Influenza and seasonal colds (acute respiratory infections - acute respiratory infections) caused by other non-influenza respiratory viruses account for 80–90% of the world's infectious diseases. These infections are not at all harmless. Over 60 years of life, a person suffers from them for an average of 6 years.
Often the flu gives serious complications, including lightning-fast and life-threatening. In the epidemic period, in the absence of an influenza epidemic, approximately 80% of ARI cases are caused not by the influenza virus, but by other respiratory viruses or a bacterial infection. During influenza epidemics, in contrast, the number of people with the flu rises sharply, and the disease is often more severely tolerated.
In the event that the patient’s condition deteriorates sharply in a matter of hours (fever over 39 ° C, pain in the eyes, weakness, severe cough, shortness of breath, pallor), you should immediately consult a doctor. In order to establish an accurate diagnosis (flu or other acute respiratory infections), a specialist can resort to analysis, but it is quite expensive and takes a lot of time, so doctors most often make the diagnosis “flu” intuitively. Treatment of influenza should be based on generally accepted standards, which allows for the optimal amount of diagnostic and therapeutic care.
By order of the Ministry of Health of Ukraine dated 12.28.2002 No. 507 “On the approval of standards for the provision of medical care and quality indicators of medical care”, medical care is provided for patients diagnosed with influenza on the basis of clinical, epidemiological or laboratory data, depending on the severity of the course.
In 2009, when the WHO declared a pandemic and “influenza hysteria” reigned in the world, in Ukraine, on the basis of WHO recommendations, the Ministry of Health of Ukraine dated August 12, 2009 No. 590 adopted Methodological Recommendations “Principles for the diagnosis and treatment of patients with acute respiratory viral diseases” ”, Which underwent changes and additions in the order of the Ministry of Health of Ukraine dated 02.12.2009 No. 908. In addition, the protocols of diagnosis and treatment were adopted. First, the order dated 02.06.2009 No. 385 “On the approval of the Clinical Protocol for the diagnosis and treatment of new influenza A H1N1 (California) in children” appeared, which was replaced by the order dated 07.11.2009 No.
Combined, immunostimulating, antiviral and homeopathic medicines make up the market of medicines for the treatment and prevention of colds and flu. About half of the sales of the market in the CIS countries in packaging are combined products - in monetary terms they occupy a third of the market. If combined drugs were market leaders before the influenza A (H1N1) pandemic, in the last 2 years, etiotropic drugs (direct antiviral and immunomodulating drugs) came out on top in monetary terms, displacing the combined segment. Against the background of an increase in the incidence of influenza A (H1N1) during 2009–2010. there was an increase in sales of antiviral and immunostimulating drugs.
The principles of treatment for influenza and acute respiratory infections are traditional and understandable: the use of symptomatic therapy, as well as immunomodulators with antiviral effects and antiviral drugs as a means of etiotropic therapy. It is important to note that etiotropic therapy is the most effective means in the fight against the influenza virus that can stop the replication of the virus in the human body.
In the event that the patient’s condition deteriorates sharply in a matter of hours (fever over 39 ° C, pain in the eyes, weakness, severe cough, shortness of breath, pallor), you should immediately consult a doctor. In order to establish an accurate diagnosis (flu or other acute respiratory infections), a specialist can resort to analysis, but it is quite expensive and takes a lot of time, so doctors most often make the diagnosis “flu” intuitively. Treatment of influenza should be based on generally accepted standards, which allows for the optimal amount of diagnostic and therapeutic care.
By order of the Ministry of Health of Ukraine dated 12.28.2002 No. 507 “On the approval of standards for the provision of medical care and quality indicators of medical care”, medical care is provided for patients diagnosed with influenza on the basis of clinical, epidemiological or laboratory data, depending on the severity of the course.
In 2009, when the WHO declared a pandemic and “influenza hysteria” reigned in the world, in Ukraine, on the basis of WHO recommendations, the Ministry of Health of Ukraine dated August 12, 2009 No. 590 adopted Methodological Recommendations “Principles for the diagnosis and treatment of patients with acute respiratory viral diseases” ”, Which underwent changes and additions in the order of the Ministry of Health of Ukraine dated 02.12.2009 No. 908. In addition, the protocols of diagnosis and treatment were adopted. First, the order dated 02.06.2009 No. 385 “On the approval of the Clinical Protocol for the diagnosis and treatment of new influenza A H1N1 (California) in children” appeared, which was replaced by the order dated 07.11.2009 No.
Combined, immunostimulating, antiviral and homeopathic medicines make up the market of medicines for the treatment and prevention of colds and flu. About half of the sales of the market in the CIS countries in packaging are combined products - in monetary terms they occupy a third of the market. If combined drugs were market leaders before the influenza A (H1N1) pandemic, in the last 2 years, etiotropic drugs (direct antiviral and immunomodulating drugs) came out on top in monetary terms, displacing the combined segment. Against the background of an increase in the incidence of influenza A (H1N1) during 2009–2010. there was an increase in sales of antiviral and immunostimulating drugs.
The principles of treatment for influenza and acute respiratory infections are traditional and understandable: the use of symptomatic therapy, as well as immunomodulators with antiviral effects and antiviral drugs as a means of etiotropic therapy. It is important to note that etiotropic therapy is the most effective means in the fight against the influenza virus that can stop the replication of the virus in the human body.
Etiotropic pharmacotherapy of influenza and acute respiratory infections
Oseltamivir. The recommended treatment dose for influenza for adults and children over 12 years old is 75 mg 2 times a day for at least 5 days. The drug should be started in the first 2 days of the disease. Oseltamivir is prescribed for children over 1 year old - with a body weight of less than 15 kg 30 mg, 15 to 23 kg 45 mg, 23 to 40 kg 60 mg, more than 40 kg 75 mg 2 times a day for 5 days . The drug is prescribed with caution in renal failure, it can cause nausea and vomiting when taken.
Zanamivir is prescribed for adults and children over 5 years of age with 5 mg of inhalation 2 times a day for 5 days. The total daily dose is 10 mg. The drug can not be combined with other inhaled drugs (including bronchodilators), since it can cause exacerbations in patients with bronchial asthma and other non-specific lung diseases. In a number of people without pulmonary pathology, there may be signs of irritation of the nasopharynx, reaching in rare cases before the appearance of bronchospasm.
Among the advantages of neuraminidase inhibitors - oseltamivir and zanamivir - one should note high antiviral activity against the main influenza viruses, rare cases of drug resistance of the pathogen (in 96.4%, influenza pathogens are sensitive to new drugs), and among the disadvantages there is a narrow spectrum of action (only active against influenza A and B viruses and are inactive against other viruses causing ARI). Both drugs are effective in the appointment in the first 2-3 days, in addition, in severe influenza, their use within the first 5 days from the onset of the disease is justified.
Rimantadine and Amantadina sulfate are blockers of the M2 viral protein, act only on the seasonal influenza A virus. Avian and swine flu are resistant to them. In most countries, these drugs are not used due to their high toxicity and reduced effectiveness due to the spread of resistant strains of influenza A.
Ribavirin It is possible to use this drug for the treatment of influenza in adults over 18 years of age (200 mg 3-4 times a day with meals for 5-7 days) in the absence of pregnancy, renal failure and hemolytic anemia.
IFN inducers with an additional direct antiviral effect are the most promising products for the treatment of influenza and SARS. Unlike exogenous (ready-made) IFN preparations, its inductors do not possess antigenic activity. With a single administration of these drugs, a prolonged circulation of various types of their own IFN is provided. These drugs combine well with other antiviral agents, providing a synergistic effect. As with neurominidase inhibitors, the efficacy of IFN inducers is higher the sooner treatment is started. Often their appointment in the prodromal period can stop the development of a viral infection.
Amiksin® IC ( tiloron, InterChem) - a bright representative of IFN inducers, stimulates the formation of α-, β-, γ-IFN in the body. Induction of IFN synthesis is carried out without the participation of auxiliary cells. The main producers of IFN, in response to the introduction of the drug, are intestinal cells, hepatocytes, T-lymphocytes, neutrophilic granulocytes. After taking the drug, the maximum level of IFN production in the body is noted in the following sequence: intestines - liver - blood from 4 to 24 hours, respectively. In addition, this drug, depending on the dose, enhances antibody formation, reduces the severity of immunosuppression, resumes the ratio of T-suppressors / T-helpers, activates monocytes / macrophages and NK cells, stimulating the activity of bone marrow stem cells.
For the treatment of influenza and acute respiratory infections, Amiksin® IC is prescribed orally after meals, 2 tablets of 0.125 g for adults and 0.06 g for children over 7 years of age on the first day of illness and then 1 tablet every other day. Up to 6 tablets per course of treatment. Contraindicated in pregnant women and children under 7 years of age.
Kagocel inducer of IFN (a mixture of α-, β-IFN) with direct antiviral and immunomodulating action is prescribed for adults and children with influenza and acute respiratory infections 2 tablets 3 times a day for the first 2 days (daily dose 72 mg), then 1 tablet 3 times a day (daily dose of 36 mg). In total, up to 18 tablets per 4-day course.
Amizon belongs to the group of antiviral drugs. It is an inducer of endogenous IFN, with antiviral, immunomodulatory and anti-inflammatory effects. The drug is prescribed for adults 2–4 times a day after meals with a moderate course of influenza and acute respiratory infections, 0.25 g each, and severe, 0.5 g each over 5–7 days; the course dose of treatment is 3–6.5 g. Children aged 6–12 years are prescribed 0.125 g 2-3 times a day for 5–7 days.
Arbidol is prescribed for the treatment of influenza and acute respiratory infections without complications for children from 3 to 6 years old - 50 mg, from 6 to 12 years old - 100 mg, over 12 years old and adults - 200 mg 4 times a day (every 6 hours) for 5 days, and with the development of complications (bronchitis, pneumonia, etc.), children from 3 to 6 years old - 50 mg, from 6 to 12 years old - 100 mg, over 12 years old and adults - 200 mg 4 times a day (every 6 hours) for 5 days, then a single dose 1 time per week for 4 weeks.
Groprinosin for the treatment of influenza and acute respiratory infections for adults is used orally after eating, 2 tablets of 0.5 g 3-4 times a day for 5-7 days and for children at the rate of 50 mg / kg body weight also 3-4 times a day within 5-7 days.
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