Strategy for improving the quality of treatment for children with acute respiratory infections
https://doi.org/10.21518/2079-701X-2020-18-22-28
Abstract
Acute respiratory infections are the most common problem in the paediatric practice, especially in young children: 112,981.86 per 100,000 population at the age of 1-2 years and 106,996.16 per 100,000 population at the age of 3–6 years. Modern features of the etiology of respiratory infections in children are represented by associations of pathogens, among which are respiratory viruses, herpes viruses, bacterial pathogens, which makes additional problems in the treatment. On the one hand, the treatment of acute respiratory infections is not such a difficult problem, yet at the same time it is very often ineffective, and a pediatrician has to prescribe additional medications, which leads to polypharmacy and a potential risk of side effects. According to statistics, the number of drugs to be administered to treat ARVI reaches three or more INNs in 70% of cases, which involves the risk of drug-drug interactions and adverse events. For example, administration of two drugs leads to drug-drug interactions in 6% of patients, administration of five drugs increases the frequency of such effects up to 50%, and if a patient administers 10 drugs, this indicator reaches 100% of cases. A modern strategy for improving the quality of treatment of children with acute respiratory infections is to use homeopathic medicines, since they have a complex effect (antiviral, anti-inflammatory, immunomodulatory, etc.), mutually reinforce and complement each other if they are given in combination, and have the maximum therapeutic effect while minimizing the drug load. According to the results of the meta-analysis of 29 clinical studies in 5,062 patients with acute upper respiratory infections, the administration of complex homeopathic medicines has demonstrated a positive result in favour of homeopathy: 6 of 7 RCTs showed that the homeopathic treatment was at least equivalent to the conventional treatment, and 8 of 16 placebocontrolled studies showed advantage of homeopathy.
About the Author
A. I. Safina
Kazan State Medical Academy – a branch of the Federal State Budgetary Educational Institution of Additional Professional Education “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Professor, Head of Department of Paediatrics and Neonatology
36, Butlerov St., Kazan, 420012, Russia
References
1. Hawke K., van Driel M.L., Buffington B.J., McGuire T.M., King D. Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children. Cochrane Database Syst Rev. 2018;9(9):CD005974. doi: 10.1002/14651858.CD005974.pub5.
2. Menneghetti A. Upper Respiratory Tract Infection. Available at: https://emedicine.medscape.com/article/302460-overview.
3. Khomich A., Kochetkov S.N., Bartosch B., Ivanov A.V. Redox Biology of Respiratory Viral Infections. Viruses. 2018;10(8):392. doi: 10.3390/v10080392.
4. Chen J., Hu P., Zhou T., Zheng T., Zhou L., Jiang C., Pei X. Epidemiology and Clinical Characteristics of Acute Respiratory Tract Infections Among Hospitalized Infants and Young Children in Chengdu, West China, 2009–2014. BMC Pediatr. 2018;18(1):216. doi: 10.1186/s12887-018-1203-y.
5. Levina A.S., Babachenko I.V., Skripchenko N.V., Imyanitov E.N. The etiological structure of diseases in frequently ill children depending on age. Rossiyskiy vestnik perinatologii i pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2017;62(2):72–77. (In Russ.) doi: 10.21508/1027-4065-2017-62-2-72-77.
6. Harper S.A., Fukuda K., Uyeki T.M., Cox N.J., Bridges C.B. Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2004;53(RR-6):1–40. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15163927.
7. Gubareva L.V., Kaiser L., Matrosovich M.N., Soo-Hoo Y., Hayden F.G. Selection of influenza virus mutants in experimentally infected volunteers treated with oseltamivir. J Infect Dis. 2001;183(4):523–531. doi: 10.1086/318537.
8. Moscona A. Oseltamivir resistance – disabling our influenza defenses. N Engl J Med. 2005;353(25):2633–2636. doi: 10.1056/NEJMp058291.
9. Fleming-Dutra K.E., Hersh A.L., Shapiro D.J., Bartoces M., Enns E.A., File T.M. Jr. et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315(17):1864–1873. doi: 10.1001/jama.2016.4151.
10. Bell I.R., Boyer N.N. Homeopathic medications as clinical alternatives for symptomatic care of acute otitis media and upper respiratory infections in children. Glob Adv Health Med. 2013;2(1):32–43. doi: 10.7453/gahmj.2013.2.1.007.
11. Jartti T., Gern J.E. Role of viral infections in the development and exacerbation of asthma in children. J Аllergy Сlin Immunol. 2017;140(4):895–906. doi: 10.1016/j.jaci.2017.08.003.
12. WHO Traditional Medicine Strategy 2014–2023. 76 p. Available at: https://www.who.int/medicines/publications/traditional/trm_strategy14_23/ru.
13. Bergemann S.M., Bornhеoft G., Bloch D., Vogt-Frank C., Righetti M., Thurneysen A. Clinical studies on the effectiveness of homeopathy for URTI/A (Upper Respiratory Tract Infections and Allergic Reactions). Homeopathy in Healthcare–Effectiveness, Appropriateness, Safety, Costs. Berlin, 2011. doi: 10.1007/978-3-642-20638-2_10.
14. BornhЕoft G., Wolf U., von Ammon K., Righetti M., Maxion-Bergemann S., Baumgartner S. et al. Effectiveness, Safety and Cost-Effectiveness of Homeopathy in General Practice – Summarized Health Technology Assessment. Forsch Komplementmed. 2006;13(Suppl. 2):19–29. doi: 10.1159/000093586.
15. Fixsen A. Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections? Homeopathy. 2018;107(2):99–114. doi: 10.1055/s-0037-1621745.
16. Grimaldi-Bensouda L., Be´gaud B., Rossignol M., Avouac B., Lert F., Rouillon F. et al. Management of Upper Respiratory Tract Infections by Different Medical Practices, Including Homeopathy, and Consumption of Antibiotics in Primary Care: The EPI3 Cohort Study in France 2007–2008. PLoS One. 2014;9(3):e89990. doi: 10.1371/journal.pone.0089990.
17. Dossett M.L., Yeh G.Y. Homeopathy Use in the USA and Implications for Public Health: a review. Homeopathy. 2018;107(1):3–9. doi: 10.1055/s-0037-1609016.
18. Gеppe N.A., Krylova N.A., Eliseeva T.I., Tyurina E.N., Yablokova E.A. Opportunities of early treatment of acute respiratory viral infection in children. Rossiyskiy vestnik perinatologii i pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2018;63(5):103–107. (In Russ.) Available at: https://www.ped-perinatology.ru/jour/article/view/732/685.
19. Mathie R.T., Frye J., Fisher P. Homeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness. Cochrane Database Syst Rev. 2015;1(1):CD001957. doi: 10.1002/14651858.CD001957.pub6.
20. Danno K., Cognet-Dementhon B., Thevenard G., Duru G., Allaert F.A., Bordet M.F. Management of the early symptoms of influenza-like illnesses and ear, nose and throat (ENT) disorders by pharmacists. Homeopathy. 2014;103(4):239–249. doi: 10.1016/j.homp.2014.04.001.
21. Siqueira C.M., Motta P.D., Cardoso T.N., de Paula Coelho C., Popi A.F., Couceiro J.N. et al. Homeopathic treatments modify inflammation but not behavioral response to influenza antigen challenge in BALB/c mice. Homeopathy. 2016;105(3):257–264. doi: 10.1016/j.homp.2016.04.002.
22. Selkova E.P., Lapitskaya E.S., Oganesyan A.S., Fedorova I.M., Lopatina T.K., Toptygina A.P. et al. A study of the clinical and epidemiologic effectiveness of a homeopathic drug with influenza and ARVI. Infektsionnye bolezni = Infection Diseases. 2012;10(3):83–89. (In Russ.) Available at: https://elibrary.ru/item.asp?id=17956596.
23. Siqueira C.M., Homsani F., da Veiga V.F., Lyrio C., Mattos H., Passos S.R. et al. Homeopathic medicines for prevention of influenza and acute respiratory tract infections in children: blind, randomized, placebo-controlled clinical trial. Homeopathy. 2016;105(1):71–77. doi: 10.1016/j.homp.2015.02.006.
24. Van Haselen R., Thinesse-Mallwitz M., Maidannyk V., Buskin S.L., Weber S., Keller T. et al. The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever: A Randomized Controlled Trial. Glob Pediatr Health. 2016;3:2333794X16654851. doi: 10.1177/2333794X16654851.
25. Mathie R.T., Frye J., Fisher P. Homeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness. Cochrane Database Syst Rev. 2015;1(1):CD001957. doi: 10.1002/14651858.CD001957.pub6.
26. Selkova E.P., Lapitskaya A.C., Gudova N.V., Radtsig E.Yu., Ermilova N.V. Strategy of non-productive cough treatment in children, in respiratory tract pathology of viral aetiology. Lechashchiy vrach. 2013;(8). (In Russ.) Available at: https://www.lvrach.ru/2013/08/15435792.
27. Braman S.S. Postinfectious Cough: ACCP Evidence-Based Clinical Practice Guidelinces. Chest. 2006;129(1S):138–146. Available at: 10.1378/chest.129.1_suppl.138S.
28. Morice A.H., McGarvey L., Pavord I. Recommendations for the management of cough in adults. Thorax. 2006;61(Suppl. 1):1–24. Available at: https://thorax.bmj.com/content/61/suppl_1/i1.
29. Geppe N.A., Farber I.M., Ozyorskaya I.V., Malyavina U.S., Malyshev V.S., Bukharov D.G. The Use of Coryzalia in Children with Acute Infectious or Persistent Allergic Rhinitis. Doktor.ru = Doctor.Ru. 2017;(4):54–60. (In Russ.) Available at: https://journaldoctor.ru/upload/iblock/761/10.pdf.
30. Karpova E.P., Tulupov D.A. Role of homeopathic complex medications in symptomatic therapy of ARVI in children. Detskaya otorinolaringologiya = Pediatric otorhinolaryngology. 2013;(2):38–41. (In Russ.) Available at: https://elibrary.ru/item.asp?id=20292754.
31. Radtsig E.Yu. Age peculiarities of the course and treatment of rhinitis in infants and young children. RMZH = RMJ. 2011;(22):1391. (In Russ.) Available at: https://www.rmj.ru/articles/pediatriya/Osobennosti_techeniya_i_lecheniya_ostrogo_rinita_u_detey_grudnogo_i_rannego_vozrasta/
32. Radtsig E.Yu. Modern homeopathic complex medications for the prevention and treatment of acute respiratory infections and influenza in children. Pediatriya = Pediatria. 2013;92(2):120–126. (In Russ.) Available at: https://elibrary.ru/item.asp?id=19394044.
33. Garashchenko T.I., Il’enko L.I., Revyakina V.A., Karneeva O.V., Garashchenko M.V. Possibilities of homeopathic therapy in treatment of infectious and allergic rhinites in children. Voprosy prakticheskoy pediatrii = Clinical Practice in Pediatrics. 2016;11(6):45–51. (In Russ.) doi: 10.20953/1817-7646-2016-6-45-51.
34. Krivopalov A.A., Ryazantsev S.V., Shatalov V.A., Shervashidze S.V. Acute rhinitis: new therapeutic possibilities. Meditsinskiy sovet = Medical Council. 2017;(8):18–23. (In Russ.) doi: 10.21518/2079-701X-2017-8-18-23.
35. Revyakina V.A., Daykhes N.A., Geppe N.A., Ablevich M.M., Abdrakhmanova S.O., Astaf’eva N.G. et al. RADAR. Allergic rhinitis in children: recommendations and algorithm for paediatric allergic rhinitis. Moscow: Original-maket; 2015. 80 p. (In Russ.) Available at: https://mosgorzdrav.ru/uploads/imperavi/ru-RU/029_2015.pdf.
36. Radtsig E.Yu. Voice disorders in children and adolescents and their treatment with Homeovox homeopathic medicine. Pediatriya = Pediatria. 2009;88(6):130–136. (In Russ.) Available at: https://pediatriajournal.ru/archive?show=302§ion=2541.
37. Radtsig E.Yu. Dysphonia: causes, methods for correction, and effects of different groups of drugs on the voice quality. Farmateka = Pharmateca. 2014;(11). (In Russ.) Available at: https://pharmateca.ru/ru/archive/article/29834.
38. Bogomil’skii M.R., Radtsig E.Yu. Laryngitis in children: specific features of its course and treatment. Vestnik otorinolaringologii = Bulletin of Otorhinolaryngology. 2009;(1):45–49.
39. Radtsig E.Yu., Ermilova N.V. Voice disorders in different periods of its training: causes and algorithm for patient management. RMZH = RMJ. 2016;(4):217–220. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Narusheniya_golosa_v_razlichnye_periody_egostanovlenyia_prichiny_i_algoritm_vedeniya_pacientov/
40. Polyakov D.P., Karneeva O.V., Ryazantsev S.V., Garashchenko T.I., Gurov A.V., Kazanova A.V., Maksimova E.A. Acute tonsillopharyngitis: clinical guidelines. Moscow; 2016. (In Russ.) Available at: http://glav-otolar.ru/assets/images/docs/clinical-recomendations/KR306%20Tonzillofaringit.pdf.
41. Karneeva O.V., Ryazantsev S.V., Radtsig E.Yu., Kim I.A. Therapeutic potentials of clinical homeopathy in the complex therapy of acute inflammatory upper airway diseases. Moscow; Saint Petersburg: Poliforum Grupp; 2017. 36 p. (In Russ.) Available at: https://elibrary.ru/item.asp?id=35406694.
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For citations:
Safina AI. Strategy for improving the quality of treatment for children with acute respiratory infections. Meditsinskiy sovet = Medical Council. 2020;(18):22-28. (In Russ.) https://doi.org/10.21518/2079-701X-2020-18-22-28
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