Possibilities of using the Bronchitis Severity Scale to assess the effectiveness of the treatment of acute bronchitis in children

Abstract

Background. In the structure of the overall morbidity, acute respiratory viral infections (ARVI) occupy the first place, which is confirmed by the official statistical and epidemiological government reports of various countries on children health problems. The incidence of ARVI in children exceeds the level of all infections by 7–7.5 times, which is 1.5–3 times as much as in adults, and in the cohort of children under 3 years of age, their share is up to 65.0 % of all registered acute infectious diseases. According to Ukrainian researchers, acute bronchitis (AB) is recorded in 20.0 % of patients with ARVI. In the etiological structure of ARVI, changes in the composition of the main pathogens occur every 15–20 years, which certainly affects the existing diagnostic and therapeutic measures. Studies on the etiological structure of diseases of the upper respiratory tract have shown that causative agents are mostly viruses, and the use of modern diagnostic methods makes it possible to establish the etiological factor of ARVI in 56.0–80.0 % of cases. The purpose of the study: to investigate the clinical features of the course of AB in children from 1 to 6 years old with an assessment of the severity of the condition in the acute period of the disease and in the period of convalescence using the Bronchitis Severity Scale; to determine clinical anamnestic and laboratory risk factors for the development of a protracted course of AB in children from 1 to 6 years old. Materials and methods. The work presents materials of clinical observation, clinical laboratory and instrumental examination of 122 children aged 1 to 6 years with AB. Conclusions. It has been found that clinical and anamnestic predictors (perinatal lesion of the central nervous system, low birth weight, maternal smoking), the severity of AB (in terms of the total score on the Bronchitis Severity Scale) and phase changes in the concentration of antimicrobial peptides and interferons determine the risk of developing a protracted course of the disease. The determination of the severity of the condition in children with AB using the Bronchitis Severity Scale makes it possible to improve therapeutic measures and provides an opportunity for a differentiated choice of pathogenetically based treatment at the stage of inpatient management.

Keywords

• acute bronchitis
• children
• bronchitis severity scale