- Features of the disease
- Development bacterial rhinitis
- Causes of pathology
- Treatment principle
- Physical treatments
- Drug therapy
- Folk remedies
Treatment of a bacterial rhinitis in children should be carried out after establishing the type of pathogen, i.e. after examination by a doctor.
Box 1: Treatment of eye symptoms
Treatment of ocular symptoms of allergic rhinitis is given in the block. Oral antihistamines are the first line treatment used by most patients, doctors and pharmacists for all allergic rhinitis. When choosing the most appropriate antihistamine for the treatment of allergic rhinitis, healthcare professionals should be aware of the significant deleterious effects of first generation antihistamines on cognitive processes in all patient populations. In the brain, it has an aphrodisiac effect and helps to focus and study.
This type of pathology is dangerous in that it can be a symptom of a serious disease, which means that its manifestation should be taken very seriously. After consulting a doctor, treatment can be carried out in various ways at home. It is important to folk remedies were used in optimal combination with antibacterial therapy.
One study shows that 25% of people over 65 have some cognitive impairment, often without clear signs of dysfunction. There are many others that are available as prescription drugs. However, they must be taken on an empty stomach for adequate absorption.
Intranasal antihistamines are more effective in reducing nasal symptoms than oral antihistamines, but do not treat extra-nasal symptoms. Although antihistamines have been shown to be effective in controlling symptoms such as sneezing, itching, and rhinorrhea or eye flow, they are significantly less effective than intranasal corticosteroids, which have a much stronger anti-inflammatory effect and are more effective in treating nasal obstruction. Corticosteroids should be used as the therapeutic agent of choice for anything more than mild illness.
Features of the disease
In general, a bacterial rhinitis is a purulent rhinitis with pathogenic bacteria in the nasopharynx. A runny nose is a nasal mucous secretion that is secreted by numerous glands located in the nasal cavity. This secret is precisely intended to protect against the penetration of microorganisms further into the body. Normally, as much mucus is produced as is necessary to provide protection, and it is not expelled.
Treatment of an infectious rhinitis
Intranasal steroids are the most effective remedy to reduce nasal inflammation and improve conjunctival symptoms. Therefore, it is important to explain to the patient that the dose of nasal steroids is in micrograms, and for most common molecules there is minimal systemic bioavailability. There is a difference between the molecules, with fluticasone propionate, furoate and mometasone furoate being the least bioavailable from the nose. It is best to use the spray in the morning, placing it next to your toothbrush to help memory.
When a bacterial environment occurs in the nasal cavity, a natural immune reaction occurs, and mucus secretion is enhanced. This excess volume, mixing with the killed microorganisms, accumulates inside, partially blocks the channel for air passage and spontaneously flows out, forming yellowish-green snot. In addition, as a result of exposure to bacteria in the cavity, an inflammatory reaction develops on the mucous membrane, which causes other symptoms.
A second dose can be used in the evening if needed, or if one is forgotten in the morning. The application method for nasal sprays and drops is shown in the figure. Spraying the nasal septum and sniffing the spray directly into the throat should be avoided. Figure 3: Method of administration for nasal sprays and nasal drops.
Start treatment early and take it daily
The correct procedure for applying nasal sprays. Correct procedure for installing nasal drops. It is important to inform patients that nasal steroids do not work immediately. Nasal steroids have been shown to take at least a few days to become fully effective, and the maximum effect may not appear until two weeks.
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Development of a bacterial rhinitis
The process of the origin and development of a bacterial rhinitis in children is divided into 3 main stages:
- The first stage (reflex): lasts from 2 to 45 hours, characterized by the penetration of bacteria into the nasal cavity and the occurrence of a reflexive reaction of the body. In the nose there is a burning sensation, perspiration, a feeling of dryness, itching, sneezing. Sometimes the child's temperature rises to 37.4 degrees and a headache.
- The second stage (catarrhal): duration 3-4 days, the appearance of a cold. The main symptom is the appearance of nasal discharge in the form of liquid, abundant mucus, which gradually thickens. Dryness in the nose is replaced by puffiness and congestion. There are problems with breathing through the nose, the sense of smell worsens, and general weakness is felt. Due to the fact that nasal cavity communicates with the ocular conjunctiva, lacrimation appears.
- The third stage (final): marked on the 5-6th day. An inflammatory process develops on the mucous membrane, which leads to the appearance of a purulent component in the nasal discharge - the snot acquires a yellowish-green tint. The consistency becomes thick, an unpleasant putrid smell appears. Such a change in the common cold is caused by the connection of phagocytes and neutrophils to the fight against bacteria and the active release of dead microorganisms. At this stage, it is necessary to use effective antibiotics in the treatment.
The development of a bacterial rhinitis without proper treatment leads to serious complications. First, the chronicity of pathology is a direct path to sinusitis. In children, purulent rhinitis can develop into pharyngitis, tracheitis, adenoiditis, sinusitis, or otitis media.
For patients with intermittent symptoms, it has been demonstrated that if malignant nasal corticosteroid therapy is started a week or two before symptoms appear, symptoms will delay onset and reduce severity. Thus, it may be helpful to ask patients with a known seasonal allergic rhinitisto mark when their symptoms started in the current year, so they can start treatment earlier next year.
Likewise, both antihistamines and nasal corticosteroids, especially the latter, are more effective when used daily, rather than when stopped and started. The symptoms of both persistent and intermittent allergic rhinitis are accentuated by persistent inflammation, which is usually present at subclinical levels even in the absence of symptoms. Daily treatment helps prevent this low-grade ongoing subclinical allergic inflammation in the nasal lining by increasing to the threshold at which symptoms occur, and thus reducing the rate and severity of flare-ups.
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Causes of pathology
Bacterial rhinitis in a child develops when exposed to various pathogenic bacteria (especially streptococci, staphylococci, Pseudomonas aeruginosa, pneumococci).
These microorganisms can be introduced from the outside from an infected person, but their own microorganisms, which have been in a latent state for a long time, can also be activated. The active vital activity of bacteria is possible only with a decrease in the protective functions of the immune system. This requires provoking factors, among which the following can be distinguished: hypothermia, air pollution, changes in the climatic zone of residence, past illness (SARS, influenza, measles, etc.), immunodeficiency, lack of vitamins. Another poorly treated rhinitis often becomes a chronic form of bacterial rhinitis when secondary bacteria take advantage of the favorable conditions.
Thus, pharmacists must explain to patients that the drug makes them symptom-free rather than treating their disease, so stopping treatment early will lead to symptoms. If they are not getting relief from the prescribed medication, they should seek further advice as other treatment options may be available.
Allergic rhinitis treatment
If their overall symptom score is more than half the path along the line, treatment should be supplemented or modified. Switching from one brand of antihistamine or intranasal corticosteroid to another is not the answer. A simple algorithm for the treatment of allergic rhinitis is shown in the figure.
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Treatment principle
Bacterial rhinitis treatment is a complex and lengthy process. The treatment regimen is based primarily on the elimination of pathogenic bacteria. In general, it includes, in addition to antibacterial therapy, cleaning the nasal cavity, restoring mucosal tissues and normalizing the secretory function of the glands, preventive measures to exclude relapses, and increase immunity. In treatment, agents for external use are widely used in the form of solutions, ointments, drops, aerosols (sprays). Folk remedies show themselves quite effectively.
Figure 4: Simple algorithm for the treatment of allergic rhinitis. Treatment progresses from left to right as severity increases. For patients with intermittent allergic rhinitis caused by seasonal allergens, as the season and the level of pollen in the atmosphere decrease, treatment may be gradually reduced if symptoms are completely controlled and cease after the season ends.
Why does the snot change color and turn green?
Patients with persistent allergic rhinitis, such as allergic reactions to perennial allergens, or those with mixed seasonal and perennial allergies, require longer therapy. Once complete control of the symptoms is achieved, you can try to gradually “retire”. Treatment should be continued for at least three to six months after symptoms have been completely controlled. If symptoms recur, treatment should be resumed, usually for longer periods.
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Physical treatments
Physical methods of treatment are based on rinsing the nasal cavity and warming it up in order to normalize blood microcirculation and thin mucus. Warming up in the form of a heat compress in the area of \u200b\u200bthe bridge of the nose gives positive results in two stages of rhinitis. The simplest methods (traditional folk) - a bag of heated salt, a hot boiled egg or hot potatoes "in their uniforms." Upon reaching the third stage, it is more correct to warm up by inhalation, i.e. more efficient use of moist heat with an effect on the inside of the nasal cavity.
There are some concerns about possible lining atrophy with prolonged use of intranasal steroids. However, in practice, with correct use this does not happen, probably due to the rapid movement due to the mucous membrane. Spraying the nasal septum multiple times can lead to soreness, nosebleeds, and possibly even perforation, so proper technique is important.
Studies involving multiple stringent allergen control measures have shown that significant reductions in allergen exposure and hence symptoms can be achieved. However, in real life situations, it is difficult to avoid air allergens to the point where they can affect patients' symptoms. Being allergic to pollen, closing windows at night, driving with closed windows, or wearing streamlined glasses outdoors can prevent worsening of symptoms. Avoiding outside during thunderstorms can also help reduce symptoms because the sudden change from dry to humid climates breaks the pollen grains and releases them into smaller particles that are allergenic, which can be easily inhaled into the lower ones. airways and cause attacks of allergic rhinitis and asthma.
Rinsing the nasal cavity is performed to remove pathogenic bacteria and accumulated thick mucus. For this purpose, you can apply any saline solutions... Saline is often used to treat babies.
Good results were recorded when using herbal infusions (in particular, sage and chamomile).
Allergen-specific immunotherapy is a treatment in which the patient's immune system becomes tolerant of the allergen by controlling increasing doses of the allergen. When used correctly, this is the only treatment that can change the course of the disease. There is also evidence that it may reduce the development of further sensitization and progression of allergic rhinitis to asthma, although positive results are required in current trials to determine whether children with allergic rhinitis who may progress from asthma will benefit.
Rinsing of the noses in infants is carried out with the help of a small rubber bulb: the solution is injected after placing the baby on his back, and then it is turned over so that the liquid flows out of the nasal cavity. To clean the noses of babies, sea water can be recommended (it contains natural salts and useful trace elements). The number of procedures is not limited, and they can be carried out at intervals of 1.5-3 hours.
Several seasonal patients with allergic rhinitis require immunotherapy; this should be considered only when allergic rhinitis is debilitating and poorly controlled by pharmacotherapy. Particular attention should be paid to poorly affected young people who face summer exams or adults whose functioning is impaired. Immunotherapy is currently available for allergic rhinitis caused by pollen, mold, house dust mites and animal allergens.
There are two main ways of administering immunotherapy; subcutaneously and sublingually. Subcutaneous immunotherapy involves injections of allergens at regular intervals in a hospital by trained medical personnel. Since the treatment lasts several years, it is necessary to be patient with hospital visits. Sublingual immunotherapy is considered to be much safer. The initial dose is supervised but can be continued daily at home. However, patients should be warned against poor adherence, which is a concern in this form of immunotherapy.
It is better to carry out the cleaning procedure from the thick mass with ready-made pharmaceutical compositions. In addition to thinning mucus, they have high antibacterial and anti-inflammatory properties. The following drugs can be recommended: Quicks, Aqualor Baby, Miramistin, Physiomer, Humer, Furacilin, Malavit, solution sea \u200b\u200bsalt with a decoction of chamomile.
Management in specific patient groups
Children with allergic rhinitis. Children metabolize drugs less well than adults because liver enzymes mature slowly and reach maximum levels around the age of ten. However, renal clearance is well developed. Therefore, it is preferable that young children are given an antihistamine that is not metabolized but excreted unchanged in the urine.
A nasal steroid with low systemic bioavailability should be used at the lowest possible dose to control symptoms, especially nasal congestion and obstruction. Compliance and effectiveness are improved if the child is trained to use the nasal spray. In older children, where liver metabolic enzymes are on the rise, it may be preferable to use fluticasone, which is cleared by first metabolism, rather than beclomethasone, which is not and therefore can accumulate. In addition, fluticasone is available for children ages 4 and older, while beclomethasone is available only for children ages 6 and older.
The inflammatory process of the mucous membrane of the nasal cavity is a whole group of diseases, all of which are characterized by such a symptom as nasal congestion or runny nose. Bacterial rhinitis is a disease of the nasopharynx of bacterial origin.
How does the disease manifest itself?
The mucous membrane of the nasopharynx, being affected by infectious stimuli, actively reacts to them, as a result of which symptoms such as:
Allergic rhinitis during pregnancy. Most drugs cross the placenta and should only be given when the apparent benefit is greater than the risk to the fetus. Regular nasal douching can be beneficial. Of the antihistamines, both loratadine and cetirizine are recommended because they appear to have good safety records as they are widely used in pregnant women. Likewise, beclomethasone and fluticasone appear to be safe. However, decongestants should be avoided.
Topical application of chromones, which have not shown teratogenic effects in animals, is probably the safest drug choice for use in the first three months of pregnancy because systemic absorption is negligible, although they require multiple daily administrations.
- swelling and inflammation of the nasal passages;
- difficulty in nasal breathing;
- profuse thick discharge from the nose;
- headaches.
The specialist notes that the rich green color of the mucus indicates a combination of viruses and bacteria that caused the nose disease. In the course of bacterial rhinitis, two forms are distinguished - acute and chronic. The treatment of bacterial rhinitis is not always reduced to the use of antibiotic therapy; it is often possible to eliminate the inflammatory process in the turbinates with other, more gentle drugs.
Disease stages
For bacterial rhinitis, its own stages of change are characteristic, which are manifested by different symptoms. In otolaryngologists, the stages are conventionally divided into three degrees:
Methods of dealing with bacterial rhinitis
Treatment of antibacterial rhinitis is quite complex and lengthy, since it usually consists of local and antibiotic therapy. Particular attention must be paid to the treatment of a bacterial rhinitis in a child during the first months of life, because the disease is a threat to the life of an infant.
In the process of diagnosing the disease, the otolaryngologist, taking into account the degree and nature of the course of the bacterial rhinitis, prescribes drugs - nasal sprays, nasal drops, antibiotics, saline solutions for washing the nasopharynx. Moisturizing, vasoconstrictor, cleansing sprays can be used, which can only be used as directed by a doctor. The purpose of the treatment 
runny nose of bacterial genesis should be suppression of infection. Therapy should consist of the following actions:
- Salt showers;
- Irrigation of the nasal cavity with saline;
- Antibiotic therapy;
- Vitamin therapy to strengthen the body's defenses.
To clear mucus from the nose, experts recommend using the following sprays:
It is not necessary to buy preparations for rinsing the nose based on sea water, it is quite easy to prepare it yourself: take a teaspoon of salt per liter of water, and completely dissolve it. It is important to know that you can use boiled water to prepare the product.
Alternative treatment
It is known that long-term use of medicines is addictive to the body, and they also have a harmful effect on it. For this reason, many parents in the treatment of bacterial rhinitis use medications only with the aim of eliminating inflammatory process, after which further therapy is carried out with safe folk remedies.