RU2170587C1 - Method of treatment of children with acute respiratory viral infections - Google Patents

Abstract

FIELD: medicine, pediatrics. SUBSTANCE: method involves additional prescription of Viferon in combination with the basis therapy to patients with influenza and/or parainfluenza of severe or medium-severe form. For treatment of children of age 1-2, 3-6 and 7-14 years Viferon-1, Viferon-1 and Viferon-3 preparations are prescribed in doses 150 000, 500 000 and 1 000 000 IU, respectively. Preparation is administrated twice per a day for 5 days. EFFECT: decreased period of treatment, decreased complications amount, expressed protective effect. 3 cl, 3 tbl, 3 ex

Description

 The invention relates to medicine and can be used to treat acute viral respiratory infections (ARVI) in children.

 SARS, including influenza, occupy a leading place in the structure of the infectious morbidity of the population and cause great socio-economic damage. Children suffer from SARS more often than adults, and the frequency of severe and complicated forms of the disease is significantly greater. In addition, these diseases have a negative effect on the health status of children in general and their development. To increase the effectiveness of treatment for acute respiratory viral infections in children, it is advisable to use preparations of interferon (IFN), which is one of the most important factors of the antiviral defense of the body.

 According to the literature and our studies, IFN production in children is reduced, especially at the age of 1-7 years. Against the background of the current infection (influenza and other acute respiratory viral infections), there is a significant decrease in the concentration of IFN in the blood and the ability of cells to form IFN [1-6].

 A known method of treatment of acute respiratory viral infections in children, including basic therapy and the introduction of IFN (reaferon) in the form of inhalation. According to this method, the drug is administered in the form of an aerosol using a special vapor-oxygen chamber, in which the temperature is constantly maintained at 28-32 degrees at 100% humidity, 40-50% oxygen content, with and without water vapor. The size of aerosol particles in the chamber varies from 0.6 to 20 microns. The dose of the drug for aerosol use is 20,000 IU / kg of body weight per inhalation with an increase by the coefficient of loss in the chamber depending on age: for children under 5 months, the value of the coefficient is 5, from 6 months to 2 years - 4 and from 3 to 5 years - 3. Treatment begins in the first 3 days of illness and is carried out over the next 4-6 days (average duration of the course is 5.5 days) with 1-2 inhalations per day [3].

However, this method has several disadvantages:
the possibility of developing adverse reactions due to irritating local action;
the need for special equipment and the inability to accurately dose the drug due to the lack of official inhalation mixtures.

 The essence of the invention lies in the fact that a method for the treatment of acute respiratory viral infections in children by administering Viferon in the form of suppositories to children aged 1-3 years at a dose of 150,000 ME (Viferon-1), at the age of 3-7 years at a dose of 500,000 ME (Viferon-2 ) and at the age of 7-14 years in a dose of 1,000,000 ME (Viferon-3) for 5 days 2 times a day.

Viferon ^® is a new antiviral and immunomodulating drug, produced in the form of suppositories and including recombinant interferon alpha-2 (IFN α-2) and membrane-stabilizing components in therapeutically effective doses. The drug is available in three versions, differing in the amount of recombinant IFN included in its composition: Viferon-1 contains 150,000 ME IFN in one candle, Viferon-2 contains 500,000 ME in one candle and Viferon-3 - 1,000,000 ME in one candle.

 All variants of Viferon contain α-tocopherol acetate (vitamin E) and ascorbic acid (vitamin C) in therapeutically effective doses (RF Patent N 2024253).

 Previously, Viferon was not used for the treatment of acute respiratory viral infections in children.

 The essential features of the proposal are the doses and the regimen of administration, which make it possible to obtain a new result - to shorten the treatment time, reduce the number of complications and subsequent ARVI.

 To disclose the invention, the results of a clinical trial of the claimed method.

When applying the inventive method in the appropriate age groups, the following results were obtained:
1. The clinical effect is a reduction in the duration of the febrile period and a more rapid relief of symptoms of intoxication, as well as a decrease in the number of complications and their duration.

 2. Economic effect - reducing the duration of inpatient treatment by 1.5 days.

 3. A beneficial effect on interferon status is an increase in the level of circulating serum IFN to adequate values for the disease and stimulation of the interferon-producing ability of leukocytes.

 4. The protective effect is a reduction in the frequency of viral and bacterial complications and subsequent acute respiratory viral infections.

Considering the research results, it was recommended: for children 1-3 years old viferon-1 (150 thousand ME), 3-7 years old viferon-2 (500 thousand ME), 7-14 years old viferon-3 (1 million ME)
The invention is illustrated in table. 1, 2 and 3 and is illustrated by the following examples.

 Example 1. Voight A., 1 g. 4 months. Clinical diagnosis: influenza, moderate form, obstructive syndrome.

Received December 16, 1997 at the end of the 1st day of illness. He became acutely ill: lethargy, refusal to eat, fever up to 37.6 ^o C, shortness of breath, cough. The boy from the group of "often sick": from 3 months of age repeated ARVI, up to 9 times a year. The condition at admission is severe: lethargic, hypodynamic, lack of appetite, pale, cyanosis of the periorbital and nasolabial triangle, fever up to 38 ^o C, unproductive cough, expiratory dyspnea, BH 48 min, tachycardia - 130 beats. in min, blood pressure = 92/60 mm Hg, in the lungs - hard breathing, dry wheezing. Viferonotherapy (Viferon-1) was started 5 hours after hospitalization and was carried out in addition to the basic one (plentiful drinking regimen, mucaltin, suprastin, 1% aminophylline in medicine, ultrasonic inhalations with soda solution and aminophylline).

 IFN status for example 1 see in table. 4.

T ^o normalized on the 2nd day of hospital stay, obstructive syndrome was also stopped on the 2nd day, the cough became milder after 1.5 days and less often from the 3rd. 4 days after hospitalization, the condition was rated satisfactory. Discharged 12/20/97.

The rapid relief of clinical signs (T ^o , cough) and the normalization of the general condition in general in a young child from the group of FWB with reduced "starting" indicators of the IFN system can be associated with the early appointment of viferonotherapy in an adequate dose.

 Example 2. Pelevin Yaroslav, 4 years. Clinical diagnosis: mixed viral infection (influenza + parainfluenza), croup syndrome I-II degree, was received on the first day of the disease in moderate condition due to intoxication, hyperthermia, respiratory syndrome (runny nose, "barking" cough, hoarseness), I stage I. In a blood test: leukocytosis, moderate neutrophilia. In IFN status: a decrease in all indicators. Complex therapy was prescribed, including penicillin 100 mg / kg / day / m, ultrasonic inhalations, mucolytics. However, the condition of the child remained without positive dynamics. 12/9/98 correction of therapy was made - viferon-2 was prescribed with a double administration. The total duration of the febrile period was 3 days, the croup syndrome was stopped on the second day, by the 4th day the condition was assessed as satisfactory and the child was discharged home with recovery. Upon discharge, IFN status was studied, where an increase in serum IFN and leukocyte interferon response was recorded. The child was followed by follow-up for 1 year. After recovering for 6 months, the boy was not ill with SARS; in the next 6 months he suffered two acute respiratory infections in a mild form.

Example 3. Sobolev Cyril, 13 years old. Clinical diagnosis: influenza, severe, obstructive syndrome, DN II degree. Received in serious condition. From the anamnesis of the disease it is known that the child fell ill 2 days ago sharply - breathing was difficult on exhalation, a rise in temperature to 39.0 ^o C was noted. The severity of the condition upon admission is due to severe intoxication syndrome (hyperthermia, reduced general motor activity, impaired skin microcirculation pallor of the skin), respiratory syndrome, expiratory dyspnea, the presence of dry rales in all parts of the lungs. In the blood test dated 11/21/99 - eosinophilia, acceleration of ESR. The etiology of the disease is the flu. From the first day of his stay in the hospital, the child was prescribed complex therapy - basic (antibacterial, pathogenetic, symptomatic) and viferon-3 (1 million ME). On the third day, the boy’s condition improved due to relief of obstructive syndrome, reduction of intoxication syndrome.

 Indicators IFN status, see table. 5.

 With recovery on day 8, the boy was discharged home. In the follow-up for 3 months did not get SARS.

Thus, from the presented data it follows that the claimed method has several advantages:
the clinical effect is a reduction in the duration of the febrile period and a more rapid relief of symptoms of intoxication, as well as a decrease in the number of complications and their duration,
economic effect - reducing the duration of inpatient treatment by 1.5 days,
a beneficial effect on interferon status - increasing the level of circulating serum IFN to adequate values for the disease and stimulating the interferon-producing ability of leukocytes,
protective effect - reducing the frequency of viral and bacterial complications and subsequent acute respiratory viral infections.

List of references
1. Bezrukov K. Yu. Clinical significance of determining the indicators of the interferon system in acute respiratory viral infections in children. Abstract of Candidate of Medical Science. M. 1989

 2. Kazakhov T.B., Ryumin I.I. and others. The state of the IFN system in newborns and their mothers. Materials of the All-Russian Congress of Obstetricians and Gynecologists, Chelyabinsk, 1992, p. 255.

 3. Kisteneva LB Clinical and pathogenetic significance of IFN in children with acute respiratory viral diseases occurring with abstructive syndrome, and the use of reaferon in complex therapy. Diss. Cand. honey. sciences. M. 1997 (prototype).

 4. Malinovskaya VV Age-related features of the interferon system. Abstract of Doctor of Biol. M. 1985.

 5. Malinovskaya VV Ontogenesis of the IFN system and the principles of the use of IFN in practical pediatric practice. In the collection "Modern aspects of the use of interferons and other immunomodulators" M. 1990, p. 70-71.

 6. Malinovskaya VV, Bezrukov K.Yu. et al. Interferon system in acute respiratory viral infections in young children and ways to correct its insufficiency. Thes. 12th All-Congress of Children's Doctors. 1988, p. 167.

Claims (4)

 1. A method of treating influenza and / or parainfluenza in severe or moderate form in children, including basic therapy and the introduction of a recombinant interferon alpha-2 drug, characterized in that viferon in the form of suppositories containing interferon in a dose of 150,000 is used as this drug 1000000 IU and inject it 2 times a day for 5 days in a dose depending on age.  2. The method according to claim 1, characterized in that children aged 1 to 2 years are injected with viferon containing 150,000 IU of interferon (Viferon-1).  3. The method according to p. 1, characterized in that children aged 3 to 6 years are injected with viferon containing 500,000 IU of interferon (Viferon-2).  4. The method according to claim 1, characterized in that at the age of 7 to 14 years, viferon containing 1,000,000 IU of interferon (Viferon-3) is administered.

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