Update: February 2019
Anyone who graduated from any medical school is firmly
know and remember that antibiotics for colds, ARVI and flu are not
help Doctors in clinics remember this
doctors in hospitals. However, antibiotics are prescribed and not rarely.
just prophylactic. Because when you go to a doctor when you have an arvi
the patient requires treatment.
And in cases of a cold, acute respiratory viral
infection, except for the well-known rules – excessive drinking, bed rest
regimen, fortified, limited (dietary) nutrition,
medications and folk methods of gargling,
washing the nose, inhalation, rubbing warming ointments –
nothing else is required, that is all the treatment for colds and
is limited. But no, a person is waiting for a doctor’s medication, often
just begging for an antibiotic.
Worse, the patient can independently begin to receive any
antibiotic by experience or someone’s advice. Seeing a doctor
Today takes a lot of time, and medication is very simple
to purchase. There is no such open in any civilized country.
access to medicines, as in Russia. Fortunately today
most pharmacies use antibiotics by prescription, but always
There is a chance to get the drug and without a prescription (by softening
pharmacist or by choosing a pharmacy that values its
As for the treatment of colds in a child, the situation is most often
marred by the fact that the pediatrician is simply reinsured, appoints
effective, good, “child” antibiotic for colds for
prevention, in order to avoid possible complications. If on time
baby begin to drink plenty of water, moisten, air the room, when
high temperature give antipyretics for children
to use all known means for colds and folk methods –
the body must cope with the majority of respiratory viral
Why, then, the pediatrician prescribed
antibiotics? Because complications are possible.
Yes, the risk of developing complications in preschool children is very
high Today, not every mother can boast of strong immunity.
and the overall good health of your child. And the doctor in this case
It turns out to be guilty, did not notice, did not check, did not appoint. Fear
accusations of incompetence, inattention, the danger of litigation
harassment pushes pediatricians to prescribe antibiotics for children
with a cold as a prophylaxis.
It should be remembered that a cold in 90% of cases is viral
origin, and viruses are not treated with antibiotics.
Only in cases where the body has failed to cope with the virus and
complications occurred, bacterial infection joined,
localized in the mouth, nose, bronchi or lungs – only in
In this case, antibiotics are indicated.
Можно ли по анализам понять, что нужны antibiotics?
Laboratory tests confirming bacterial character
infections do not always:
- Since sputum culture, urine today is quite expensive
pleasure for clinics and they are trying to save.
- Exceptions are pharyngeal and nasal swabs with angina on
Leflera’s wand (diphtheria pathogen) and selective crops
discharge of tonsils in chronic tonsillitis or urine
pathologies of the urinary tract.
- More likely to get bacteriological confirmation
microbial infection in hospital patients.
- Indirect signs of bacterial inflammation will be changes.
clinical blood test. Here the doctor can navigate by
increase in ESR, increase in the number of leukocytes and shift leukocyte
formulas to the left (an increase in the stab and segmented
How to understand by well-being that complications have arisen?
By eye, the adherence of bacteria can be determined by:
- Change the color of discharge of the nose, pharynx, ear, eyes, bronchi –
from transparent it becomes cloudy, yellow or green.
- Against the background of a bacterial infection, it is usually marked
re-rise in temperature (for example, in pneumonia, which complicated
- With bacterial inflammation in the urinary system urine,
most likely to become cloudy and the visible eye will appear in it
- With the defeat of intestinal microbes in the feces mucus, pus appear
Understand that complications of ARVI are possible by the following
- If after the onset of colds or a cold after the improvement of 5-6
the temperature rises again to 38-39C, deterioration occurs
state of health, increased cough, shortness of breath or pain in
chest breathing and coughing – high risk of pneumonia.
- Sore throat worse at high temperature or appear
Tonsils on tonsils, enlarged cervical lymph nodes –
it is necessary to exclude a sore throat or diphtheria.
- There is pain in the ear, which increases with
pressure on the trestle, or from the ear flowed – medium is likely
- Against the background of a runny nose, pronounced nasal voices appeared,
headaches in the forehead or face that are aggravated by
leaning forward or lying down, the smell is completely gone – there are signs
inflammations paranasal sinuses.
Many ask what antibiotics to drink for colds, which
Is antibiotic better for colds? If complications arise, choose
antibiotic depends on:
- localization of complications
- age of child or adult
- history of the patient
- drug tolerance
- and of course, antibiotic resistance in the country where
there was a disease.
The appointment should be made only by the attending physician.
When antibiotics are not shown for colds or uncomplicated
- Muco-purulent rhinitis (rhinitis), lasting less than 10-14
- Viral conjunctivitis
- Viral tonsillitis
- Tracheitis, bronchitis (in some cases at high temperatures and
acute bronchitis antibacterial drugs are needed)
- Attaching a herpes infection (herpes on the lips)
- Laryngitis in children (treatment)
When it is possible to use antibiotics for uncomplicated
- With pronounced signs of reduced immunity – constant
low-grade fever, more than 5 p / year cold and viral
diseases, chronic fungal and inflammatory diseases,
HIV, any cancers or congenital disorders
- A child up to 6 months – rickets in infants (symptoms, treatment),
various malformations, with a lack of weight
- Against the background of some blood diseases (agranulocytosis,
Indications for antibiotics are
- Бактериальная ангина (с одновременным исключения дифтерии
by taking swabs from the pharynx and nose) requires treatment with penicillins
- Purulent lymphadenitis requires broad spectrum antibiotics.
actions, consultations of the surgeon, sometimes hematologist.
- Laryngotracheitis or acute bronchitis or exacerbation of chronic
bronchitis or bronchiectasis will require macrolides
(Macropen), in some cases, x-ray chest
cells to exclude pneumonia.
- Acute otitis media – choice between macrolides and cephalosporins
conducts ENT doctor after otoscopy.
- Pneumonia (see the first signs of pneumonia, treatment of pneumonia in
child) – treatment with semi-synthetic penicillins after
radiological confirmation of the diagnosis with mandatory control
drug efficacy and X-ray control.
- Inflammation of the paranasal sinuses (sinusitis, sinusitis, ethmoiditis)
– the diagnosis is established by radiological
research and characteristic clinical signs. Treatment holds
otolaryngologist (see signs of sinusitis in adults).
We give an example of a study conducted on the basis of data
one children’s clinic, when analyzing data from the medical history and
outpatient cards 420 children 1-3 years. In 89% of cases in children
Orvi and acute respiratory infections were registered, 16% had acute bronchitis, 3% had otitis and
only 1% pneumonia and other infections.
И в 80% случаев только при воспалении верхних
respiratory tract in acute respiratory disease and ARVI
antibiotics were prescribed, with pneumonia and bronchitis in 100% of cases.
Most doctors on the theory of the inadmissibility of use
antibacterial agents for colds or viral infections, but
- administrative installations
- early age of children
- preventive measures to reduce complications
- reluctance to go to assets
they are still assigned, sometimes by short 5-day courses and with
reducing the dose, which is highly undesirable. Also not considered
спектр возбудителей orz у детей. In 85-90% of cases, these are viruses, and
among bacterial agents it is in 40% pneumococcus, in 15% hemophilic
wand, 10% mushrooms and staphylococcus, less often atypical pathogens –
chlamydia and mycoplasma.
With the development of complications on the background of the virus, only for its intended purpose
doctor, according to the severity of the disease, age, patient history
such antibiotics are prescribed:
- Penicillin row – in the absence of allergic reactions to
penicillins may use semi-synthetic penicillins
(Flemoxine Soljutab, Amoxicillin). For severe resistant
infections among penicillin preparations doctors prefer
�”Protected penicillins” (amoxicillin + clavulanic acid),
Amoxiclav, Ekoklav, Augmentin, Flemoklav Solyutab. This drugs
first row with angina.
- Cephalosporin series – Cefixime (Supraks, Pancef, Ixim Lupine),
Cefuroxime axetil (Zinacef, Supero, Axetin, Zinnat), etc.
- Macrolides – usually prescribed for chlamydia, mycoplasma
pneumonia or infections of upper respiratory tract – Azithromycin (Sumamed,
Zetamaks, Zitrolid, Hemomitsin, Z-factor, Azitroks), Makropen –
drug of choice for bronchitis.
- Fluoroquinolones – are prescribed in cases of intolerance to others
antibiotics, as well as bacteria resistance to drugs
пенициллинового ряда — Левофлоксацин (Таваник, Флорацид,
Hyleflox, Glevo, Flexid), Moxifloxacin (Avelox, Plevilox,
Moximac). Completely prohibited for use in children
fluoroquinolones, since the skeleton has not yet been formed, as well as
the reason that this drugs “reserve”, which can be useful
when he grows up when treating infections with a drug
In general, the problem of choosing an antibiotic today is a challenge for
the doctor he has to decide so that best help
patient in the present and do no harm in the future. The problem is complicated
the fact that the pharmaceutical company in pursuit of today’s profits is absolutely
do not take into account the seriousness of the increasing resistance of pathogens
diseases to antibiotics and are thrown into a wide network of those
antibacterial novelties that could be for a long time
time in reserve.
If your doctor prescribes an antibacterial drug, it is worth
familiar with 11 rules How to drink antibiotics.
- Antibiotics are indicated for bacterial infections, and cold in
80-90% is of viral origin, so their reception is not only
meaningless, but also harmful.
- Antibiotics have serious side effects such as
like depression of liver and kidney function, allergic reactions, they
reduce immunity, cause an imbalance of intestinal microflora and
mucous membranes in the body.
- Antibiotics for the prevention of complications
viral-bacterial infections are unacceptable. The task of the child’s parents
see a doctor in time, and a therapist or pediatrician in time
detect possible deterioration of the child’s or adult’s well-being and
only in this case to take “heavy artillery” in the form of
- The main criterion for the effectiveness of antibiotic therapy
is a decrease in body temperature to 37- 38 ° C, relief of the overall
condition, in the absence of this antibiotic should be replaced by another.
The effectiveness of the antibiotic is assessed within 72 hours and only
after that the drug changes.
- Frequent and uncontrolled use of antibiotics leads to
development of resistance of microorganisms, and with each person
increasingly aggressive drugs will be required, often
simultaneous use immediately 2 or more antibacterial