medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-8-16-19medsovet-2425Research ArticleИНФЕКЦИИ В ОТОРИНОЛАРИНГОЛОГИИINFECTIONS IN OTORHINOLARYNGOLOGYКомплексная терапия острого бактериального риносинуситаComplex therapy of acute bacterial rinosinusisКочетковП. А.KochetkovP. A.

к.м.н.

PhD in medicine

МокоянЖ. Т.MokoyanZ. T.Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский университет)РоссияFederal State Funded Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University under the Ministry of Health of the Russian Federation (I.M. Sechenov First MSMU)Russian Federation201819042018081619Copyright © Кочетков П.А., Мокоян Ж.Т., 20182018Кочетков П.А., Мокоян Ж.Т.Kochetkov P.A., Mokoyan Z.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2425

Острый риносинусит является широко распространенным заболеванием, приводящим к нетрудоспособности и снижению качества жизни. В амбулаторной практике с данной нозологией сталкиваются врачи-оториноларингологи, терапевты и педиатры. Острый бактериальный риносинусит чаще всего развивается в исходе ОРВИ и острого вирусного риносинусита. Однако универсальных достоверных критериев дифференциальной диагностики вирусной и бактериальной природы риносинусита на сегодняшний день нет. Врачу амбулаторной практики приходится руководствоваться клинико-анамнестическими данными для постановки диагноза и выбора терапии. Лечение острого бактериального риносинусита требует комплексного подхода, при этом, несмотря на инфекционную природу патологического процесса, вопрос о рациональности антибактериальной терапии остается наиболее дискутабельным среди различных авторов. Этиопатогенетическое лечение бактериального риносинусита должно быть направлено на основные звенья патологического процесса, соответственно, препараты должны обладать противовоспалительным, секретолитическим и мукоактивным действием.

Federal State Funded Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University under the Ministry of Health of the Russian Federation (I.M. Sechenov First MSMU) Acute rhinosinusitis is a common disease with worldwide prevalence. It is a disease that leads to the temporary disability and associates with decrease of quality of life. Patients with acute rhinosinusitis seek a medical care not only at otorhinolaryngologist but also to general practitioner, physician and pediatrician of the outpatient departments. Acute bacterial rhinosinusitis (ABRS) usually comes from acute viral upper respiratory infections or acute viral rhinosinusitis. Distinguishing acute viral rhinosinusitis and acute bacterial rhinosinusitis is a frequent challenge to the primary care clinician because of the lack of reliable criteria. So, the diagnosis of acute bacterial rhinosinusitis is most appropriately made on the basis of the medical history, length of the disease and clinical features. The treatment of ABRS should be complex, because despite the infectious etiology of the disease the necessity of antibiotics is still the point at issue. The main required effects of treatment of the acute bacterial rhinosinusitis are anti-inflammatory, mucolytic and anciliary. Phytotherapy is recommended for ABRS treatment by European, American and Russian guidelines.

острый бактериальный риносинуситфитотерапия риносинуситаacute bacterial rhinosinusitisPhytotherapy of sinusitisReferencesFokkens WJ, Lund VJ, Mullol J. EPOS 2012: European position paper on rhinosinusitis and nasal polyps. Rhinology, 2012, 50 (1): 1–12.Fokkens WJ, Lund VJ, Mullol J. EPOS 2012: European position paper on rhinosinusitis and nasal polyps. Rhinology, 2012, 50 (1): 1–12.Chow AW, Benninger MS, Brook I. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis, 2012, 54(8): e72-e112.Chow AW, Benninger MS, Brook I. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis, 2012, 54(8): e72-e112.Anand VK. Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl, 2004, 193: 3–5.Anand VK. Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl, 2004, 193: 3–5.Крюков А.И., Студеный М.Е., Артемьев М.Е. Лечение пациентов с риносинуситами: возможности консервативного и оперативного воздействия. Медицинский совет, 2012, 11: 92-96.Kryukov AI, Studenyi ME, Artemiev ME. Treatment of patients with rhinosinusitis: the prospects for conservative and surgical management. Meditsinsky Sovet, 2012, 11: 92-96.Gwaltney JM, Hendley JO, Simon G, Jordan WS Jr. Rhinovirus infections in an industrial population. Characteristics of illness and antibody response. JAMA, 1967, 202: 494–500.Gwaltney JM, Hendley JO, Simon G, Jordan WS Jr. Rhinovirus infections in an industrial population. Characteristics of illness and antibody response. JAMA, 1967, 202: 494–500.Лопатин А.С. Антибиотикотерапия острых воспалительных заболеваний околоносовых пазух. Consilium mediсum, 2003, 5(4): 1–8.Lopatin AS. Antibiotic therapy of acute inflammatory diseases of the paranasal sinuses. Consilium mediсum, 2003, 5 (4): 1-8.Рязанцев С.В. Острый синусит. Подходы к терапии. Методические рекомендации. М., 2003. 16 с.Ryazantsev SV. Acute sinusitis. Approaches to therapy. Methodological guidelines. M., 2003. 16 p.Little DR, Mann BL, Godbout CJ. How family Phisitians distinguish acute sinusitis from upper respiratory tract infections: a retrospective analysis. J Am Board Fam Pract, 2000, 13: 101–106.Little DR, Mann BL, Godbout CJ. How family Phisitians distinguish acute sinusitis from upper respiratory tract infections: a retrospective analysis. J Am Board Fam Pract, 2000, 13: 101–106.Страчунский Л.С., Тарасов А.А., Крюков А.И. Возбудители острого бактериального риносинусита. Результаты многоцентрового микробиологического исследования SSSR. Клиническая микробиология и антимикробная химиотерапия, 2005, 7(4): 337–349.Strachunsky LS, Tarasov AA, Kryukov AI. The causative pathogens of acute bacterial rhinosinusitis. Results of SSSR multicenter microbiological study. Klinicheskaya Mikrobiologiya i Antimikrobnaya Khimioterapiya, 2005, 7 (4): 337-349.Hadley JA, Pfaller MA. Oral beta-lactams in the treatment of acute bacterial rhinosinusitis. Diagn Microbiol Infect Dis, 2007, 57(3): 47-54.Hadley JA, Pfaller MA. Oral beta-lactams in the treatment of acute bacterial rhinosinusitis. Diagn Microbiol Infect Dis, 2007, 57(3): 47-54.Brown T. Antibiotics May Not Be Needed for Acute Rhinosinusitis. Medscape Education Clinical Briefs, 2012. JAMA. 2012, 307: 685-692.Brown T. Antibiotics May Not Be Needed for Acute Rhinosinusitis. Medscape Education Clinical Briefs, 2012. JAMA. 2012, 307: 685-692.Rybak MJ. Increased bacterial resistance: PROTEKT US -- an update. The Annals of pharmacotherapy, 2004, 38(9 Suppl): 8-13.Rybak MJ. Increased bacterial resistance: PROTEKT US -- an update. The Annals of pharmacotherapy, 2004, 38(9 Suppl): 8-13.Сидоренко С.В. Тенденции в распространении антибиотикорезистентности среди возбудителей внебольничных инфекций на территории Российской Федерации. Consilium Medicum, 2007, 9(1).Sidorenko SV. Trends in antibiotic resistance among community-acquired infection pathogens on the territory of the Russian Federation. Consilium Medicum, 2007, 9 (1).Sahm DF, Benninger MS, Evangelista AT. Antimicrobial resistance trends among sinus isolates of Streptococcus pneumoniae in the United States (2001–2005). Otolaryngol Head Neck Surg, 2007, 136(3): 385–389.Sahm DF, Benninger MS, Evangelista AT. Antimicrobial resistance trends among sinus isolates of Streptococcus pneumoniae in the United States (2001–2005). Otolaryngol Head Neck Surg, 2007, 136(3): 385–389.Hsueh PR, Huang WK, Shyr J. Multicenter surveillance of antimicrobial resistance of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis to 14 oral antibiotics. J Formos Med Assoc, 2004, 103(9): 664–670.Hsueh PR, Huang WK, Shyr J. Multicenter surveillance of antimicrobial resistance of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis to 14 oral antibiotics. J Formos Med Assoc, 2004, 103(9): 664–670.European Antimicrobial Resistance Surveillance Network (EARS-Net). EARSS Annual Report, 2008. http://www.ecdc.europa. eu/en/activities/surveillance/EARS-et/ Documents/2008_EARSS_Annual_Report.pdf.European Antimicrobial Resistance Surveillance Network (EARS-Net). EARSS Annual Report, 2008. http://www.ecdc.europa. eu/en/activities/surveillance/EARS-et/ Documents/2008_EARSS_Annual_Report.pdf.Gracia M, Diaz C, Coronel P. Antimicrobial susceptibility of Haemophilus influenzae and Moraxella catarrhalis isolates in eight Central, East and Baltic European countries in 2005–06: results of the Cefditoren Surveillance Study. J Antimicrob Chemother, 2008, 61(5): 1180–1181.Gracia M, Diaz C, Coronel P. Antimicrobial susceptibility of Haemophilus influenzae and Moraxella catarrhalis isolates in eight Central, East and Baltic European countries in 2005–06: results of the Cefditoren Surveillance Study. J Antimicrob Chemother, 2008, 61(5): 1180–1181.Козлов Р.С., Сивая О.В., Кречикова О.И. Динамика резистентности Streptococcus pneumoniae к антибиотикам в России за период 1999–2009 гг. (Результаты многоцентрового проспективного исследования ПеГАС). Клин. микробиол. антимикроб. химиотер., 2010, 12(4): 329–341.Kozlov RS, Sivaya OV, Krechikova OI. Dynamics of Streptococcus pneumoniae resistance to antibiotics in Russia for the period 1999-2009. (Results of Pegasus multicenter prospective study). Klin. Mikrobiol. Antimikrob. Khimioter. 2010, 12 (4): 329-341.Garbutt JM, Banister C, Spitznagel E, Piccirillo JF. Amoxicillin for acute rhinosinusitis: a ran-domized controlled trial. JAMA, 2012, 307(7): 685–692.Garbutt JM, Banister C, Spitznagel E, Piccirillo JF. Amoxicillin for acute rhinosinusitis: a ran-domized controlled trial. JAMA, 2012, 307(7): 685–692.Рязанцев С.В. Острый синусит. Подходы к терапии. Методические рекомендации. М., 2003, 16.Ryazantsev SV. Acute sinusitis. Approaches to therapy. Methodological guidelines. M., 2003, 16.Рязанцев С.В. Принципы этиопатогенетической терапии острых синуситов Методические рекомендации. СПб., 2013, 40 с.Ryazantsev SV. Principles of ethiopathogenetic therapy for acute sinusitis. Methodical guidelines. St. Petersburg, 2013, 40 p.Guo R, Peter H Canter, Edzard Ernst. Herbal medicines for the treatment of rhinosinusitis: A systematic review. Otolaryngology – Head and Neck Surgery, 2006, 135(4): 496-506.Guo R, Peter H Canter, Edzard Ernst. Herbal medicines for the treatment of rhinosinusitis: A systematic review. Otolaryngology – Head and Neck Surgery, 2006, 135(4): 496-506.Systematic review of clinical data with BNO-101 (Sinupret) in the treatment of sinusitis.Systematic review of clinical data with BNO-101 (Sinupret) in the treatment of sinusitis.Melzer J, Saller R, Schapowal A, Brignoli R. Systematic Review of Clinical Data with BNO-101 (Sinupret®) in the Treatment of Sinusitis. Forsch Komplementä rmed, 2006, 13: 78–87.Melzer J, Saller R, Schapowal A, Brignoli R. Systematic Review of Clinical Data with BNO-101 (Sinupret®) in the Treatment of Sinusitis. Forsch Komplementä rmed, 2006, 13: 78–87.Rossi A, Dehm F, Kiesselbach Ch, Haunschild J, Sautebin L, Werz O. The novel Sinupret® dry extract exhibits anti-inflammatory effectiveness in vivo. Fitoterapia, 2012, 83(4): 715-720.Rossi A, Dehm F, Kiesselbach Ch, Haunschild J, Sautebin L, Werz O. The novel Sinupret® dry extract exhibits anti-inflammatory effectiveness in vivo. Fitoterapia, 2012, 83(4): 715-720.

The authors declare that there are no conflicts of interest present.