In the article is discussed the problem of antibiotic resistance, widespread and not always justified use of systemic antibiotics in the treatment of acute rhinosinusitis. The main spectrum of bacterial pathogens of acute rhinosinusitis, their sensitivity and resistance are showed, including in the Russian Federation. Presents topical inhalational drug Fluimucil IT contains mucolitic and antibiotic as a possible replacement of systemic antibiotics, in conjunction with its better tolerability, including in children, and less pronounced side effects.
Acute otitis media (OSA) is one of the most common diseases in children and adults and the most common cause of antibiotic therapy, often unreasonable. 20–70% of respiratory infections in adults and children is complicated by the development of CCA. Despite the fact that only 10% of CCA has a viral etiology, the vast majority of CCA are also viral-bacterial co-infection. The article presents the main pathogenetic mechanisms of the development of CCA, such as viral and virus-induced. The term “heat-generating” microorganisms is introduced. A review of the most common pathogens of CCA viral and bacterial. An otomicroscopic picture is described based on the generally accepted domestic classification of CCA. The main tympanometric curves and their types during CCA are presented. Much attention is paid to the modern principles of pathogenetic and symptomatic therapy. In particular, local anti-inflammatory and analgesic therapy using ear drops containing lidocaine. Some progress in the prevention of acute otitis media is discussed, which has led to a decrease in the frequency of visits to doctors about otitis media and the appointment of antibiotics. This is due to the widespread use of vaccines, as well as the introduction of “wait-and-see” tactics in mild and moderate cases of CCA without initial antibiotic treatment. Success in reducing the incidence of CCA will depend mainly on preventing the colonization of the nasopharynx by otopathogens, as well as reducing the incidence of viral infections. According to international and domestic recommendations, the basis for the prevention of acute otitis media is vaccination against pneumococcus, hemophilus bacillus and influenza virus.
Post-traumatic reactive changes in the area of ENT-organs can cause cosmetic defects, contribute to the development of infectious and inflammatory processes. The formation of limited edema and bruising is natural after certain even adequately performed surgical interventions. In clinical practice, the question arises of the effective and safe use of local drugs that have anti-inflammatory, anti-edema and analgesic effects to accelerate the course of post-traumatic reactive processes. Naturopathic agents have high safety, sufficiently pronounced anti-inflammatory, analgesic and reparative effect. The drug based on arnica mountain (Arnica montana) is a unique topical drug that only contains fresh Arnica plants in a concentration of 7% TM. Efficiency and high safety of this drug allows us to recommend it for the treatment of bruises and hematomas of the skin in the area of ENT-organs, including after surgical interventions.
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