Influenza and acute viral infection prevention in children with recurrent respiratory pathology

Introduction. Despite numerous scientific works devoted to the problem of acute respiratory diseases, its relevance does not decrease throughout the world, since serious complications with an unfavorable prognosis are possible.

Aim. To evaluate the effectiveness of preventive antiviral therapy in children with recurrent respiratory pathology.

Materials and methods. Under observation were 43 children (average age 7.43 ± 3.05 years) with recurrent respiratory pathology, who underwent health treatment in the summer period once for 14 days. The main group consisted of 22 children who were prescribed the antiviral therapy as a monotherapy for prophylactic use. The comparison group included 21 patients who underwent preventive treatment using nasopharyngeal irrigation with local antiseptic chemicals. The observation period was 3 months after prophylactic treatment.

Results and discussion. After preventive treatment, the total number of episodes of ARI during the observation period in the main group in relation to the comparison group was according to nosologies: acute pharyngitis (p = 0.0317), exacerbation of chronic tonsillitis (p = 0.0137), acute rhinitis (p = 0.0692), rhinosinusitis (p = 0.0429). In the main group, during the observation period, when episodes of upper respiratory tract diseases occurred, antibacterial drugs were prescribed statistically significantly less frequently (p = 0.0296). After the preventive course, compared with the initial data, there was a decline in the number of cases of upper respiratory tract diseases per child on average per quarter. Thus, in the main group, a more pronounced significant difference was revealed in all nosological forms (acute rhinitis, rhinosinusitis p = 0.0081, acute pharyngitis p = 0.0129, tonsillopharyngitis p = 0.0384). In the comparison group – respectively: p = 0.0426; 0.0387; 0.0439.

Conclusions. Carrying out preventive treatment as monotherapy in children with recurrent respiratory pathology demonstrated high effectiveness (86.37%) of the antiviral therapy.

1. Захарова ИН (ред.). Современные возможности диагностики и лечения в педиатрии. М.: Ремедиум; 2022. 392 с.

2. Pikuza OI, Zakirova AM, Volyanyuk EV, Filatov VS, Pikuza AV, Zakirov AM. Functional potential of colonization defense of buccal epitheliocytes as an indicator of the clinical course of respiratory tract diseases. Practical Medicine. 2023;21(1):76–80. (In Russ.) https://doi.org/10.32000/20721757-2023-1-76-80.

3. Belousov DYu, Cheberda AE. Pharmacoepidemiological studies: methodology and regulation. Good Clinical Practice. 2017;(1):34–41. (In Russ.) Available at: https://www.clinvest.ru/jour/article/view/76.

4. Baranov AA, Lobzin YuV, Namazova-Baranova LS, Tatochenko VK, Uskov AN, Kulichenko TV et al. Acute respiratory viral infection in children: modern approaches to diagnosis and treatment. Pediatric Pharmacology. 2017;14(2):100–108. (In Russ.) https://doi.org/10.15690/pf.v14i2.1724.

5. Osidak LV, Dondurey EA, Obraztsova EV, Golovacheva EG, Afanasyeva OI. Morbidity pattern and modern approaches to ARVI treatment in children. RMJ. Medical Review. 2019;(3):37–42. (In Russ.) Available at: https://www.rmj.ru/articles/pediatriya/Struktura_zabolevaemosti_i_sovremennye_podhody_k_terapii_ORVI_u_detey/.

6. Gorbacheva EV, Mizanova IV, Otvodnikova NI. Pharmacoepidemiological aspects of anti-viral drugs of choice for treating acute respiratory infections in children. Far Eastern Medical Journal. 2015;(4):51–53. (In Russ.) Available at: http://www.fesmu.ru/dmj/20154/2015412.aspx.

7. Karpishchenko SA, Rodneva YuA. The importance of the nasopharyngeal mucosa protection for prevention of acute respiratory viral infections and influenza in children. Meditsinskiy Sovet. 2022;(1):257–263. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-1-257-263.

8. Svistushkin VM, Mokoyan ZhT. Preventive and therapeutic role of nasal irrigation in management of acute respiratory disease during COVID-19 pandemic and beyond. Meditsinskiy Sovet. 2021;(6):58–64. (In Russ.) https://doi.org/10.21518/2079-701X-2021-6-58-64.

9. Poryadin GV, Salmasi ZhM, Kukes IV, Kazimirskii AN, Danilov AnB, Lazareva NB, Danilov AB. Modern knowledge of inflammatory diseases of various localization and etiology: new possibilities of pharmacotherapy. Farmateka. 2020;(14):37–46. (In Russ.) https://doi.org/10.18565/pharmateca.2020.14.37-46.

10. Kazimirskii AN, Poryadin GV, Salmasi ZM, Semenova LYu. Endogenous Regulators of the Immune System (sCD100, Malonic Dialdehyde, and Arginase). Bulletin of Experimental Biology and Medicine. 2018;164(5):693–700. (In Russ.) https://doi.org/10.1007/s10517-018-4061-6.

11. Vakhitov KhM, Pikuza OI, Suleymanova ZYa, Zakirova AM, Akhmetvaleeva JuN. Cascade of metabolic disorders in respiratory organ disorders in children. The Bulletin of Contemporary Clinical Medicine. 2017;10(3):56–60. (In Russ.) https://doi.org/10.20969/VSKM.2017.10(3).56-60.

12. Souza FC, Mocellin M, Ongaratto R, Leitão LAA, Friedrich FO, Silveira VD et al. OM-85 BV for primary prevention of recurrent airway infections: a pilot randomized, double-blind, placebo-controlled study. Einstein (Sao Paulo). 2020;18:eAO5262. https://doi.org/10.31744/einstein_journal/2020AO5262.

13. Krasnova EI, Loskutova SA, Panasenko LM. Modern approach to antiviral therapy of acute respiratory viral infections in children. How to avoid polypharmacy? Lechaschi Vrach. 2014;(10):60–73. (In Russ.) Available at: https://www.lvrach.ru/2014/10/15436073.

14. Kochetkov PA, Meytel IYu. Prevention and treatment of acute viral infections of the upper airways and their bacterial complications. RMJ. 2016;(4):231–235. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Profilaktika_i_lechenie_ostryh_virusnyh_infekciyverhnih_dyhatelynyh_putey_i_ih_bakterialynyh_osloghneniy.

15. Bulgakova VA. Immunomodulation in modern therapy of respiratory infections. Russian Pediatric Journal. 2015;18(3):45–53. (In Russ.) Available at: https://elibrary.ru/uaxnvr.

16. Boyko NV, Letifov GM, Kim AS, Stagnieva IV. Evaluation of efficacy of treatment of acute tonsillopharyngitis associated with acute respiratory viral infections in children. Pediatriya – Zhurnal im G.N. Speranskogo. 2018;97(4):168–172. (In Russ.) https://doi.org/10.24110/0031-403X-2018-97-4-168-172.

17. Bulgakova VA. Treatment of respiratory infections in children: possibilities for reducing drug load. Farmateka. 2015;11(304):23–29. (In Russ.) Available at: https://pharmateca.ru/ru/archive/article/31669.

18. Pikuza OI, Fayzullina RA, Zakirova AM, Samorodnova EA. Rapid diagnostic tests in the outpatient practice of a pediatrician. Practical Medicine. 2021;19(5):37–41. (In Russ.) https://doi.org/10.32000/2072-1757-2021-5-37-41.

19. Zakirova AM, Moroz TB, Shayapova DT, Kadriev AG, Palmova LYu, Rashitova EL et al. Influence of a combined interferon-alpha-containing drug on the course of respiratory diseases in frequently ill children. Meditsinskiy Sovet. 2023;(12):32–44. (In Russ.) https://doi.org/10.21518/ms2023-202.

20. Yang E, Li MMH. All About the RNA: Interferon-Stimulated Genes That Interfere With Viral RNA Processes. Front Immunol. 2020;11:605024. https://doi.org/10.3389/fimmu.2020.605024.

21. Li SF, Gong MJ, Zhao FR, Shao JJ, Xie YL, Zhang YG, Chang HY. Type I Interferons: Distinct Biological Activities and Current Applications for Viral Infection. Cell Physiol Biochem. 2018;51(5):2377–2396. https://doi.org/10.1159/000495897.

22. Bokova TA. The influenza and acute respiratory viral infections in children: the place of interferon drugs in pathogenic therapy. Lechaschi Vrach. 2017;(5):58–60. (In Russ.) Available at: https://www.lvrach.ru/2017/05/15436728.

23. Loginova SYa, Shchukina VN, Savenko SV, Borisevich SV. Antiviral activity of Kagocel® in vitro against virus SARS-CoV-2. Antibiotics and Chemotherapy. 2020;65(3-4):3–6. (In Russ.) https://doi.org/10.37489/0235-2990-2020-653-4-3-6.

24. Borovskaya TG. Preclinical and Clinical Evidence of Safety of Antiviral Drug with Immunomodulatory Activity. Serbian Journal of Experimental and Clinical Research. 2018;19:(3):271–276. https://doi.org/10.2478/sjecr-2018-0040.

25. Sologub TV, Tsvetkov VV. Kagocel in the therapy of influenza and acute respiratory viral infections: Data analysis and systematization from the results of preclinical and clinical trials. Terapevticheskii Arkhiv. 2017;89(8):113–119. (In Russ.) https://doi.org/10.17116/terarkh2017898113-119.

26. Svistushkin VM, Morozova SV, Artamonova PS. Symptomatic therapy of acute respiratory viral infections with damage to the upper respiratory tract. Consilium Medicum. 2020;22(11):37–42. (In Russ.) https://doi.org/10.26442/20751753.2020.11.200489.

27. Dondurey EA, Obraztsova EV, Semiletko YuS, Ovchinnikova NV, Golovacheva EG, Osidak LV, Afanasyeva OI. ARVI antiviral therapy in children in modern clinical practice. Meditsinskiy Sovet. 2019;(2):183–187. (In Russ.) https://doi.org/10.21518/2079-701X-2019-2-183-187.

28. Safiullin TR, Vakhitov HM, Eremeeva ON, Loskutova EV, Vorontsova IA, Ibragimova ZhR, Samoilova NV. Etiology of respiratory diseases in children: modern diagnostic capabilities. Medical Newsletter of Vyatka. 2018;(2):57–65. (In Russ.) Available at: https://vyatmedvestnik.ru/index.php/vmv/issue/view/28/no2-58-2018.

29. Ruzhentsova TA, Levitskaya DS. Treatment of acute viral respiratory infections and influenza in children: metaanalysis results. Lechaschi Vrach. 2020;(3):52–57. (In Russ.) https://doi.org/10.26295/OS.2020.93.40.008.

30. Goldina TA, Zhigunova DS, Sinyagina MA, Frolova YaS. Monitoring in non-interventional studies. Medical Technologies. Assessment and Choice. 2020;42(4):21–29. (In Russ.) https://doi.org/10.17116/medtech20204204121.