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Recurrent episodes of bronchial obstruction in preschool children are one of the important risk factors for the development of bronchial asthma.Purpose. The study aimed at investigating the clinical and immunological characteristics of children with acute bronchitis and to determine the clinical effectiveness of course anti-inflammatory therapy.Material and methods. The study was a single-center prospective cohort, including 1–5-year-old patients with acute bronchitis (main group, n = 109): a group with acute simple bronchitis (n = 34) and acute obstructive bronchitis (n = 75). Reference group: children of health group 2 (n = 29). Clinical and anamnestic and laboratory methods were used. Patients with a positive API (Asthma Predictive Index) were administered montelukast at a dose of 4 mg orally once a day for 3 months (control points at 1 and 3 months), reference patients received symptomatic therapy for respiratory infection. The end point of the study is the absence of bronchial obstruction. The effectiveness of the use of Montelukast was evaluated by calculating the clinical index, efficiency coefficient. Results. A statistically significant predominance of intoxication symptoms was found in patients with acute simple bronchitis (p = 0.02), signs of respiratory failure (p < 0.001), and peripheral eosinophilia — in children with acute obstructive bronchitis (p = 0.02). In etiology, rhinovirus significantly prevailed in patients with bronchial obstruction, and RS virus prevailed in patients with acute simple bronchitis (p = 0.02). The cytokine profile of patients with acute obstructive bronchitis is characterized by a decrease in the levels of macrophage inflammatory proteins (p = 0.01) and IL-8 (p = 0.048). A prolonged course of montelukast in children with a positive API significantly reduces the severity of subsequent acute respiratory infections, reduces the frequency of bronchial obstruction and the risk of bronchial asthma (p < 0.001).Conclusion. Evaluation of the results of montelukast therapy demonstrated clinical efficacy in patients with a positive API index.

Introduction. Cough is one of the most common symptoms faced by a pediatrician in clinical practice. The most common cause of acute cough in children is a viral infection. A growing amount of scientific data indicates that phytotherapy is an effective and safe form of auxiliary treatment of acute and chronic inflammatory diseases of the respiratory tract, accompanied by cough and sputum formation (tracheitis, tracheobronchitis, bronchitis).Aim. To evaluate the effectiveness of the use of herbal medicinal product (extract combination of thyme herb and Hedera helix leaves) in acute bronchitis, including in children with bronchitis of atypical etiology.Materials and methods. A comparative prospective follow-up of 60 outpatient patients aged 3–12 years with a diagnosis of Acute bronchitis was carried out. The patients were divided into groups: group 1 (n = 28) – receiving the phytopreparation, of which 8 children with mycoplasma bronchitis – a combination of herbal medicinal product + clarithromycin; group 2 (n = 32) – receiving ambroxol, of which 10 patients with mycoplasma bronchitis – a combination of ambroxol + clarithromycin. Patients were included in the study for 2–3 days of the disease, control points of examinations – 6–7 days and 10–12 days. The time period of the study is 2019–2021.Results. Against the background of taking the drug herbal medicinal product, there was a faster decrease in cough episodes (from 85 to 10% of patients), the transfer of dry cough to wet, as well as normalization of daily activities (95%), compared with ambroxol. The maximum effect was achieved by the 10th day of observation. In atypical bronchitis, results were obtained confirming the effectiveness and safety of using the drug herbal medicinal product with an antibiotic.Conclusions. The results obtained indicate the expediency of using the drug herbal medicinal product in acute bronchitis, including in combination with an antibiotic for bronchitis of atypical etiology.

Aim: To present the relevant information on the new approaches to the management of obliterating bronchiolitis in children, based on the data generated by foreign researchers. Key Points. Obliterating bronchiolitis is a non-reversible chronic obstructive lung disease associated with respiratory insufficiency, significant deterioration in the quality of life, and steady signs of disability. Despite the fact that this topic is of high interest, the management of patients and efficient therapy algorithms are a burning issue. A risk of side effects from systemic corticosteroids necessitates the search for alternative therapies. This overview presents information on a combined use of inhaled corticosteroids, azithromycin, monteleukast, and N-acetylcysteine. Conclusion. Further development of alternative therapies for chronic obliterating bronchiolitis can help in achieving efficient control of this disease. Keywords: obliterating bronchiolitis, therapy, children.