this sequence. Penicillins are the mildest and the first to be prescribed. In addition, most drugs in this group have convenient "children's" dosage forms - they can be taken in suspension, solution (his parents are often called syrup), there are self-dissolving tablets. In situations where the course of the disease is complicated, penicillin antibiotics in injections may be prescribed.
The doctor will prescribe antibiotics - macrolides in the second place if the penicillins did not have the proper effect. In other words, if the acute symptoms of the disease do not go away after 72 hours after the start of the antibiotic - penicillin, the physician can replace the drug by choosing a macrolide. Such funds have a minimal list of side effects, rarely cause allergic reactions, and therefore are considered relatively safe for the child's body.
Doctors try to prescribe cephalosporin antibiotics in injections. They have powerful antimicrobial properties, but alas, they can cause allergies. And the list of contraindications and similar actions they have is higher. Such drugs are prescribed for complex forms of bronchitis, as well as for purulent obstructive bronchitis, as well as in cases where macrolides and penicillins have not helped.

There is another family of antibiotics that can be prescribed by a doctor for bronchitis. These are fluoroquinolones. They are used only in the most extreme cases. If the means of all other groups of antibiotics for a number of reasons do not work on the causative agent of the disease, or with a very severe course of the disease that threatens the life of the child. Fluoroquinolones are quite "heavy" drugs, and it is prohibited to use them for the treatment of children under 12-14 years of age.

On average, antibiotic treatment for bronchitis lasts from 7 to 10 days, in some cases up to two weeks.

The most common names in treatment regimens for childhood bronchitis are:

Penicillins: "Ampiox", "Amoxicillin", "Flemoxin", "Ampicillin", "Flemoklav", "Ospamox", "Hinkocil", "Augmentin" and others.

Macrolides: Azitrox, Sumamed, Azitral, Zitrolide, Azithromycin, Macropen, Rovamycin, Roxithromycin, Binoclar, Clarithromycin and others.

Cephalosporins: Ketocef, Suprax, Medaxon, Tsefaxon, Natsef, Ancef, Asketil, Zinnat, Zinacef.

Fluoroquinolones: "Ciprolet", "Cipronol", "Levofloxacin".

List of antibiotics for bronchitis

Let's consider some drugs in more detail:

"Ampiox". It is a combined antibiotic that is widely used in the treatment of bacterial bronchitis. The drug has two forms of release - capsules and dry substance for a solution that is injected intramuscularly and intravenously. You need to take the drug 4-6 times a day. Capsules should not be given to children under 3 years of age. From 3 to 7 years old with bronchitis, the daily dose is calculated by the formula: 50 mg of the drug per 1 kilogram of weight, for children from 7 to 14 years old, the dose is doubled. Teenagers over 14 are prescribed 2-4 grams per day. "Ampiox" injections can be given even to newborns and premature babies. Injections are given 3-4 times a day. The dosage is calculated by the doctor individually for each patient.

Flemoxin Solutab. It is a semi-synthetic penicillin antibiotic often used for bronchitis and pneumonia. It is a pleasure to give it to children as it comes in a convenient form - dispersible tablets. They dissolve easily, dissolve and taste good. Such a pill can be taken before a meal or immediately after it, or you can dissolve it in water and you get what mothers on forums often call "syrup". The dosage is determined by the doctor strictly individually. The average values of the daily dose are as follows: children under 1 year of age are given the drug 2-3 times a day in the amount of 30-60 mg. medicines per 1 kilogram of crumbs weight, babies from 1 to 3 years old - 250 mg twice a day, children from 3 to 10 years old - 375 mg twice a day.

"Amoxicillin". It is an acid-fast antibiotic. It does not exist in injections, the drug is intended only for oral administration. It is produced in capsules and tablets of various dosages, as well as in granules, from which it is easy to prepare a suspension at home. This is the most popular form of medicine for children. The suspension can be given to newborns three times a day, the total amount per day is 20 mg of medication per 1 kilogram of weight. For children from 2 to 5 years old, the daily dose is 125 mg in three doses, children from 5 to 10 years old are given 5 ml of suspension per day three times.

Augmentin. This is almost the same "Amoxicillin", only more protected by clavulanic acid. The drug is especially effective in the treatment of chronic bronchitis and bronchopneumonia. Pharmacists on sale always have tablets of three dosage types, a dry substance for self-preparation of a suspension, as well as powders, from which solutions for injection are made intramuscularly or intravenously. The dosage of the drug is made by analogy with "Amoxicillin". Children under 2 years old can dilute the suspension in half with water, although it is already quite pleasant and easy to drink. In tablets "Augmentin" is given to children over 5 years old. The doctor can prescribe injections to a child at any age, if his condition requires it.

"Khinkocil". This penicillin antibiotic can be taken in capsules or in suspension. True, there is no ready-made suspension in pharmacies, but it can be prepared from a special powder form of the medicine. This antibiotic is contraindicated in children with bronchial asthma! Do not give it to babies under 1 year old. The medicine is taken three times a day. The daily dose for children from 1 to 2 years old is 20 mg. drug for every kilogram of weight. Children from 2 to 5 years old can be given a fixed 125 mg per day, children from 5 to 10 years old, this dose is doubled and is 250 mg.

Sumamed. It is an effective macrolide. It helps well with acute bronchitis of bacterial etiology, with painful manifestations of chronic bronchitis. You can buy the medicine in tablets of two types of dosage, in capsules. There is also a dry substance for injections and suspensions. It is advisable for children under 4-5 years old to take a suspension, over - you can drink tablets. The doctor can prescribe injections to a child of any age. "Sumamed" is not given to children up to six months. In the treatment of bronchitis, the daily dose of the suspension is calculated as follows: 30 mg of the drug for each kilogram of the child's weight. The medicine is taken once a day, the general course of treatment is up to 3 days.

"Azitrox". Antibiotic - macrolide, which proved to be the best in the treatment of complex atypical bronchitis, as it successfully copes with chlamydia. Available in capsule form (for children over 12 years of age) and as a powder for suspension. It can be taken once a day at 5-10 mg. drug per kilogram of the child's weight. It is possible to be treated with Azitrox in suspension for up to 5 days. The antibiotic has a large list of side effects, so it is not recommended to give it to children under 6 months of age. Children under 12 years old are prohibited from taking Azitrox capsules. Do not drink the drug at the same time as food.

"Zitrolide". This antibiotic of the macrolide family successfully copes with most pathogens of bacterial and atypical bronchitis. The medicine is produced only in capsules. Babies under 3 years old are completely contraindicated. For older children, the drug is given once a day, 10 mg of the substance for each kilogram of the child's body weight. The average course of treatment is three days.

"Binocular" ("Klacid"). This macrolide can be prescribed for any form and degree of bronchitis, as well as for pneumonia. It is available in tablets, powders for suspension of two types of dosage, as well as in the form of a dry substance for the preparation of solutions for injection. Suspension "Binoclar" can be given to a child even with milk. The maximum daily dosage is 500 mg. An antibiotic is taken 12 hours later (twice a day). The individual dosage is calculated by the doctor. Children under the age of three are not recommended to give the drug in tablets, only in suspension. This antibiotic has a large list of side effects and contraindications. Read it carefully and consult your doctor.

"Suprax". This is one of the most famous representatives of the cephalosporin series. The drug is most often prescribed in the treatment of exacerbations of chronic bronchitis and in acute bronchitis of bacterial origin. On the shelves of pharmacies "Suprax" exists in the form of capsules and granules, from which a suspension is prepared. The medicine is not available in tablets and syrup. Adolescents over 12 years old are given 400 mg once a day. A suspension is recommended for children under 12 years of age (8 mg per kilogram of body weight once a day). 6-10 ml of the suspension is given per day to children from 5 to 11 years old, 5 ml of the medicine is given per day to children 2-4 years old.The maximum dose for a baby is 4 ml. per day. The exact amount will be prescribed by the doctor.

"Natsef" ("Cefazolin"). This antibiotic of the cephalosporin family can be given to children from birth. However, up to 1 month, this should only be in a hospital under the constant supervision of doctors. An antibiotic is produced only in the form of a dry substance for injection. The children's dose is 20-50 mg of the substance for each kilogram of the child's weight per day. If bronchitis is severe and the child's condition is threatening, the dosage is doubled and given every 6 or 8 hours.

Important: the choice of the drug is the prerogative of the doctor, not the patient, therefore, self-medication is strictly prohibited! Since 2017, all of these drugs have been dispensed in pharmacies strictly on prescription.

Alternatives

Inhalation is quite effective in treating bronchitis, including with antibiotics, which are prescribed by a doctor. It is necessary to carry out procedures exclusively using special inhalers (nebulizers).

Inhalation is usually prescribed as an adjunct to antibiotic treatment. Inhalation with mineral medicinal water has proven itself well. Most often, mucolytic drugs, bronchodilators, antihistamines (for allergic bronchitis), antiseptics and even propolis are inhaled through a nebulizer, if they are not allergic, and only with the permission of a doctor who will prescribe a remedy based on the type of cough in the child.

Recommendations for parents

Give your child plenty of fluids. The mucous membrane of the bronchi should not "dry out", especially if the baby breathes through the mouth due to a stuffy nose. In addition, bacteria cause toxicity. Drinking will help restore water balance and facilitate the elimination of toxins.
In severe forms of bronchitis or tracheobronchitis, try to provide the baby with bed or semi-bed rest. Peace is very important for his recovery.
If your doctor has prescribed antibiotics for you, take them in accordance with all dosages and frequency of administration.
Do not give up antibiotic treatment if your child is feeling better. Complete the course prescribed by your doctor.
Do not forget about the prevention of dysbiosis, because antibiotics destroy not only pathogenic microbes, but also useful and necessary ones, such as lactobacilli and bifidobacteria. Therefore, ask your doctor to prescribe a course of prebiotics and probiotics along with antibiotics.
If the doctor insists on hospitalizing the child, even in the absence of fever, there is no need to resist. Some forms of bronchitis, as atypical and fungal bronchitis, are more effectively treated in a hospital.