The peculiarities of the treatment of acute and chronic sinusitis under conditions of growing resistance to antibacterial preparations

Viruses of the ARVI group that are tropic to the epithelium of the upper respiratory tract are able to inhibit the function of the mucociliary system to a certain extent, which contributes to the attachment of bacterial infection. Thus, in respiratory inflammatory diseases, the infection is often combined. This means, that the question about approaches to treatment at the stage of prevention of the development of complications of ARVI arises. A significant increase in the relapse of chronic sinusitis has been observed over the past 10 years. According to A.I. Kryukov et al. the relapse of inflammatory diseases of the paranasal sinuses, the chronic process has no tendency to decrease, aided by the unfavorable ecological situation, the growth of allergic and viral respiratory diseases, poor nutrition to which the body is not evolutionarily adapted. Worsening of chronic sinusitis contributes to many factors, but the starting point is almost always viral infections. Relapse, as a rule, begins with viral rhinitis, which is rarely an independent disease. Most often, a runny nose is a symptom of ARVI or ARI (influenza, parainfluenza, adenovirus infection, etc.). The entrance gate of infection is the epithelial cells of the respiratory tract. The main pathological process in sensitive cells develops both as a result of the penetration of the virus from the outside, and due to the activation of latent or chronic viral infection under the influence of various factors, including other infection.The appointment of drugs with anti-inflammatory, immunomodulatory, adaptogenic activity is one of the promising options for the prevention of both primary viral infection and the development of bacterial complications.We have included a drug that combines adaptogenic and immunomodulatory activities in the treatment of chronic sinusitis. Trekrezan belongs to the group of adaptogens – low-toxic compounds, it is recommended as a measure for the treatment and prevention of viral infections and increasing resistance to various stress factors (hypoxia, hypothermia) and adverse environmental effects.

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Topical antibiotic therapy for perforated otitis in the COVID-19 pandemic

Ryazantsev

Balatskaya

Tkachuk

et al. 2022

Medicinskij sovet

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The developing resistance of microorganisms to the effects of antibacterial drugs creates difficulties in the treatment of purulent diseases. This is especially reasonable in the pandemic of a new coronavirus infection (COVID-19). The aggressive effect of new strains of the virus on the mucous membrane of the nasal cavity and nasopharynx contributes to the occurrence of complications such as acute purulent otitis media and exacerbation of chronic purulent otitis, both during coronavirus infection and in the postcovid period. Even before the start of the pandemic, antibiotic resistance was already one of the big problems in most countries of the world, this was due to the frequent unjustified appointment of systemic antibacterial agents for viral infection, as well as uncontrolled self-medication of the population with all available drugs. Due to the fear of people getting sick with COVID-19 and disagreements among doctors in treatment tactics, the use of systemic antibiotics and hormonal drugs increased already in the first months of the pandemic. In the future, the unjustifiability of this tactic was proved, but many doctors continued to prescribe several systemic antibacterial drugs to patients with uncomplicated viral infection. Under the current conditions, when there is evidence of bacterial infection, it is rational to use local antibacterial drugs, which allows you to quickly reach high concentrations in the focus of inflammation and avoid side effects of systemic antibiotics. Among the existing means in the complex therapy of perforated otitis, a special place belongs to the preparations of the group of quinoxaline derivatives, which include hydroxymethylquinoxalindioxide (Dioxidine). The advantage of the drug is its effectiveness against resistant microorganisms, as well as stimulation of marginal tissue regeneration. This property is especially important in the treatment of perforated otitis media.

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The peculiarities of the treatment of acute and chronic sinusitis under conditions of growing resistance to antibacterial preparations

Cited by 4 publications

References 3 publications

Topical antibacterial therapy of rhinosinusitis

Topical antibacterial therapy of rhinosinusitis

Ways to prevent acute viral infection and its bacterial complications

Topical antibiotic therapy for perforated otitis in the COVID-19 pandemic

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