Peculiarities of Prescribing Mucolytic Therapy to Children in Post-Attack Period of Bronchial Asthma

Abstract

Bronchial asthma is the most common chronic pathology in childhood. Chronic inflammatory process of the respiratory tract forms bronchial hyperreactivity which is manifested by typical clinical symptoms. Like any other chronic disorder, the course of bronchial asthma consists of periods of exacerbation and remission. A productive cough in the post-attack period determines the prescription of mucolytic drugs by doctors to liquefy viscous sputum, to remove it more quickly, especially among the paediatric population. There are different approaches to prescribing mucolytic drugs during exacerbation of symptoms of bronchial asthma in scientific publications. The purpose of the study was to evaluate the clinical effectiveness of mucolytic therapy in children with bronchial asthma to optimize the treatment of disease exacerbations. Material and methods. One hundred two medical records of patients treated for asthma exacerbation in pulmonological department of the Chernivtsi Regional Children Clinical Hospital were analyzed. Four clinical groups were formed depending on the prescription of mucolytic drugs. There were not any significant differences by sex, place of residence, however the average age of patients who were prescribed carbocisteine. It was significantly less than in children of other clinical groups. Results and discussion. It was determined that acetylcysteine and carbocysteine were prescribed to patients on the first day of the productive cough onset. Instead to children of the IV clinical group where ambroxol was prescribed on average 1.6 days before the wet cough onset. The study results showed that the average duration of hospitalization in patients receiving ambroxol was 1.5 days less than in children taking acetylcysteine or carbocysteine. The difference was significant. However, the duration of hospitalization for children of I clinical group was not significant longer in comparison with patients received drugs with mucolytic effect in the complex therapy of asthma exacerbation. Conclusion. Despite the fact that acetylcysteine and carbocysteine were significantly more often prescribed for more severe and pronounced asthma exacerbation a decrease in the relative and absolute risks of longer hospitalization was observed in patients taking carbocysteine