The use of amoxicillin in the treatment of upper respiratory tract diseases

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The review of the literature, devoted to the prevalence of etiopathogenetic mechanisms, clinical picture, methods of diagnostics and treatment of inflammatory diseases of ENT organs is presented – Acute rhinosinusitis and acute purulent otitis media. There is convincing evidence of the necessity of antibacterial therapy for these pathologies. It is emphasized that the drug of first choice for inflammatory diseases of ENT organs is a semi-synthetic antibiotic of aminopenicillin group – Amoxicillin, which holds its positions due to good tolerability, favorable safety profile, convenient regimen, the possibility of step therapy and low cost.

Acute respiratory viral infections (ARI) account for up to 90% of cases of infectious diseases. Temporary disability due to acute respiratory infections reaches 30% of total temporary disability. ARI can have a severe course and provoke life-threatening conditions, such as ENT-organ damage, pneumonia, myocarditis, especially in weakened patients and elderly patients.

According to modern epidemiological studies, rhinosinusitis occupies the leading position in the overall disease incidence in the USA and Western Europe. Rhinosinusitis has been shown to affect between 17 and 36% of patients who are hospitalized in otorhinolaryngology departments. Sinusitis accounts for an even larger proportion among outpatient upper respiratory tract diseases.

Rhinosinusitis is the most common chronic condition in the United States, according to the National Center for Disease Statistics. In Germany, between 7 and 10 million cases of acute or chronic sinusitis have been diagnosed each year over the last decade. Acute respiratory infections are complicated by bacterial rhinosinusitis in 0.5–2% of cases in adults and 5–10% of cases in children.

European Position Paperon Rhino sinusitis and Nasal Polyps (EPOS) of 2012. The following forms of rhinosinusitis are distinguished:

  • acute – duration not more than 12 weeks;
  • Chronic – Duration more than 12 weeks.

Classical signs of acute bacterial rhinosinusitis: increase in body temperature to subfebrile digits, purulent or mucopurulent nasal discharge, headaches in the perinasal projection, which persist for 3–4 days, or syndrome «double-sickening» (the appearance of the above symptoms after a passed viral rhinosinusitis, which lasted 5–6 days).

The most common pathogens of acute bacterial rhinosinusitis include Streptococcus pneumoniae and Haemophilus influenzae. In pathogenesis of acute bacterial rhinosinusitis the damage of perinasal sinus epithelium caused by cytotoxic action of viruses plays a major role, which as a rule leads to malfunctioning of epithelial cell cilia due to desquamation of surface layers of nasal cavity mucosa. This leads to inhibition of mucociliary clearance, which in turn creates favorable conditions for secondary bacterial infection with the formation of purulent exudate.

Another frequent complication in the practice of a general practitioner and otorhinolaryngologist is acute suppurative otitis media. It is now one of the most common childhood illnesses: about 71% of children have acute suppurative media otitis by the age of three. 95% of children have at least one episode of acute bacterial rhinosinusitis during the first 7 years of life. According to the Health Maintenance Organization, 48% of children have a single episode of perforative or nonperforative acute bacterial rhinosinusitis in the first six months of life or ≥2 cases in the first year of life. Increased incidence of exudative otitis media, including.ч. The following is an important indicator of the recurrent course of middle ear infections in children, which has been observed for several decades. In acute bacterial rhinosinusitis, the inflammatory process is not only in the tympanic cavity.