Acute bronchitis - modern possibilities of mucactive therapy

Aim. Analysis of the clinical effectiveness and safety of erdosteine use in comparison with standard (real practice) mucoactive therapy in patients with acute bronchitis (& Acy;B) in adults.Materials and methods. The observational program included 100 adult patients with & Acy;B, 50 of them (group 1) received erdosteine, the group 2 also included 50 patients who received acetylcysteine, bromhexine and other mucolytics (real clinical practice). The following were assessed: cough severity, average time for resolution of night and daytime cough, satisfaction with treatment, NO concentration in exhaled air, levels of C-reactive protein (CRP) and interleukin-6 (IL-6).Results. The average duration of relief of severe daytime cough requiring continued therapy was: in group 1 - 3.7 +/- 0.46 days, night cough - 1.14 +/- 0.94 days. In the second group, daytime cough was relieved in 3.8 +/- 0.4 days, night cough - 1.08 +/- 0.7 days. The duration of mucoactive therapy in group 1 was 5.32 +/- 0.82 days, in group 2 this figure was 8.5 +/- 1.4 days (p<0.05). The number of & Acy;B patients with a significant reduction in the severity of productive cough (1 point on cough severity scale) on the 6th day from the beginning of treatment in group 1 (erdosteine) amounted to 32 (64%), in group 2 - 27 (54%). Satisfaction with the treatment was higher in the group receiving erdosteine: according to the indicators "very satisfied" and "extremely satisfied" the patients of the group 1 - 42 - were the leaders in comparison with the group 2, where these positions were marked by 28 patients. The level of CRP in patients with & Acy;B in group 1 was 24.7 +/- 21.24 mg/l, in group 2 - 16.37 +/- 16.5 mg/l, which indicates the viral etiology of the process and no need in the prescription of antimicrobial drugs. For the first time in Russian practice, the following were determined: the level of IL-6, which in the group 1 was 10.3 +/- 6.7 pc/ml; in the group 2 - 10.03 +/- 3.94 pc/ml; the level of exhaled NO in group 1 was 16.5 +/- 5.1 ppb, in group 2 - 14.9 +/- 4.6 ppb (the norm is up to 25 ppb). These indicators, against the background of mucoactive therapy, decreased to normal values by 6th day. Conclusion. The findings expand our understanding of & Acy;B in adults. New results have been obtained on the role of CRP, IL-6 and NO in exhaled air during & Acy;B. The use of erdosteine was accompanied by a significant mucoactive effect in the form of a pronounced regression of cough in patients with & Acy;B compared to the comparison group in shorter term.