Can antibiotics raise the temperature. Fever when taking antibiotics - what to do

Today, antibacterial drugs can be purchased at any pharmacy, and in most cases a prescription is not required. Antimicrobial therapy is widely used in all areas of medicine in various dosage forms- tablets, injections, suppositories and ointments. But there is no medicine that is exceptionally useful - a complaint of fever after an antibiotic in children or adults reflects the essence of fever as one of the likely side effects of antibacterial agents.

Antibacterial therapy is used to treat patients of all age groups. The purpose of the appointment is to influence the causative agent of an infectious disease, which is clinically manifested by a decrease in the severity of the intoxication syndrome. Antibiotics have no effect on the thermoregulation system, however, body temperature is one of the characteristics that allow assessing the patient's condition and determining the need for further antimicrobial therapy.

An increase in temperature when taking antibiotics may be due to such reasons as:

• no effect on the pathogen if the wrong drug is selected;
• the presence of pathogen resistance to an antibacterial drug (resistance);
• development drug fever;
• serum-like syndrome;
• tubulointerstitial nephritis;
• pseudomembranous colitis.

An incorrectly selected antibiotic can cause not only a lack of improvement, but also a deterioration in the condition - if the medicine does not work, the patient does not receive treatment. Antibacterial agents, like any other drugs, must have a "point of application".

Even antibiotics a wide range, applied empirically until the identification of the microorganism that caused the disease, are active against only certain types bacteria. In addition, antimicrobial therapy is ineffective in viral infection, although it can be used in case of attachment of secondary bacterial flora.

Consideration should be given to the possibility of resistance and associated insensitivity to the action of the drug. Current antibiotic resistance actual problem, which is difficult to solve due to the uncontrolled use of antimicrobial agents and the constant emergence of resistant bacterial strains. If fever without signs of improvement persists against the background of antibiotic therapy more than 48 hours, a drug change should be considered.

The temperature increase during and after antibiotic therapy should be assessed taking into account not only the numbers recorded on the thermometer scale, but also the characteristics of the patient's condition. A temperature of 37 ° C after antibiotics in a child with normal health is not pathological sign. However, severe fever accompanied by pain syndrome- an excuse to see a doctor. An increase in body temperature to 37.9-40 ° C after antibiotics may occur due to the death of a large number of bacteria at the same time, which leads to the release of bacterial endotoxins and increased symptoms of general intoxication.

If a child or adult has a fever after taking antibiotics, the possibility of complications of the underlying pathology cannot be ruled out. When treatment is started too late or finished too early, is carried out using insufficient doses of the drug, the primary infectious process may be supplemented with new characteristics (for example, the development of abscesses of the internal organs in osteomyelitis).

medicinal fever

Temperature after antibiotics may be a manifestation of drug fever, the development mechanisms of which have not been fully established. There are suggestions about the participation in the pathogenesis of immunocomplex reactions. An increase in temperature to 38-40 ° C is usually observed on the 6-8th day of therapy. Drug fever is listed as a probable side effect the use of beta-lactams (amoxicillin, cefuroxime), sulfonamides (sulfadimethoxine) and a number of other drugs.

In drug fever, the patient remains relatively satisfactory; an increase in body temperature may be the only symptom or combined with the appearance of an itchy skin rash.

Blood tests reveal eosinophilia, leukocytosis, thrombocytopenia, and increased ESR.

A feature of fever is the presence of bradycardia (decrease in heart rate) during a rise in temperature.

In an adult or child, the temperature after taking antibiotics in the case of drug fever returns to normal within 2 or 3 days, provided that the drug is discontinued.

If you use it again, a feverish state occurs within a few hours from the moment the drug enters the body.

Serum-like syndrome

The classic variant of serum sickness occurs with the use of immunobiological preparations of animal origin, but a clinically similar reaction, called the serum-like syndrome, may complicate antibiotic therapy. SPS develops with the use various groups antimicrobial agents (penicillins, fluoroquinolones, sulfonamides, tetracyclines, etc.). The pathogenesis is based on an immunocomplex reaction that causes damage to blood vessels and connective tissue.

Symptoms usually appear 2-3 weeks after taking antibiotics. The temperature rises to 37.5-39 ° C, which is accompanied by:

• rash of a different nature;
• pain in muscles and joints;
• enlargement of the liver and / or spleen;
• enlargement of the lymph nodes.

In severe cases, myocarditis, glomerulonephritis, pleurisy develops, various options defeats nervous system and gastrointestinal tract. Complaints that the temperature has risen after taking antibiotics are quite rare - usually patients are concerned about the symptoms present at the time of the examination and the fact of using antibacterial drugs can only be identified through careful history taking.

Treatment is based on the withdrawal of the causative drug. Also apply antihistamines(levocetirizine), in the presence of complications - glucocorticosteroids (prednisolone), symptomatic remedies(antipyretics, antispasmodics, etc.).

Tubulointerstitial nephritis

Antibacterial drugs belonging to beta-lactams and sulfonamides can cause damage to the tubular membranes and interstitial tissue of the kidneys and the development of acute tubulointerstitial nephritis. The disease occurs within a period of 2 days to 6 weeks after taking the drug and is characterized by the following symptoms:

1. General weakness, sweating.
2. Drowsiness, fatigue, lethargy.
3. Loss of appetite, nausea.
4. Fever, muscle and joint pain.
5. Pain in lumbar region whining character.
6. The appearance of a skin rash.
7. Polyuria (increased amount of urine).

The temperature in an adult or child after taking antibiotics rises to 37.5-39 ° C. In acute nephritis, the drug that caused the disease is canceled, the patient is hospitalized in a nephrological hospital. Mandatory diet (table number 7 according to Pevzner), bed rest. Prescribe glucocorticosteroids, desensitizing agents, correct water and electrolyte disorders and acid-base balance use symptomatic therapy.

Pseudomembranous colitis

Pseudomembranous colitis is also called antibiotic-associated colitis, since the disease develops against the background of antibiotic therapy. It is caused by the anaerobic bacterium Clostridiulm difficile. The main symptoms are:

• weakness;
• diarrhea;
• nausea;
• vomit;
• abdominal pain;
• fever.

Pain in the abdomen is spastic in nature, aggravated by palpation, during the urge to defecate. The chair is frequent (from 5 to 20 or 30 times a day), watery, often contains an admixture of mucus and / or blood. The temperature after antibiotics in an adult in the case of pseudomembranous colitis rises to 38-39 ° C, less often up to 40 ° C.

If untreated, there is a risk of complications - toxic megacolon, intestinal perforation.

Treatment begins with the abolition of the antibiotic. If it is necessary to continue therapy, it should be replaced with an antimicrobial agent belonging to another group. Metronidazole and vancomycin are indicated as etiotropic drugs. Rehydration is also necessary, that is, replenishment of fluid losses and correction of electrolyte disturbances (regidron, infusions of sodium chloride and glucose solution, etc.), symptomatic therapy.

An increase in body temperature after antibiotics in a child or adult is a symptom that needs attention. Antibacterial agents should be used only if indicated, taking into account the age of the patient, the presence of chronic diseases and a predisposition to allergic reactions. The appearance of fever, rash, nausea, abdominal pain while taking an antibiotic should be reported to your doctor.

Antibiotics are substances of animal, plant or synthetic origin, which, by their action, are capable of inhibiting the growth and reproduction of certain pathogenic microorganisms or cause their death.

Antibiotics are serious drugs, even though they can be bought without a prescription at any pharmacy. They should be taken only as prescribed by the attending physician, otherwise, complications and errors cannot be avoided.

Many patients wonder if the temperature when taking such drugs is normal condition or pathological? Definitely, such a question must be asked to the doctor, because it depends on the type of disease, which antibiotic is taken, its dosage and other reasons.

However, it is still worth figuring out on what day the temperature drops when taking antibiotics? Why doesn't it go down, but stays for some time?

It is worth recalling that the use of antibiotics is justified when infectious diseases that are caused by bacteria. Infections of a viral and fungal nature will not be affected in any way.

It is also worth noting that in a hospital in the treatment of advanced and complicated cases of infectious diseases (for example, meningitis), the responsibility for adequate treatment and the right drug is solely the responsibility of the attending physician, who invariably monitors the patient, knowing the results of all the required tests and laboratory tests.

In the treatment of minor diseases caused by infection, which do not require a stay in the hospital, things are a little different.

Antibiotics can be prescribed to patients on their own, without any visible criteria and without a prescribed treatment regimen, which not only will not bring benefits and recovery, but can be harmful and lead to subsequent complications.

In the best outcome, the local doctor will be called. For example, many patients ask to prescribe an antibiotic in order to recover more quickly, while not having the slightest idea whether they really need it or whether it will help in a particular situation.

For some reason, many people think that since an antibiotic is a strong drug, it will save you from any disease in the shortest possible time.

Unfortunately, many doctors make concessions and prescribe antibiotics, not wanting to waste their time explaining to the patient the complete inappropriateness of its use.

Temperature while taking antibiotics

So, after all, why the temperature does not subside when taking antibiotics. This situation can be explained by the following reasons:

• At an existing disease prescription of antibiotics is not justified. For example, the disease is of a bacterial nature, so the drug does not have the desired effect.
• Any drug prescribed for antibiotic therapy is selected taking into account the sensitivity of pathogenic microorganisms to it. It often happens that an antibiotic is prescribed, but sensitivity tests have not been done. In this option, the recommended remedy simply will not work on the instigators of the disease, therefore, it was not initially chosen correctly.
• Incorrect dosage of medication. This means that the treatment regimen is incorrectly scheduled, which does not allow to destroy the infection. Microorganisms simply slow down their development, but at the same time, the negative impact continues.
• To reduce the high temperature regime of the body, such drugs are not prescribed. Antibiotics should affect the causative agents of infection, and not on the centers of thermoregulation. In these cases, drugs from the group of antipyretics are taken.
• A number of antibiotics can provoke a high temperature, this will be a side effect of taking it.
• If on the second day after taking the medicine the patient's condition improved, but after the temperature became elevated again, it is assumed that an additional infection has joined. And on the second infection, the drug taken can not affect in any way.

Why isn't the temperature dropping?

Even when taking antibiotics, the temperature can be observed for some time in such situations:

1. When the medicine is chosen correctly, the temperature drops on the third or fourth day after taking the first pill. Therefore, if the temperature does not subside for the first two days, there is no reason to worry. The medicine needs time to work on the infection.
2. In some cases, antibiotic therapy heat indicates an allergic reaction to this remedy. greatest danger is penicillin series, and, as a rule, an allergy occurs when such a remedy is taken a second time. Elevated temperature may be the only and autonomous sign of an allergic reaction. In the vast majority of cases, it occurs on the 5th-7th day of taking the medicine, and completely disappears if the course of treatment is interrupted (it disappears in two days). In some cases, the temperature during allergies can reach up to 40 degrees, an additional symptom is tachycardia.
3. If the remedy is correct, then a mercury column at 37 may mean that there is a lot of bacteria being killed. The death of microorganisms proceeds with the release of a huge amount of toxins into the blood - the decay products of microbial cells. Therefore, a temperature of 37 when taking the medicine is quite normal, and with special additional medicines you don't need to lower it. When the body, together with the antibiotic, fully copes with the infection, and the bacteria disappear, it will normalize by itself.
4. If the temperature persists for 6-7 days, and does not decrease, then the antibiotic is not chosen correctly. You need to visit a doctor to prescribe another drug. It is best to undergo a sensitivity test so as not to burden the body with another drug later.
5. In some situations, the temperature remains at around 38 or slightly lower. This should not be frightening, the main thing is that no pathologies were found in the blood and urine tests. If everything is in order with the results of the tests, it is not advisable to cancel the treatment.

You can pre-check the temperature with a common method at home, just put your hand on your forehead, it is important to know.

Of course, this method will not give the exact number of degrees, but it is possible to determine violations.

To determine the exact indicators, you need to use mercury thermometer or electronic thermometer.

As for the reasons why, when taking antibiotics, the temperature does not drop, and in some situations it even rises, the doctor chooses the methods of diagnosis, depending on the disease, on the magnitude of the temperature regime, on the rationality of the medications taken, and so on.

Diagnosis may include the following:

• Data collection and survey.
• A general blood test is taken, as well as biochemistry.
• General urine analysis.
• Consultation with an allergist is possible, samples are taken for allergic reactions.
• Abdominal ultrasound.
• Ultrasound of the cardiovascular system, cardiography.
• Antibiotic susceptibility testing.
• In some pictures, after all the tests, x-rays may be prescribed.

Taking antibiotics and treating fever

Whether the treatment of fever is required when taking antibiotics or not, the decision is made only by the doctor. Definitely, in order to make an informed decision, it is necessary to establish the exact reasons for its occurrence:

1. If the occurrence of temperature is allergic reaction(it can additionally be expressed in redness skin, the appearance of a rash, itching), then the medicine is completely canceled, or, in some cases, it can be replaced by another. The treatment regimen additionally includes antihistamines, for example, Chloropyramine, Loratadin, Diazolin.
2. If on day 5 the temperature remained the same, and it was found that this is due to the inappropriate prescription of an antibiotic, it is canceled and a more appropriate one is prescribed in a particular situation. Antiviral or antiviral drugs may be prescribed antifungal action depending on the disease found.
3. If at additional diagnostics a parallel disease was discovered, then, after a new treatment regimen is prescribed, which takes into account all the pathologies and their causes. For example, if initially there was bronchitis, and the scheme was prescribed for its treatment, but after the temperature rose due to complications, pneumonia arose, then the doctor will in any case review the prescribed medications and replace the medication with another one that is more productive in this particular situation (It is possible to prescribe several drugs at the same time).

Need to drink a large number of warm liquid, which will help to remove toxic substances from the body and stabilize the temperature regime. It can be tea, not too sweet compotes and fruit drinks, broths, natural juices.

If the mercury column shows more than 38 degrees, the body can be helped to cope with the temperature through antipyretic drugs, for example, take Paracetamol.

Temperature forecast

As for the forecast of temperature during the period of antibiotic therapy, it can be said that if the medicine was recommended correctly and correctly, then after its use, temperature regime over time, it will return to normal and the patient will recover.

At self-treatment antibiotics, the prognosis may not be predictable at all. Therefore, it is better not to self-medicate and prescribe medications for yourself, but go to the doctor.

In addition, those situations where the temperature fluctuates in undulating jumps and falls have negative forecasts. They alternate after certain periods of time, and the temperature is always at different levels. As a rule, this indicates an aggravation of the disease and the development of complications.

In conclusion, we can say that in the vast majority of situations, the temperature when taking antibiotics is considered normal and natural. In rarer situations, prolonged fever is a sign of complications.

What happens in each case, only the doctor decides. It is he who voices the verdict, what is the norm and what is pathology. The task of each patient is to choose a qualified doctor, carefully follow all the recommendations and not self-medicate. In conclusion, we offer an interesting video in this article about antibiotics.

Antibiotics are a revolutionary discovery in medicine. With the help of them, diseases of a bacterial nature can be defeated. Before the introduction of antibiotics in medical practice The human body could only rely on own forces immune system. Many mothers are perplexed: why does the child's temperature not subside when taking antibiotics? Consider the reasons why the high temperature does not decrease? How long can it last and after how many days will it pass?

The effect of antibiotics on the body

Antibacterial drugs are widely used in a variety of forms - capsules, ointments, injections. But recently, more and more people began to talk about the ongoing fever against the backdrop of medical therapy. There was an opinion that the fever does not fall due to the intake of antibacterial drugs as a side effect. However, this is just a version of the possible effects of drugs.

The causes of fever can be as follows:

• incorrectly selected drug;
• microbial resistance to the drug;
• development of a new infection;
• medicinal fever.

Consider what it is. In the case of an incorrect diagnosis, the patient takes a medicine that does not help him. Accordingly, healing does not occur, and the temperature is kept at a high level. Moreover, the fever can rise even more.

If the infectious agents are resistant to the drug, that is, they have adapted to its formula, then healing also does not occur, and the temperature does not drop.

Note! Antibiotics do not treat a viral or fungal infection. These are different triggers.

If the fever rises, it always speaks of a struggle immune protection with malicious agents. If the temperature rises while taking antibiotics, then the medicine is not working.

Antibacterial drugs are designed to destroy microbes, they do not affect thermoregulation. However, the heat and fever pass due to the reduction of the harmful action of pathogens. That is, there is a direct relationship between taking drugs and lowering the mark on the thermometer.

There is also such a clinical picture: the fever began to decline, and on the third or fourth day the temperature rose again. Could this be? Maybe if the child caught an infection of a different nature - not bacterial. It may also indicate the activity of microbes of another group, on which this drug has no effect.

Important! Treatment of a child should always be under the supervision of a doctor. It is impossible to give antibacterial drugs on your own - they hit the immune system.

Sometimes mothers try to treat children without medical supervision, and then they wonder why the temperature keeps on and does not subside. Temperature in children can be caused different reasons, and immediately giving “tested in practice” antibiotics to drink is unacceptable. It is especially dangerous to confuse a viral and bacterial infection and treat a child with useless drugs.

Fever during treatment

If the treatment regimen was chosen correctly, the temperature after taking antibacterial drugs should decrease by day 4. If after 5 or 7 days the fever does not subside stubbornly, it means that the child's body cannot cope with the disease. Only a doctor can understand the reasons for the temperature discrepancy.

The temperature when taking antibiotics in a child may also rise due to a simple allergy to the components of the medication. This can happen on the fourth - seventh day after the start of treatment. The increase will disappear immediately after the drug is discontinued. Usually happens subfebrile temperature 38 degrees, holding for several days.

Fever after taking antibiotics may be the result of the body's reaction to the mass death of microbes. When toxic substances leave the body, the fever will subside. Let the patient drink more liquids so that toxins can quickly get out of the body tissues. A temperature of 37 or 38 is not a cause for alarm.

How to help a child

What can I do to keep the temperature down? Many children do not tolerate fever well, and mothers seek to alleviate their condition. However, only a pediatrician should decide on the appointment of antipyretics.

If the body reacts with fever to the components of the drug (allergy), antibiotics are canceled or another group of drugs is prescribed.

If the drug does not work, develop another treatment regimen. In this case, the pediatrician prescribes other medicines.

If the treatment regimen is chosen correctly, and the medicine was drunk at the indicated time, but there is a fever, doctors recommend giving more liquid. The body must be cleansed of the destroyed microbes. The microbial mass acts on the tissues of the body like a poison, so there is a strong intoxication of the body.

Parents should understand that it is not always necessary to trust the readings of a thermometer. True indicator the state of the child is his well-being. If the thermometer shows 38.5, and the child feels acceptable, there is no need to worry. There is a healing process - we take drugs, drink more fluids. Does the temperature drop? Talk to your doctor, but don't take action yourself.

Outcome

Why does the child have a fever during antibacterial treatment? Moms sound the alarm: I give the medicine according to the scheme, but the baby does not get better. Only a pediatrician can give the correct answer. Sometimes it can be a reaction to the components of the drug, sometimes it can be an incorrectly chosen treatment regimen, and sometimes it can be a complication.

01.02.2007, 14:43

Tell me what can be said next situation: A 3.5-year-old girl, tracheitis was diagnosed, Sumamed 125 mg (5 days 1) and Lazolvan were prescribed. On the 4th day of taking the antibiotic jump temperatures up to 39. Before that, the temperature was 37.2-37.7. the temperature drops for a maximum of 3 hours, then a new rise. Today is the 5th day of taking Sumamed - the picture is still the same - the temperature is 39. What should I do?

01.02.2007, 16:36

Dear guest, the provided information is not enough for consultation.
So, tracheitis does not require the appointment of Sumamed, at the same time, tracheitis is not typical high jumps temperature. Those. the diagnosis is inconsistent with the treatment. Complaints and research results you do not describe. So the range possible situations from pneumonia (unlikely) - we continue treatment with AB until SARS (more likely) - AB are not indicated, mucolytics are unnecessary, treatment is drinking, affection and patience.

Describe complaints and medical history.

01.02.2007, 16:37

A 3.5-year-old girl was diagnosed with tracheitis, Sumamed 125 mg (5 days 1) and Lazolvan were prescribed.
O.tracheitis - viral disease. It is not treated either by sumamed or lazolvan.
The general rule for any antibiotic, regardless of the indication for prescribing: if within 48 hours after taking the antibiotic, there is no clinical effect from it, this antibiotic is canceled.

01.02.2007, 17:09

What you said is just awful! The card says tracheitis in black and white, and the doctor told me the same thing. Today she came and canceled Sumamed and prescribed Flemoxin. We drank the first pill, but it turned out that it was not necessary. clinical analyzes did not do - tomorrow a urine test is scheduled. Objectively, only a high temperature and hard breathing that the doctor heard, as well as de dullness in the lungs (again, from her words). The child coughs with a non-productive cough. Well, of course, the symptoms of intoxication: lethargy, tearfulness, and so on. If tomorrow will be the same temperature - what to do?

01.02.2007, 17:15

And one more thing from the history of the disease - it all started with powerful discharge from the nose, which literally turned green in one day (by evening). Immediately the temperature rose to 37.3 and lasted 5 days, by the fifth day a cough (dry) began. They called the doctor, she prescribed the treatment indicated above, and on the 4th day of taking Sumamed, the temperature was 39. Then you know. Moreover, the temperature practically does not go astray, for a maximum of 3 hours and all over again 38.7-39.

01.02.2007, 18:32

That is, tomorrow, when the doctor comes, say to her: Please give us an X-ray? Of course, I will do so, I hope they will meet me, although tomorrow is Friday.

01.02.2007, 18:41

In principle, finding "dullness in the lungs" the doctor himself should suspect pneumonia and prescribe a chest x-ray.
Tell him that you are afraid of pneumonia.

01.02.2007, 19:02

Is it possible to independently go with the child to the nearest hospital and take an x-ray today? Indeed, tomorrow is Friday, then the x-ray (polyclinic) will be in best case on Monday, adjustment of appointments - on Tuesday.

01.02.2007, 20:33

No, today there is no way to do an x-ray. since, firstly, we live in the suburbs, and secondly, the temperature is 39 and I can’t imagine how I will marinate it for at least 4 hours outside the house, even if I take a taxi back and forth. It will still take 2 hours in the hospital. Yes, I still can’t imagine the situation when they will do an x-ray without a referral, since the local pediatrician will obviously not go to our house today (we live in the village of Novoselye. I will be on her (the doctor) tomorrow morning on the phone for an x-ray appointment. Now I really I'm afraid of pneumonia.

02.02.2007, 10:35

Today we have both positive and negative news: On the positive side, the temperature dropped last night (2200) to 37.5 and we have not been taking antipyretics for 12 hours now. Of the negative ones, the doctor refused us an x-ray, motivating this with the words: "Dullness in the lungs in your case does not suggest pneumonia and the temperature, as you can see, decreased when the antibiotic was changed. I do not see any objective signs of pneumonia in you." Another of the incomprehensible - the child began moist cough, which I also reported to the doctor and she prescribed Erispal instead of Lazolvan. The doctor said that we would wait until Monday (although he made a reservation that if the temperature rises again tomorrow, call the doctor on duty). I don't get it, is she taking responsibility? Will have to wait for at least tomorrow and hope that it was a banal ARVI, although tracheitis was diagnosed. If you have at least some recommendations on how I should act in a similar situation - I look forward to it!

02.02.2007, 10:43

Hello!
Considering that you have pneumonia, then continue taking Flemoxin. This antibiotic is quite adequate for the treatment of pneumonia.
In addition to Flemoxin, you do not need to give anything else, plentiful drink and that's all. No erispals and lazolvans.
Erispal is a drug with unproven efficacy. Lazolvan is a mucolytic. There is no need to prescribe mucolytics to children.

02.02.2007, 16:29

There is no need to prescribe mucolytics for children.
May I ask what your opinion is based on?

02.02.2007, 17:00

Can.
For example, read first here[Only registered and activated users can see links] although this is for parents.
Introduction to Children's Cold Medicines
Expectorants contain guaifenesin and are supposed to help loosen mucus. They have never been proven to be helpful in children and are probably unnecessary. Also avoid using a multi-symptom medicine, unless your child has all of the symptoms that it relieves.[Only registered and activated users can see links]
use:
Although a large number of expectorants are sold each year, there is little proof that they provide any clinical improvement of asthmatic symptoms. In general, The Asthma Center specialists find this treatment ineffective for the typical cough of asthma.
Cough suppressants ineffective for children
Journal of Family Practice, Oct, 2004 by I.M. Paul, K.E. Yoder, K.R. Crowell
Absolutely wonderful article (it should be translated and posted in the FAQ) [Only registered and activated users can see links]
Actually, you can also search the net. :)

Children up to about 4-5 years old do not know how to cough up sputum. Therefore, when prescribing expectorants little child You are only making his condition worse.

02.02.2007, 17:20

Children up to about 4-5 years old do not know how to cough up sputum. Therefore, by prescribing expectorants to a small child, you only worsen his condition.
Personally, I will add the following: do not prescribe any medicines to children if you can do without them.
I completely agree, but it seems to me that there is still a difference between mucolytics and expectorants, or am I mistaken? :eek:

02.02.2007, 17:48

May I ask what your opinion is based on?
Here is a guide to pneumonia in children

It is necessary to use only those drugs whose effectiveness has been proven. That is antibiotics. The effectiveness of mucolytics, expectorants (as well as physiotherapy) in community-acquired pneumonia has not been proven.

02.02.2007, 17:51

Personally, I will add the following: do not prescribe any medicines to children if you can do without them.
The endorser is broken. Gold words!

02.02.2007, 18:50

The presence of other medical problems may affect the use of acetylcysteine. Make sure you tell your doctor if you have any other medical problems, especially:
Asthma-Acetylcysteine ​​may make the condition worse
Decreased ability to cough-The mucus may have to be removed by suctioning [Only registered and activated users can see links]

CONCLUSION: Acetylcysteine ​​is being prescribed frequently for children with various pulmonary disorders by general practitioners whilst the use of this drug is not being supported by literature data.[Only registered and activated users can see links]

However, here
6.2 Mucolytic drugs
These include drugs containing a free thiol group, such as N-acetylcysteine, which
work by breaking sulfhydryl bonds and directly thinning the sputum. Mucolytic
agents are often administered by mouth or by inhalation to persons with chronic
respiratory conditions characterized by excess mucus production, such as cystic
fibrosis and chronic bronchitis (56). Although mucolytics alter sputum viscosity
and may lead to subjective improvement in these patients, their use has not
resulted in any consistent improvement in pulmonary function (30,56).
There are no published RCTs on mucolytic drugs meeting the stated quality criteria
in either adults or children.
Side effects of mucolytic drugs. Adverse effects reported following oral administration
of acetylcysteine ​​include bronchospasm, gastrointestinal disturbances and
fever. Some antibiotics, including ampicillin, erythromycin, and some tetracyclines
are physically incompatible with or may be inactivated by acetylcysteine ​​(56).
Conclusion. While adjunctive therapy with a mucolytic may bring subjective improvement
in persons with chronic respiratory diseases, there are no data to support
their use in children with acute respiratory infections such as the common cold.
[Only registered and activated users can see links]

02.02.2007, 19:29

Let's not touch cystic fibrosis and asthma.
Take ambroxol and lower respiratory tract infections.

03.02.2007, 11:37

I believe that over 20 years our knowledge has deepened a little ... I gave a link for 2001. Your link is from 1986.
Well, well, after what I, offhand, read here [Only registered and activated users can see links] somehow I don’t feel like prescribing Ambroxol to children unless absolutely necessary :).

03.02.2007, 16:39

I think that if the study is done exactly in accordance with the principles of DM. while its holding is secondary. :)
Until you convince me :rolleyes:
In general, an interesting topic, I had to do datamining.
[Only registered and activated users can see links]
RESULTS OF STUDIES IN CHILDREN: 1. Antitussives: Antitussives were no more effective than placebo (one study) 2. Expectorants: No studies using expectorants met our inclusion criteria. 3. Mucolytics: The results of one trial favored active treatment over placebo from day four until day 10.

I would like to hear more substantiated arguments about the ineffectiveness of mucolytics (bromhexine, ambroxol) in bronchitis and pneumonia.

03.02.2007, 17:38

03.02.2007, 18:07

1) The review you quoted from refers to only one study that confirms the effectiveness of mucolytics against cough in diseases of the upper respiratory tract, and the conclusion is that there is not enough evidence for effectiveness.

The conclusion applies to all OTC drugs. and the point is that there is not enough data to conclude. A subgroup of mucolytics improves the course of the disease.

2) This is not about pneumonia, pneumonia is not a disease of the upper respiratory tract.
About pneumonia, I gave a link. Let's eat fresh.
In addition, there are works showing the effectiveness of ambroxol in RDS.
3) No need to prove inefficiency. We need to prove the effectiveness.
Works that show the inefficiency of generally accepted schemes are also very important.

In general, we must wait for the verdict of Yana Sergeevna. :)

03.02.2007, 18:16

In addition, there are works showing the effectiveness of ambroxol in RDS. IMHO, an exogenous surfactant will still be more effective;)

03.02.2007, 18:20

I am not the greatest specialist in the field of link search, moreover, I am not at all the greatest specialist in the field of scientific searches and evaluations of certain scientific works:) . I am an ordinary district pediatrician :). In my daily work, I mainly use AAP guides extrapolated to Israel (in some cases, the viral and microbial flora that causes various respiratory diseases is distributed in Israel in a slightly different proportion than in America), but not in any of the modern guides on the treatment of pneumonia in children, I have not come across recommendations for the use of antitussive and expectorant (including mucolytics) drugs, moreover, it says "Not recommended" everywhere.
For example here [Only registered and activated users can see links]
or here [Only registered and activated users can see links]

03.02.2007, 18:28

A subgroup of mucolytics improves the course of the disease.
Just one study is not enough to draw such a conclusion and to recommend the drug for use in pneumonia. In addition, the review was, as far as I understood, about coughing, i.e. not a very important checkpoint in the case of pneumonia.
As for the work on pneumonia in 1986, unfortunately, it is not possible to judge from the abstract how it corresponds to EBM.

03.02.2007, 18:33

Dear Artem, well, be simpler - start by reading the Medical Literature Reader's Guide - otherwise your whole life will be spent on a persistent search for outdated links in the absence of the ability to evaluate these very links (as well as evaluate the WEIGHT of one or another symptom)

03.02.2007, 18:56

Antipyretics generally do not improve the outcome of pneumonia either. But for some reason it's in the guides. ;)
Dear Artem, well, be simpler - start by reading the Medical Literature Reader's Guide - otherwise your whole life will be spent on a persistent search for outdated references with no ability to evaluate these very links (as well as evaluate the WEIGHT of one or another symptom)
Thank you, dear Galina Afanasievna for good wishes. :o
I think 2 days is enough :)
IMHO, exogenous surfactant will still be more effective;)
In general, I already have experience of such a dispute (then still on your side :)), if interested, I can look for a link.
It would be nice, but somehow only one reasoned objection is the old link.

04.02.2007, 10:02

[Only registered and activated users can see links]
A new guide to chronic cough in children.
(About mucolytics is not bad and not good)
[Only registered and activated users can see links] - this is about the study where the mucolytic was superior to placebo. For some reason, letosteine, unknown to anyone, was investigated.
It’s even strange, I can’t find anything about Ambroxol. Although mucosolvan sells well in the USA. :confused:
Suspicious: rolleyes: This is directly from your link about treating coughs in children:
In children with cough, cough suppressants and other OTC cough medicines SHOULD NOT be used as patients, especially young children, may experience significant morbidity and mortality. (In children who are coughing, cough suppressants, as well as other OTCs, MUST NOT be used, especially in young children.)
OTC stands for Over-the-counter drugs. over-the-counter medicines. Expectorants and mucolytics fall into this category.

04.02.2007, 12:00

Good morning dear! Fortunately, my child’s temperature has been normal for a day now, apparently with the appointment of Flemoxin, the doctor hit the mark. True, the child's macros began to depart very strongly, or it gives me such an impression, since the cough has intensified, it has become wet and she constantly swallows. Let me remind you that my daughter is 3.5 years old. Because of this cough, he practically did not sleep all night - he coughs and swallows all the time. We still accept Erispal, despite your heated argument. The question is this - Do X-rays on Monday, or given the fact that the temperature has dropped, do not do it? And I also read it in the FAQ and realized that it is pointless to keep the child at home nursing for 2 weeks after the illness, therefore, the daughter can be taken to the kindergarten on January 12, that is, give her a week at home after the antibiotic is canceled and the temperature drops.

What expectorants and cough suppressants bring more harm what's the use, I knew this for a long time. :)
I was interested in research on ambroxol. Still the best-selling cough medicine.
I did not find convincing evidence in favor of the appointment. For the sake of objectivity, and I also did not find evidence of inefficiency.
But, since the fewer appointments, the faster baby recovers, with mucolytics we tie.
Though not often, but used.
You convinced me.
PS. If you believe Galina Afanasievna, I'll go to put things in order.

Katerina ;-) Zubareva, Woman, 28 years old

Hello. A child of 2.4 years old went to kindergarten 3 weeks ago. After 2 days, snot began to be treated for almost 2 weeks (washing, Nazivin, ascorbic acid) without result. Everything just got worse yellow snot, unblowed went to Laura, she diagnosed rhinoadonoiditis. She prescribed a local antibiotic to breathe through a nebulizer, vibrocil, lavage and a field-valent pyobacteriophage (in the summer they gave a mason from the pharynx and nose, but for these indications, she said that it suits us best) after 2 days the child’s temperature rose, by the evening 40. half an hour again 40. The ambulance injected analgin with diphenhydramine, but the injection did not help, I had to give nurofen again. The temperature was maintained for 1.5 days. The next day they called a doctor, she looked, said that there were no noises and a very red throat, she ruled out a sore throat. She said there is a small sore. She prescribed suprax, viferon, miramistin inhalations and nasal lavage. Feel better. The throat is already better, red only around the sore, it also turned pink-red. We drank the whole course in 2 days, i.e. today the temperature is again, 37.2 All day. I'm panicking, can there be a temperature after a full course of antibiotics? What are our actions, weekends, there are no doctors. How to further treat the child? Thanks in advance

Katerina ;-) Zubareva

Hello again, the ENT appointed us cefataxime for 5 days, they pierced us, the problem did not go away, subfibrality. The temperature is the same .... Not in a dream, jumps during the day, at 21.00 The largest and on the decline. 37.5 The largest. Passed analyzes soe 2 hemoglobin 114 erythrocytes 4.55 average content 25.2 platelets 497 leukocytes 9 stab 2 segmented 35 eosinophils 2 lymphocytes 53 monocytes 8 in the urine there is neither glucose nor protein. I don’t know 3 what to do anymore, my nose is stuffed up from time to time, somewhere inside, there is no snot ... But if it cries, then the white temperature hasn’t dropped in total for 18 days. drawing on the right, but the sinuses are clean. What analyzes still to hand over? Lor discharged us, said in her part the problem is solved, the padiatrician shrugged his shoulders, says, maybe thermoneurosis or residual after an orvi, I have read everything already, and about tuberculosis and about adenovirus, can we have these dianoses with such x-rays and blood?

Good afternoon! The temperature often persists after general intoxication after an illness, when the infection is gone, the waste products of the viruses are still circulating. The child is prescribed a plentiful drink, viferon, erespal and just wait. Sincerely, Ekaterina Anatolievna

Katerina ;-) Zubareva

Hello, Ekaterina Anatolyevna. I have a couple more questions for you about our problem. The temperature never drops, it jumps. The ENT doctor discharged us. But the next day, the pediatrician looked at the throat and said that it was not red, but there was loose and mucus. And at night the child has a stuffy nose, but not with snot, but more somewhere inside, he does not sleep well, therefore (there is no such thing during the day). Passed the blood test again soy also 2 monocytes 11.2 were 8 leukocytes 7.6 were 9 lymphocytes also 53 platelets 412 were 497 the rest also passed PCR tuberculosis, tsvm, web, streptococcus, all neg. But the pediatrician looked and said that it was better to donate not blood, but urine and saliva. A couple of questions from here. 1. Can our throat cause temperature. 2. I am very worried about tuberculosis, with our tests and negative blood PCR, is it possible to dismiss this diagnosis or donate more saliva. 3. If this is a tail, then how much can the temperature jump? (With us, it is 36.4 in the morning, then it reaches 37-37.1, then it falls, not in a dream, then either by 6 pm or by 9 again the temperature is at a maximum, it can reach 37.1-37.5, in bed she is already subsiding and in a dream she becomes 36)

Good afternoon! It's not tuberculosis, I'm more inclined to think that it's CMV (or Epstein Barr virus), which is a very typical picture for them. and to be sure of this, it would be better to donate saliva. But in any case, the treatment will consist of taking immunomodulators (Viferon), as well as Erespal and warm drinks.

Katerina ;-) Zubareva

Thank you for the quick response, passed the saliva tests! Today we received an analysis for sbr, the result is 11. One shows inflammation, and the other is normal, soe 2, and sb 11? Or is one of the analyzes wrong?

Consultation of a pediatrician on the topic "Temperature after antibiotics" is given for reference purposes only. Based on the results of the consultation, please consult a doctor, including to identify possible contraindications.

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