What are bacterial lysates. The effectiveness of bacterial lysates in the prevention of respiratory infections in children Contraindications for use

Imudon + IRS19 - can be taken at the same time?

Can. The instructions for both drugs allow combination with other drugs.

Can a child 2 years old Imudon?

No. Age less than 3 years is a contraindication to admission, and children from 3 to 6 years of age are allowed to take only under the supervision of adults.

Table of drugs and prices:

There are contraindications. Please consult your doctor before taking.

All antibacterial, antiviral, antifungal.

Medicines for the treatment of symptoms of the common cold.

You can ask a question or leave a review about the medicine (please do not forget to indicate the name of the drug in the text of the message).

Preparations containing Lysates (shells of killed) bacteria and fungi - are used to stimulate general and local immunity in different body systems:

Imudon - official instructions for use:

Release form and composition

Tablets for resorption of white or almost white color, flat-cylindrical, with a smooth shiny surface, with bevelled edges, with a mint smell, slight marbling is allowed.

1 tablet contains a mixture of bacterial lysates (Imudon®) 2.7 mg,

(including Lactobacillus acidophilus, Lactobacillus delbrueckii ss lactis, Lactobacillus helveticus, Lactobacillus fermentum, Streptococcus pyogenes groupe A, Streptococcus sangius groupe H, Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis, Kfuformsiella pneumoniae ss pneumoniae, Fusobacterium nucleatum, pseudodiphtheriticum, Candida albicans - 0.1575 mg).

Immunostimulating drug for local use in dentistry and ENT practice

pharmachologic effect

Immunostimulating drug of bacterial origin for local use in otorhinolaryngology, dentistry. It is a polyvalent antigenic complex, which includes lysates of bacteria that most often cause inflammation in the oral cavity and pharynx.

Imudon® activates phagocytosis, promotes an increase in the number of immunocompetent cells, increases the production of lysozyme and interferon, immunoglobulin A in saliva.

Pharmacokinetics

The drug mainly acts in the oral cavity, there are currently no data on systemic absorption.

Indications for use of the drug IMUDON®

Treatment and / or prevention of inflammatory and infectious diseases of the oral cavity and pharynx:

• pharyngitis;
• chronic tonsillitis;
• preoperative preparation and postoperative period after tonsillectomy;
• superficial and deep periodontitis, periodontitis, stomatitis (including aphthous), glossitis;
• erythematous and ulcerative gingivitis;
• oral dysbacteriosis;
• infections after tooth extraction, implantation of artificial dental roots;
• ulceration caused by dentures.

Dosing regimen

For adults and adolescents over 14 years of age with acute inflammatory diseases of the oral cavity and pharynx and exacerbation of chronic diseases, the drug is prescribed at a dose of 8 tablets per day. Tablets dissolve (without chewing) in the oral cavity with an interval of 1-2 hours. The average duration of the course of treatment is 10 days.

To prevent exacerbation of chronic inflammatory diseases of the oral cavity and pharynx, the drug is prescribed at a dose of 6 tablets per day. Tablets dissolve (without chewing) in the oral cavity with an interval of 2 hours. The duration of the course of treatment is 20 days.

For children aged 3 to 14 years, in the treatment of acute and exacerbation of chronic inflammatory diseases of the oral cavity and pharynx, the drug is prescribed at a dose of 6 tablets per day. Tablets dissolve (without chewing) in the oral cavity with an interval of 1-2 hours. The duration of the course of treatment for acute diseases is 10 days, for the prevention of exacerbation of chronic diseases - 20 days.

Side effect

Allergic reactions: rarely - skin rash, urticaria, angioedema.

From the digestive system: rarely - nausea, vomiting, abdominal pain.

On the part of the respiratory system: rarely - exacerbation of bronchial asthma, cough.

Dermatological reactions: very rarely - erythema nodosum.

From the blood coagulation system: very rarely - hemorrhagic vasculitis, trobocytopenia.

Other: rarely - fever.

Contraindications to the use of the drug IMUDON®

• autoimmune diseases;
• children's age up to 3 years;

The use of the drug IMUDON® during pregnancy and lactation

Information on the use of Imudon during pregnancy is insufficient. Relevant data from animal experiments and epidemiological studies are not available.

special instructions

You should not eat and drink, as well as rinse your mouth for 1 hour after using Imudon, so as not to reduce the therapeutic efficacy of the drug.

When prescribing the drug to patients on a salt-free or low-salt diet, it should be borne in mind that 1 tablet of Imudon contains 15 mg of sodium.

Patients with bronchial asthma, in whom the use of drugs containing bacterial lysates, causes an exacerbation of the disease (an asthma attack), the use of the drug is not recommended.

Pediatric use

Children aged 3 to 6 years should dissolve tablets under adult supervision.

There is no data indicating the need for any restrictions on activities related to driving a car or other mechanisms during the treatment period.

Overdose

To date, cases of overdose of Imudon® have not been reported.

drug interaction

No drug interactions were noted. Imudon® can be used simultaneously with other drugs.

Terms of dispensing from pharmacies

Terms and conditions of storage

The drug should be stored out of the reach of children at a temperature not exceeding 25 ° C. Shelf life - 2 years. The drug should be transported in accordance with SP3.3.2.1248-03 at a temperature not exceeding 25°C.

IRS-19 - official instructions for use:

Release form and composition

Nasal spray 20 ml in the form of a clear, colorless or yellowish liquid with a slight specific odor.

• bacterial lysates 43.27 ml
• Streptococcus pneumoniae type I 1.11 ml
• Streptococcus pneumoniae type II 1.11 ml
• Streptococcus pneumoniae type III 1.11 ml
• Streptococcus pneumoniae type V 1.11 ml
• Streptococcus pneumoniae type VIII 1.11 ml
• Streptococcus pneumoniae type XII 1.11 ml
• Haemophilus influenzae type B 3.33 ml
• Klebsiella pneumoniae ss pneumoniae 6.66 ml
• Staphylococcus aureus ss aureus 9.99 ml
• Acinetobacter calcoaceticus 3.33 ml
• Moraxella catarrhalis 2.22 ml
• Neisseria subflava 2.22 ml
• Neisseria perflava 2.22 ml
• Streptococcus pyogenes group A 1.66 ml
• Streptococcus dysgalactiae group C 1.66 ml
• Enterococcus faecium 0.83 ml
• Enterococcus faecalis 0.83 ml
• Streptococcus group G 1.66 mg

Clinico-pharmacological group:

Immunostimulating drug of bacterial origin

pharmachologic effect

Immunostimulating drug based on bacterial lysates. IRS® 19 increases specific and non-specific immunity.

When spraying IRS® 19, a fine aerosol is formed that covers the nasal mucosa, which leads to the rapid development of a local immune response. Specific protection is due to locally formed antibodies of the class of secretory immunoglobulins type A (IgA), which prevent the fixation and reproduction of infectious agents on the mucosa. Nonspecific immunoprotection is manifested in an increase in the phagocytic activity of macrophages, an increase in the content of lysozyme.

Pharmacokinetics

The drug mainly acts in the upper respiratory tract; currently there are no data on the systemic absorption of the drug.

Indications for use of IRS® 19

Adults and children over 3 months old:

• prevention of chronic diseases of the upper respiratory tract and bronchi;
• treatment of acute and chronic diseases of the upper respiratory tract and bronchi, such as rhinitis, sinusitis, laryngitis, pharyngitis, tonsillitis, tracheitis, bronchitis and others;
• restoration of local immunity after the flu or other viral infections;
• preparation for planned surgical intervention on the ENT organs and the postoperative period.

Dosing regimen

The drug is used intranasally by aerosol administration of 1 dose (1 dose = 1 short press of the spray gun).

For the purpose of prevention, adults and children from 3 months of age are administered 1 dose of the drug in each nostril 2 times a day for 2 weeks (it is recommended to start a course of treatment 2-3 weeks before the expected rise in incidence).

For the treatment of acute and chronic diseases of the upper respiratory tract and bronchi, children aged 3 months to 3 years are prescribed 1 dose of the drug in each nostril 2 times a day after preliminary release from the mucous discharge until the symptoms of infection disappear; children over 3 years of age and adults - 1 dose of the drug in each nostril 2 to 5 times a day until the symptoms of infection disappear.

To restore local immunity after influenza and other respiratory viral infections, children and adults are prescribed 1 dose of the drug in each nostril 2 times a day for 2 weeks.

In preparation for a planned surgical intervention and in the postoperative period, adults and children are prescribed 1 dose of the drug in each nostril 2 times a day for 2 weeks

In preparation for a planned surgical intervention and in the postoperative period, adults and children are prescribed 1 dose of the drug in each nostril 2 times a day for 2 weeks (it is recommended to start the course of treatment 1 week before the planned surgical intervention).

Rules for the use of the drug

For the correct functioning of the aerosol can, put the nozzle on the can, center it and gently, without force, press it. After that, the device is ready for use.

When injecting the drug, the vial should be in a strictly vertical position, the patient should not tilt his head back.

If you tilt the balloon during injection, the propellant will flow out in a few seconds and the device will become unusable.

With regular use of the drug, it is not recommended to remove the nozzle from the vial.

If the drug is left for a long time without use, a drop of liquid may evaporate and the resulting crystals will clog the outlet of the nozzle. This happens most often when the nozzle is removed and placed in the packaging with the top end down next to the cylinder, without first rinsing and drying it. If the nozzle is clogged, several clicks should be made in a row so that the liquid can pass under the action of excess pressure; if there is no effect, lower the nozzle for several minutes in warm water.

Side effect

Dermatological reactions: rarely - erythema-like and eczema-like reactions; in isolated cases - thrombocytopenic purpura and erythema nodosum.

Allergic reactions: rarely - urticaria, angioedema.

From the respiratory system: rarely - asthma attacks and cough, at the beginning of treatment - nasopharyngitis, sinusitis, laryngitis, bronchitis.

From the digestive system: rarely (at the beginning of treatment) - nausea, vomiting, abdominal pain, diarrhea.

Others: rarely (at the beginning of treatment) - an increase in body temperature (> 39 ° C) for no apparent reason.

Side effects may or may not be related to the action of the drug.

Contraindications to the use of the drug IRS® 19

• autoimmune diseases;
• hypersensitivity to the components of the drug.

The use of the drug IRS® 19 during pregnancy and lactation

There is insufficient data on the potential for teratogenic or toxic effects on the fetus during pregnancy. Therefore, the use of the drug IRS 19 during pregnancy is not recommended.

special instructions

At the beginning of treatment, reactions such as sneezing and increased nasal discharge may occur. As a rule, they are of short duration. If these reactions take a severe course, the frequency of administration of the drug should be reduced or it should be canceled.

At the beginning of treatment, in rare cases, an increase in body temperature ≥ 39 ° C is possible. In this case, the drug should be discontinued. However, this condition should be distinguished from an increase in body temperature, accompanied by malaise, which may be associated with the development of diseases of the upper respiratory tract.

In case of clinical symptoms of a bacterial infection, the advisability of prescribing systemic antibiotics should be considered.

When prescribing the drug IRS® 19 to patients with bronchial asthma, an increase in attacks is possible. In this case, it is recommended to stop treatment and not take drugs of this class in the future.

Influence on the ability to drive vehicles and control mechanisms

IRS® 19 does not affect the psychomotor functions associated with driving vehicles or operating machines and mechanisms.

Overdose

To date, cases of overdose of the drug IRS® 19 have not been reported.

drug interaction

The drug interaction of the drug IRS® 19 is unknown.

It is possible to prescribe antibiotics against the background of the continued use of IRS® 19.

Terms of dispensing from pharmacies

The drug is approved for use as a means of OTC.

Terms and conditions of storage

The drug should be stored out of the reach of children, in a strictly vertical position at a temperature not exceeding 25 ° C; do not freeze. Shelf life - 3 years.

The bottle should be protected from heating above 50°C and from direct sunlight; do not pierce the cylinder, do not burn it, even if it is empty.

Immunotropic preparations based on lysates of microorganisms (vaccinating preparations)

This is an antigenic polyvalent complex preparation, consisting of fragments of inactivated microorganisms, which are most often found in pathological processes in the oral cavity. The antigens of such microorganisms activate the immune system, which is manifested by an increase in the phagocytic activity of macrophages, an increase in the content of lysozyme and sIgA in saliva, and an increase in the number and activation of plasma cells. Since there is a so-called phenomenon of “mucosal solidarity”, local immunity increases not only in the oral cavity, but also on all mucous membranes of the macroorganism. To achieve the maximum effect, the drug is recommended to be used after a course of detoxification therapy.
Indications for use. The drug is used for the treatment and prevention of gingivitis, periodontitis, stomatitis, glossitis, tonsillitis, pharyngitis. For the treatment of acute and exacerbations of chronic diseases, imudon is used in a dose
8 tablets per day for 10 days. 1 tablet is dissolved in the oral cavity every 2-3 hours. For the prevention of oral diseases, the drug is taken at a dose of 6 tablets per day for a course of 20 days.
Side effect. It is possible to develop allergic reactions, as well as dyspeptic phenomena.
Contraindications. Contraindications for the use of imudon are allergic reactions to the drug.

IRS-19

This is a complex preparation of bacterial lysates, which are the most common pathogens of infectious diseases of the upper respiratory tract. The lysis of microorganisms was carried out using an original biological technique, which makes it possible to obtain non-pathogenic fragments of bacteria with preserved specific antigenic properties. Due to these properties, the lysate initiates immune defense reactions in the mucosa of the upper respiratory tract, manifested in the form of activation and proliferation of immunocompetent cells, an increase in the level of lysozyme, sIgA and interferons, and increased phagocytosis.
Indications for use. It is advisable to use the drug for the treatment of acute and chronic infectious diseases of the upper respiratory tract (sinuitis, rhinitis, otitis), tracheitis, bronchitis, rhinotracheobronchitis, as well as in the pre- and postoperative period for the prevention of infectious complications of surgical interventions on the upper respiratory tract.
For the treatment of infections of the upper respiratory tract, the drug is used in the form of injections into each nostril 2-5 times a day until the symptoms of the disease disappear. For the purpose of prevention, the drug is used in a different dose: 2 injections per day for 2 weeks.
Side effect. At the beginning of the reception, an increase in inflammatory manifestations is possible, due to the activation of immune reactions. Rarely, allergic reactions occur in the form of urticaria.
Contraindications. IRS-19 is contraindicated in the event of allergic reactions to the drug.

RIBOMUNE

The drug contains ribosomes of microorganisms that most often cause respiratory infections (Klebsiella pneumoniae, Diplococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae), as well as proteoglycans of the cell wall of Klebsiella pneumoniae. It is known that prokaryotic ribosomes differ significantly in structure from similar organelles of eukaryotic organisms, which practically excludes the possibility of cross-reactions to human autoantigens.
The drug is intended for the treatment and prevention of recurrent infections of the ear, throat and nose, as well as respiratory organs (bronchitis, tracheobronchitis, infection-dependent bronchial asthma). The ribosomal fraction of the drug activates T- and B-lymphocytes specific to the injected antigens, which provides a vaccinating effect due to the synthesis of antibodies to respiratory tract infections. Klebsiella pneumoniae proteoglycans have a modulating effect on innate resistance factors, activating macrophages and neutrophils to carry out chemotaxis, adhesion and phagocytosis, as well as increasing the production of α-IFN and interleukins (IL-1β, IL-6, IL-8).
Mode of application. A single dose of the drug - 3 tablets in the morning on an empty stomach. Scheme of administration - the first 4 days of the week for 3 weeks, in the next 2-5 months, the drug is taken on the first 4 days of each month.
Side effect. Transient hypersalivation at the beginning of treatment.
Contraindications. Increased individual sensitivity to the components of the drug.
Release form. In the form of tablets, 12 tablets in a blister pack.

BRONCHO-MUNAL

This is a preparation of bacterial lysates that causes respiratory infections (Diplococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, Klebsiella ozaenae, Staphylococcus aureus, Streptococcus viridans, Neisserria catarrhalis).
It is advisable to use the drug for chronic and recurrent infections of the respiratory tract (brochitis, tonsillitis, pharyngitis, rhinitis, sinusitis, otitis media). Bronchomunal provides immunization to antigens of the most common pathogens of the respiratory tract by inducing activation, proliferation and differentiation of specific T- and B-lymphocytes, production of immunoglobulins (mainly sIgA, as well as IgG). Since the principle of “solidarity of mucous membranes” is triggered, the formed immunocompetent cells and immunoglobulins are distributed throughout all mucous membranes, and not only enter the mucous membrane of the respiratory system, which provides a generalized protective effect.
Mode of application. One capsule per day for 10 days of the month
3 consecutive months for infection prevention. For treatment, one capsule is used for 10 to 30 days (depending on the severity of the disease). In the next 2 months, the drug is taken 1 capsule for 10 days in a row. 10-day intervals are recommended between courses.
Side effect. Rarely, mild dyspeptic disorders and fever are observed.
Contraindications. Individual hypersensitivity to the components of the drug.
Release form. In capsules of 7 mg No. 10 or No. 30 per package.

Preferanskaya Nina Germanovna
Associate Professor of the Department of Pharmacology of the Pharmaceutical Faculty of the First Moscow State Medical University. THEM. Sechenov, Ph.D.

BACTERIAL LYSATES FOR INFECTIOUS-INFLAMMATORY DISEASES
ENT AND RESPIRATORY

Broncho-Munal- a mixture of lyophilized bacterial lysates in capsules (Broncho-Munal P 3.5 mg and Broncho-Munal 7 mg) - contains lysates of the following bacteria - Moraxellacatarrhalis, used for prevention and in combination therapy of infectious and inflammatory diseases of the bronchopulmonary system. The lyophilisate of the lysates was preserved by freezing followed by vacuum drying. Children aged 6 months to 12 years are allowed to use only the drug "Broncho-Munal P" 3.5 mg; adults and children over 12 years old - Broncho-Munal at a dose of 7 mg - 1 time per day, in the morning on an empty stomach (daily dose - 1 caps.).

The drug reduces the incidence, duration and severity of the disease, helping to reduce the doses of antibiotics and other drugs.

The immune response is realized through the recognizing receptors of the lymphopharyngeal ring of the nasopharynx to the pulmonary alveoli. Increases humoral and cellular immunity, providing an immunomodulatory effect. The drug stimulates the activity of alveolar macrophages, peripheral monocytes, increases the number of circulating T-lymphocytes, increasing their number and activity, increases the production of cytokines. On the mucous membranes of the respiratory tract and through the Peyer's patches of the digestive tract, the concentration of secretory IgA increases, the production of protective adhesive molecules, IgA, IgG and IgM antibodies increases. In the blood, the concentration of IgE antibodies decreases. When taking the drug, the body's natural defense mechanisms against respiratory tract infections are stimulated, their frequency and severity decrease.

Broncho-Munal is used as a prophylactic for chronic infectious diseases of the upper and lower respiratory tract, in particular for chronic bronchitis, tonsillitis, pharyngitis, laryngitis, rhinitis, sinusitis, otitis media. Broncho-Munal is prescribed as an auxiliary drug for all diseases of the respiratory tract and for recurrent infections of the ENT organs, purulent and unspecified otitis media. When using the drug, body temperature may increase, allergic reactions and dyspeptic disorders may occur.

Broncho-Vaksom(Broncho-Vaxom adult 7 mg and Broncho-Vaxom child 3.5 mg, caps. gelatin.) - standardized lyophilisate of bacterial lysates Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus, Klebsiella pneumoniae, Klebsiella ozaenae,Moraxellacatarrhalis, under the influence of these antigens, the immune defense of the body is stimulated, resistance to infections of the respiratory system increases. The drug has a powerful stimulating effect on most types of leukocytes, increases the number of circulating B-lymphocytes and triggers the necessary biological reactions that increase the body's resistance to infections. The action of the drug is based on the activation of immune defense cells and is mediated through the intestinal lymphatic system. The effect is manifested through antigen-presenting cells in Peyer's patches of the small intestine. Activated B-lymphocytes enter the bloodstream and are carried throughout the body. Immunopharmacological studies have shown that the effective amount of cytokines, the production of IgA secreted by the respiratory mucosa and saliva increases in humans, and the selective production of IgG polyclonal antibodies increases in serum. Activation of natural killers, metabolic and functional activity of macrophages is observed, however, there is no increase in the complement component C 3 and C-reactive protein.

Broncho-Vaxom is used to prevent recurrent infections of the respiratory tract and exacerbations of chronic bronchitis, which helps to reduce the frequency of infections and reduce the duration of their course. Included in the complex treatment of acute respiratory tract infections, which undoubtedly reduces the likelihood of exacerbations of the chronic course of these diseases. For the treatment of acute and exacerbation of chronic respiratory infections, it is prescribed for children aged 6 months to 12 years. If the capsule is difficult for a child to swallow, the capsule should be opened and the contents mixed with liquid food or drink. Children over 12 years of age and adults are taken orally 1 capsule daily on an empty stomach until symptoms disappear, for 10 days. For the prevention of exacerbations and maintenance therapy, 1 capsule is used daily in the morning on an empty stomach. The course of treatment includes 3 cycles, each of which consists of a daily intake of the drug for 10 days, the interval between cycles is 20 days. The duration of treatment is determined by the doctor based on the individual condition of the patient, if necessary combined with antibiotic therapy.

Important! Side effects when applied are mild and amount to 3-4%. Manifested in the form of gastrointestinal disorders (nausea, abdominal pain, vomiting), skin reactions (itching), respiratory system disorders (cough, shortness of breath), as well as headache, fatigue. Contraindication is hypersensitivity to the components of the drug.

Ribomunil does not apply to preparations based on bacterial lysates, however, in terms of its pharmacological action, it is very similar to them. The drug is a ribosomal-proteoglycan complex, which includes the most common pathogens of infections of the ENT organs and respiratory tract ( Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae) and refers to stimulants of specific and nonspecific immunity. The ribosomes that make up Ribomunil contain antigens that are identical to the surface antigens of bacteria, and when they enter the body, they cause the formation of specific antibodies to these pathogens. Membrane proteoglycans stimulate nonspecific immunity, which is manifested in increased phagocytic activity of macrophages and polynuclear leukocytes, and an increase in nonspecific resistance factors. The drug stimulates the function of T- and B-lymphocytes, the production of serum and secretory immunoglobulins of the IgA type, interleukin 1, as well as alpha and gamma interferons.

Ribomunil is used in complex therapy, which allows to increase the effectiveness and reduce the duration of treatment, significantly reduce the need for antibiotics, bronchodilators, and increase the period of remission. It is used to treat chronic diseases and recurrent infections of the ENT organs (otitis, rhinitis, sinusitis, pharyngitis, laryngitis, tonsillitis) and respiratory tract (chronic bronchitis, tracheitis, pneumonia, infectious-dependent bronchial asthma). It is recommended to take it for prevention purposes before the start of the autumn-winter season, especially in ecologically unfavorable regions, as well as for frequently and long-term ill children and the elderly. Assign the drug 1 time per day in the morning on an empty stomach. A single dose (regardless of age) is 3 tablets of 0.25 mg (with 1/3 of a single dose) or 1 tablet of 0.75 mg (with one dose), or granules from one sachet, previously dissolved with boiled water at room temperature .

Children of early age (from 6 months) are recommended to prescribe Ribomunil in the form of granules. In the first month of treatment and / or for prophylactic purposes, the drug is taken daily for the first 4 days of each week for 3 weeks. Over the next 2-5 months - the first 4 days of each month. It is recommended to carry out three-month preventive courses of treatment 2 times a year, six-month preventive courses - 1 time per year.

BACTERIAL LYSATES FOR INFECTIONS IN UROLOGY

Uro-Vaksom— lyophilized bacterial lysate from 18 strains Escherichiacoli, available in 6 mg capsules, is used for urinary tract infections. In the body it stimulates T-lymphocytes, induces the formation of endogenous interferon, increases the content of IgA in the urine. Stimulates the metabolic and functional activity of macrophages, promotes the release of various lymphokines: IL-2, IL-6, TNF. Prevents the development of infections, has a stimulating effect on macrophages, immunocompetent cells in Peyer's patches and B-lymphocytes, increases the content of IgA. Clinical studies have shown that the drug reduces the frequency of recurrence of urinary tract infections, especially cystitis.

The drug is included in the combined treatment, used to prevent recurrence of chronic urinary tract infections, especially cystitis, regardless of the nature of the microorganism, in combination with antibiotics or antiseptics. In the treatment of acute cases, 1 capsule is used daily in the morning on an empty stomach, as an additional drug during conventional antimicrobial therapy until the symptoms disappear, but not less than 10 days. The maximum duration of treatment is 3 months. Prevention and treatment of an infection that is difficult to treat - 1 capsule daily in the morning on an empty stomach. also within 3 months. The duration of treatment and the appointment of a second course of therapy should be determined by the doctor, based on the state of health of the patient.

Individuals may experience minor gastrointestinal (diarrhea, nausea, vomiting), skin (pruritus, exanthema, erythema) disorders, and limited allergic skin reactions. Rarely - a slight fever.

BACTERIAL LYSATES FOR INFECTIONS IN GYNECOLOGY

Floragin- a mixture of lysates of lactobacilli ( L. Bulgaricus, L. Acidophilus, S. Termophilus, B. Bifidus,L. Helveticus,L. plantarum and L. casei), is available in the form of vaginal suppositories "Floragin Ovuli" 2 g No. 6, vaginal gel "Floragin Gel" bottle 9 ml No. 6 and a solution "Floragin Solutsio" 140 ml. Lactobacillus lysates are stabilized with seaweed extract, which has a softening and soothing effect, effectively eliminates itching. Lactic acid, which is included in the composition, provides the necessary pH level (3.5-4.5) of the vaginal area. Lysate strains work together to normalize the vaginal microflora and create a protective effect to suppress the growth of pathogenic microflora, as well as to normalize the physiological pH level of the vaginal mucosa.

Suppositories are intended for the prevention of violations of the vaginal microflora, the normalization of the vaginal microflora and the physiological pH of the vagina, are prescribed for the appearance of dryness in the vagina, irritation, burning, itching and vaginitis, to improve the local immunity of the vagina, have a restorative, normalizing and soothing effect. With vulvovaginal candidiasis ("thrush"), it is used to restore the microflora of the vagina simultaneously with systemic drugs.

The gel is intended for daily prevention of violations or normalization of the vaginal microflora and restoration of the physiological state of the vaginal mucosa; it is used for dryness and irritation of the vagina during menopause, in the presence of an unpleasant odor and abundant discharge, with burning and itching caused by menstrual irregularities, stress, taking antibiotics, contraceptives or other drugs. Application: 1 vial. per day intravaginally. Produced in the form of a disposable soft polyethylene bottle with an applicator containing 9 ml of gel (6 vials in a pack of cardboard.). As a prophylactic - 1 vial. per day for 6 days.

Gel "Floragin" is not recommended for use during conception attempts. A low level of vaginal acidity negatively affects the activity of spermatozoa, thereby making it difficult to conceive. It is not recommended to use the gel as a contraceptive.

"Floragin Solution" in the form of a solution is intended for intravaginal administration in order to normalize the vaginal microflora in a short time, reduce the risk of fungal infections of the vulva and vagina, incl. caused candida albicans. Recommended for use after each sexual contact and in the postmenstrual period.

The use of these drugs allows you to control, maintain and restore the natural balance of the vaginal microflora, the natural pH level, softens and heals the vaginal mucosa. Important! Their use is allowed during pregnancy and lactation. Long-term use may cause local reactions in the form of hypersensitivity and irritation. If any of the listed side effects persist, discontinue use and consult your physician.

BACTERIAL LYSATES FOR INFECTIONS IN PROCTOLOGY

Posterisan , Posterisan forte(ointment and suppositories) contains different amounts of inactivated microbial cells Escherichiacoli. In one gram of ointment, about 330 million cells of Escherichia coli are injected into the anus with an applicator daily in the morning, at bedtime and after defecation. One rectal suppository contains about 660 million E. coli cells. As excipients, solid emulsifying fat, hydroxystearate and glycerin-acrogol, etc. are used. Both the ointment and suppositories Posterisan have anti-inflammatory, regenerating, immunostimulating, and antipruritic effects. The use of the drug helps in the formation of both nonspecific and specific immunity. The suspension of inactivated bacteria and the products of their metabolism, which is part of the suppositories and ointment Posterisan, have a pronounced effect on the T-system of the human body's immunity. Under the influence of active components, the activity of leukocytes and cells of the reticuloendothelial system is enhanced. It is intended for the treatment of diseases affecting the anorectal region (anal fissures, itching, burning, hemorrhoids, anopapillitis). The drug interacts with the rectum and skin areas of the anogenital region, increases the resistance of local tissues to the adverse effects of pathogenic microflora, promotes tissue regeneration, reduces vascular exudation in inflammatory processes, increases and restores their permeability.

Important! When using immunostimulating drugs, care must be taken for people with hypersensitivity, should not be used for acute intestinal diseases, pregnant women (especially in the first trimester) and mothers during breastfeeding.

■ Clinical pharmacology and pharmaceutical news

Bacterial lysates in programs for the prevention of respiratory infections in children

A.B. Malakhov, N.G. Kolosova, E.V. Khabibullina

The use of bacterial lysates has become widespread in many countries around the world. The clinical effect of these drugs is aimed at reducing the frequency, duration and severity of infectious respiratory diseases. The article presents data on the mechanisms of action and clinical efficacy of bacterial lysates in children with respiratory infections, as well as summarizes information about a new drug of this class - Ismigen.

Key words: bacterial lysates, respiratory infections, prevention, Ismigen.

The child's immune system begins to form even before birth, and the processes of maturation and development of the body's immune functions continue until the end of puberty. To understand the functional capabilities of the immunity of a growing organism, it is important to know the physiology of its formation: it is characterized by the presence of critical periods of development that must be taken into account when assessing the state of health, developing preventive programs and prescribing treatment.

Stages of development of the immune system

By 6-9 months of a child's life, immunoglobulins (mainly class O) received from the mother are completely eliminated. The synthesis of one's own reaches the level of an adult only by 6-8 years. The level of IgA, which provides local protection of the mucous membranes, is low in newborns and young children and reaches the level of an adult only by the age of 10-12, which causes a higher susceptibility of the child to respiratory infections. When all these factors are taken into account, it becomes clear why the unfavorable

Department of Pediatric Diseases, Faculty of Medicine, SBEE HPE "First Moscow State Medical University named after I.M. Sechenov" of the Ministry of Health of the Russian Federation. Alexander Borisovich Malakhov - Professor. Natalya Georgievna Kolosova - Ph.D. honey. sciences, associate professor. Ekaterina Andreevna Khabibullina - post-graduate student.

The slow course of pregnancy, prematurity, intrauterine infection, artificial feeding and other factors significantly increase the risk of developing acute respiratory viral infections (ARVI).

Acute respiratory diseases are the most common childhood pathology. The frequency of respiratory infections in children in different age periods ranges from 2-3 to 10-12 per year. Carriage of opportunistic bacterial flora of the respiratory tract serves as a reservoir of infection, especially in the inter-epidemic period.

The incidence increases sharply with the beginning of visits to preschool institutions. So, in the 1st year of the visit, half of the children suffer from 6 SARS or more, and their frequency decreases only in the 2nd-3rd years of the visit. With age, antibodies to a greater number of infectious agents appear, which is accompanied by a decrease in the incidence. In the conditions of the children's team, group immunity to a number of pathogens is formed, as indicated by a high percentage of carriers in the absence of diseases.

However, about 10% of children still have a high incidence of acute respiratory viral infections, which leads to large economic losses. In cases of frequent respiratory morbidity in a child, the development of severe complications in him, signs of immune imbalance are often revealed, which requires immunocorrection.

Application of bacterial lysates

In the arsenal of immunoprophylaxis there are vaccines against a number of pathogens of acute respiratory diseases (HIB (Haemophilus influenzae type b - vaccine against Haemophilus influenzae type B), pneumococcal, pertussis, diphtheria, influenza vaccines), but there are no specific vaccines against the main pathogens of SARS yet.

All this led to the creation of a large number of drugs to reduce respiratory morbidity, which include drugs from the group of bacterial lysates. The effectiveness of bacterial lysates, demonstrated in Europe in the 1980-1990s and somewhat later in Russia, underlies their recommendation as a safe means of non-specific prevention of acute respiratory viral infections in children.

The prescription of immunomodulators of bacterial origin has become widespread in many countries: to date, approximately 150 million patients worldwide have been treated with these drugs since their commercialization.

Bacterial lysates are assigned to the group of immunotropic drugs and in the modern classification they constitute a separate subgroup - immunomodulators of microbial origin (table). Currently, there are three types of drugs:

Purified bacterial lysates;

Immunostimulating membrane fractions;

Bacterial ribosomes stimulated by proteoglycans, i.e. membrane fractions.

Bacterial lysates, in turn, are divided into:

Systemic (Broncho-Vaxom, Broncho-munal, Ribomunil);

Local (Imudon, IRS-19);

Systemic and local (Ismigen - double action).

Mechanism of action

Although lysates are close to vaccines, their mechanism of action on the immune system is different. These drugs are complex PAMP-containing (PAMP - pathogen-associated molecular patterns) drugs that affect the innate immune system mainly through signal pattern-recognizing receptors. At the same time, the effectiveness of the use of this group of drugs is associated not only with the activation of innate immunity effectors, but also with the initiation of the adaptive immunity system.

Bacterial lysates stimulate the body's specific and non-specific defenses by stimulating the T-helper type 1 (Th1) immune response, which is more mature than the T2-type response with which children are born. Under the influence of microbial stimulation, the child develops a Thl-type response, the lack of which at present may be associated with the relative rarity of bacterial infections and the unreasonably widespread use of antibiotics that suppress the commensal flora, as well as the irrational use of antipyretic drugs for any increase in body temperature, which suppress production

Types of immunocorrectors of microbial origin

Drug Composition

Ismigen, Stada, Italy Lysates of bacteria Staphylococcus aureus, Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae (types TY1/EQ11, TY2/EQ22, TY3/EQ14, TY5/EQ15, TY8/EQ23, TY47/EQ24), Klebsiella pneumoniae, Klebsiella ozaenae , Haemophilus influenzae type b, Neisseria catarrhalis

Immunovac-VP-4, Federal State Unitary Enterprise NPO Microgen, Russia Cell-free multicomponent vaccine - antigens and associated lipopolysaccharides of S. aureus, K. pneumoniae, Proteus vulgaris, E. coli, as well as teichoic acid

Broncho-Waxom, OM Pharma SA, Switzerland Lyophilized lysate of 8 bacteria: S.pneumoniae, H. influenzae, K.pneumoniae, K. ozaenae, S. aureus, S. viridans, S. pyogenes, M. catarrhalis

Broncho-munal, Lek d.d., Slovenia Lyophilized lysate of 8 bacteria: S.pneumoniae, H. influenzae, K.pneumoniae, K. ozaenae, S. aureus, S. viridans, S. pyogenes, M. catarrhalis

Imudon, Solvay Pharma, France Lysate mixture of 13 bacteria: Streptococcus pyogenes group A, Enterococcus faecalis, Enterococcus faecium, Streptococcus sanguis, Staphylococcus aureus, K.pneumoniae, Corynebacterium pseudodiphtheriticum, Fusobacterium nucleatum, Lactobacillus acidophilus, L. fermentum, L. helveticus, L Delbrueckii ss lactis, Candida albicans

IRS-19, Solvay Pharma, France Lysates of 18 bacteria: S.pneumoniae (6 serotypes), S.pyogenes (groups A and C), H. influenzae, K.pneumoniae, N.perflava, N.flava, M. catarrhalis, Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis, Group G Streptococcus, Acinetobacter calcoaceticus

Ribomunil, Pierre Fabre Medication Production, France Ribosomal fractions K.pneumoniae (35 shares), S.pneumoniae (30 shares), S.pyogenes (30 shares), H. influenzae (5 shares) + Klebsiella membranous proteoglycans

cytokines that cause a Thl-type response (y-interferon (y-IFN), interleukin-1 (IL-1), IL-2, tumor necrosis factor a (TNF-a)). Suppression of the Thl-type response prevents the development of a more stable response to infection and the formation of immunological memory.

Bacterial lysates stimulate the production of Thl-type cytokines, increase the production of IgA, slgA (secretory IgA), lysozyme in the mucous membranes of the respiratory tract, stimulate the activity of natural killers, normalizing the level of CD4+ cells when it decreases, and also suppress the production of IgE and antibodies of this class. It is this action of lysates that is currently considered as the main one that contributes to the formation of a mature immune response and a decrease in respiratory morbidity. In addition to stimulating the formation of specific antibodies to the microorganisms included in their composition, bacterial lysates activate the humoral activity characteristic of a Thl-type response.

Clinical effect

All drugs in this group can be used to prevent recurrent acute respiratory viral infections and related respiratory diseases (rhinitis, sinusitis, pharyngitis, tonsillitis, laryngitis, acute and recurrent bronchitis), including in children with recurrent diseases and with allergic pathology. You can start using drugs both in a healthy child and with the next respiratory disease, continuing the course after recovery.

The clinical effect of bacterial immunomodulators is aimed at reducing the frequency and severity of exacerbations of respiratory infections. Specific and nonspecific mechanisms of action of bacterial immunomodulators determine their effect not only against bacteria, the lysates of which are part of the preparations, but also against other pathogens of respiratory infections, which can be traced by the frequency of acute respiratory viral infections in the group of frequently ill children.

Ismigen: features of action

In the manufacture of bacterial lysates, after in vitro cultivation of bacterial strains, antigens are isolated by either mechanical or chemical lysis, followed by lyophilization and mixing in certain proportions. Mechanical lysis is carried out by increasing pressure on the wall of an inactivated bacterium, which preserves coarse antigens, while chemical lysis is carried out using a chemical alkali to act on inactivated bacteria.

bacteria that can denature proteins and therefore antigens. The drug obtained by mechanical lysis has a stronger immunogenicity.

Ismigen is the first official mechanical bacterial lysate, the drug is recommended for use in the treatment of infections of the upper and lower respiratory tract and the prevention of relapses. 1 tablet (50 mg) contains lyophilized bacterial lysates, including bacterial lysates of Staphylococcus aureus, Streptococcus pyogenes, Streptococcus viridans, Streptococcus pneumoniae (types TY1/EQ11, TY2/EQ22, TY3/EQ14, TY5/EQ15, TY8/EQ23, TY47 /EQ24), Klebsiella pneumoniae, Klebsiella ozaenae, Haemophilus influenzae type b, Neisseria catarrhalis - 7.0 mg; excipient: glycine - 43 mg.

Ismigen contains the six most pathogenic types of pneumococci. The natural reservoir of S. pneumoniae is the human nasopharynx, the pathogen is transmitted by airborne droplets. A high frequency of pneumococcal infections is observed in children and the elderly, who are at risk for developing immunodeficiency. Most strains of H. influenzae are opportunistic pathogens. In neonates and young children, H. influenzae type b (Hib infection) causes bacteremia, pneumonia, and acute bacterial meningitis. In some cases, inflammation of the subcutaneous tissue, osteomyelitis, and infectious arthritis develop. Moraxella catarrhalis, or Neisseria catarrhalis, is a Gram-negative bacterium that causes infections of the respiratory tract, middle ear, eyes, central nervous system, and joints. M. catarrhalis is an opportunistic pathogen that poses a threat to humans and persists in the respiratory tract. M. catarrhalis in 15-20% of cases causes acute otitis media in children.

Ismigen activates phagocytosis, increases the level of lysozyme in saliva, the number of immunocompetent cells, the functional activity of macrophages (including alveolar), polymorphonuclear leukocytes. The drug activates lipid peroxidation, increases the expression of adhesion molecules on monocytes and granulocytes (LEA-1, MAC-1, p150, ICAT-1), activates CD4+-, CD8+-cells, increases the expression of receptors for IL-2, enhances T- lymphocytes and antigen-presenting cells and the destruction of infectious agents. Ismigen increases the synthesis of prostaglandin E2 by cells of the macrophage-phagocytic star

on, activates natural killers, synthesis of anti-inflammatory cytokines IL-1, IL-2, IL-6, IL-8, y-IFN, TNF-a; reduces the synthesis of IL-4, IL-12; increases the level of sIgA in saliva, serum IgA, IgG, IgM; reduces the level of serum IgE.

Studies have demonstrated the high efficiency of Ismigen in the treatment and prevention of acute and chronic diseases of the upper and lower respiratory tract.

In an open comparative randomized controlled trial, which included 114 patients, the effectiveness of Ismigen in the treatment of upper respiratory tract infections was studied by assessing the duration and severity of the disease. During the 3-month course of treatment and follow-up in patients taking Ismigen, there was a decrease in the duration of upper respiratory tract infections (the difference is statistically significant) compared with the control group and the group receiving chemical lysate, as well as a decrease in the number of absences from work during treatment by 93% and during follow-up by 87%. Ismigen was 10 times more effective than the chemical lysate.

When using Ismigen in 120 children (age 4-9 years) with recurrent nasopharyngitis, and/or otitis media, and/or recurrent pharyngotonsillitis, a statistically significant decrease in the number of episodes of infections was observed over 3 months of treatment (Fig. 1, 2). In children receiving Ismigen, the need for antibiotics was significantly reduced (3 times compared with the control group and 2 times compared with the chemical lysate), antipyretic and anti-inflammatory drugs. There was a decrease in the severity and duration of episodes of infections (by 2 times compared with the control group and 1.7 times compared with chemical lysates), a decrease in the number of school absences. All children were observed and treated in the same period, which made it possible to exclude the seasonality factor.

When Ismigen was prescribed to patients with diseases of the lower respiratory tract, a decrease in the frequency of their exacerbations was noted. The efficiency of Ismigen compared to the chemical lysate was 2 times higher. The need for antibiotics in the group receiving Ismigen was 2.5 times lower.

Ismigen is allowed in adults and children from 3 years of age. In acute and subacute infections of the upper and lower respiratory tract, the drug is prescribed 1 tablet per day until the symptoms disappear.

4 oh b! m D EN O O No. d h az

Chemical lysate

Control

Rice. 1. Results of a study on the treatment and prevention of recurrent bacterial infections of the upper respiratory tract in children (rhinitis, pharyngitis, otitis media, tonsillitis, laryngitis). Here and in fig. 2: n = 120 (4-9 years) (3 groups of 40 patients); observation period of 6 months (3 months of therapy + 3 months after treatment); R< 0,016. (По Ьа МапШ. I. е! а1., 2007.)

Ismigen Chemical Control

(1 tablet 1 time per day, 10 days per month x3 months)

(1 capsule 1 time per day, 10 days per month x3 months)

Rice. 2. Average number of episodes of acute respiratory infections (ARI) with the use of antibiotics. (According to La Manja I. e! a1., 2007.)

disease (at least 10 days) under the tongue on an empty stomach. The tablet should be kept under the tongue until completely dissolved. As a prevention of recurrent infections of the upper and lower respiratory

paths, exacerbations of chronic respiratory diseases are prescribed 1 tablet per day for 10 days. The prophylactic course includes 3 cycles of 10 days with 20-day intervals between them. A preventive course should be carried out no more than 1-2 times a year.

Thus, the use of bacterial lysates, in particular Ismigen, for the treatment and prevention of acute and chronic respiratory diseases helps to reduce the frequency of respiratory infections, reduce the duration of diseases, reduce the need for antibiotics, due to their effect on systemic and local immunity, as well as high immunogenicity. and low incidence of side effects. Ismi gene is an important component of a comprehensive scheme for the treatment and prevention of respiratory infections, especially in frequently ill children.

Akhmatova N.K. Molecular and cellular mechanisms

action of immunomodulators of microbial origin

on the functional activity of effectors of innate immunity: Dis. ... doc. honey. Sciences. M., 2006. Lebedinskaya E.A. and others // Fundam. research 2010. No. 12. S. 5152.

Markova T.P. // Rus. honey. magazine 2009. No. 3. S. 2427.

Revyakina V.A. // Lech. doctor. 2015. No. 4. P. 24.

Boris V.M. et al. // Giorn. It. Mal. Tor. 2003. V. 57. P. 210.

Bouvet J.P. et al. // Trends Immunol. 2002. V. 23. P. 209.

Cazzola M.A. // Trends Med. 2006. V. 6. P. 199.

Cogo R. et al. // Acta Biomed. 2003. V. 74. P. 81.

Dagan R. et al. // J. Antimicrob. Chemother. 2001. V. 47.

Falchetti R. // American College of Chest Physicians: Italian chapter. National meeting. Naples, Italy, June 20-22, 2002.

La Mantia I. et al. // GIMMOC. 2007.V.XI. No. 3. P. 1. Macchi A., Vecchia L.D. // Arzneimittelforschung. 2005. V. 55. P. 276.

Maul J. // Respiration. 1994. V. 61. P. 15. Melioli G. // Gior. It. Mal. Tor. 2002. V. 56. P. 245. Rossi S., Tazza R. // Arzneim. Forsch. drug. 2004. V. 54. P. 55.

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Tricarico D. et al. // Arzneim. Forsch. drug. 2004. V. 54. P. 52.

Today I will tell you why many children and even adults sometimes get worse due to the use of immunostimulants, etc. You will find out what these drugs can do, what they cannot, and how to properly use them to prevent and treat respiratory infections. I will also justify the feasibility of the scheme " first a course of Galavita, then a course of bacterial lysate". And in the end I will describe the features of each immunomodulator. The article is very large (about 50 thousand characters), the main conclusions are at the end.

Examples of feedback on the unsuccessful use of IRS-19

IRS-19 is the most famous and commonly used bacterial lysate, so there are a lot of negative reviews about it on Internet forums:

We sprayed only in the nose, but when applied, it only got worse, the child got sick even more.

After a single use of IRS-19, we started getting snot, and after the second "zipper" at night on the same day, my daughter sneezed 20 times in her sleep!!! And in the morning, her nose and eyes were pouring SO !!! that it took 100 napkins before lunch !!!

I tried to spray it on my daughter, but we have snot started from him, always flowed from the nose and I never use it again. My experience is negative.

Sharply negative! The child “gave out” out of the blue (tried to treat with IRS simple light snot) temperature 39.2

last year we had a severe sore throat, a cough, the pediatrician prescribed IRS-19 for us and we were treated with it, but nothing went away, and it worsened even more. It's up to the pulmonologist. passed the analysis - a swab from the throat, they did not reveal anything, although the pulmonologist clearly said that you have staphylococcus aureus (or I don’t remember streptococcus anymore). the second analysis really revealed streptococcus and the pulmonologist explained to us that the worsening of the disease was precisely due to the fact that we were treated with IRS-19. since it contains various bacteria, they did not cure us, but intensified the disease.

To understand the errors in the use of IRS-19, we will analyze what bacterial lysates are.

What are bacterial lysates

Bacterial lysates(from Greek lysis - dissolution, decay) are crushed particles of bacteria that are used to prevent and treat bacterial infections (usually upper and lower respiratory tract). Note that in the lysates no live bacteria and there are no viral remnants, so by themselves they cannot be a source of infection.

Preparations of bacterial lysates ( IRS-19, Imudon, Broncho-munal, Broncho-Vaksom, Ismigen etc.) refer to immunostimulants i.e. enhance immunity. Unjustified immunostimulation leads to a deterioration in the patient's condition, and further we will analyze in detail why. is not strictly a bacterial lysate, but it contains ribosome antigens, bacterial cell wall antigens and acts similarly, so we will consider it in the group of lysates.

Bacterial lysates have routes of administration unusual for vaccines:

• - splashing in the nose,
• Imudon, Ismigen, Respibron- dissolution or resorption in the mouth,
• Broncho-Vaxom, Broncho-munal, Ribomunil- ingestion.

All bacterial lysates contain a set of residues of exactly those bacteria that most often cause inflammatory diseases of the upper and lower respiratory tract. For example, among and acute otitis media (inflammation of the middle ear) are usually found:

• Streptococcus pneumoniae (pneumococcus = Frenkel's diplococcus),
• Haemophilus influenzae (Haemophilus influenzae = Pfeifer stick),
• Klebsiella pneumoniae (Klebsiella pneumoniae = Friedlander's bacillus),
• Moraxella catarrhalis (moraxella catarrhalis).

All bacterial lysates stimulate the immune system. The detailed mechanism is described at the end of the article in the section " Mechanism of action and prospects for lysates».

Indications and contraindications for the use of lysates

indication to the appointment of bacterial lysates is stimulation of local immunity of the respiratory tract(for example, before surgery on ENT organs). They are usually prescribed to prevent recurrent acute and treat chronic (recurrent) infections of the upper and lower respiratory tract:

• rhinitis(inflammation of the nasal mucosa),
• sinusitis(inflammation of the paranasal sinuses; sinusitis at the site of inflammation is divided into sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis),
• tonsillitis(inflammation of the palatine tonsils),
• adenoiditis(inflammation of a pathologically enlarged pharyngeal, or nasopharyngeal, tonsil -)
• otitis(inflammation of the ear, most often otitis media- inflammation of the middle ear)
• pharyngitis(inflammation of the throat)
• laryngitis(inflammation of the larynx),
• tracheitis(inflammation of the trachea),
• bronchitis(inflammation of the bronchi)
• pneumonia(infectious pneumonia).

Contraindications a little:

1. hypersensitivity (allergy) to the drug,
2. pregnancy and lactation,
3. autoimmune diseases (there is no categorical prohibition, but caution is required).

For autoimmune diseases (eg. autoimmune thyroiditis [Hashimoto], autoimmune glomerulonephritis, rheumatoid arthritis etc.) lysates should be used with great care, as they stimulate the immune response and thus may enhance the autoimmune process. One of the few immunomodulators approved for autoimmune diseases is Galavit(see below). It has an anti-inflammatory effect and reduces the severity of autoaggression. Also used in autoimmune diseases Polyoxidonium, but this article will not discuss Polyoxidonium.

For allergic diseases bacterial lysates can be used if the lysate itself is not allergic. that influenza vaccines in children with bronchial asthma have a more pronounced effect in reducing the incidence of SARS than in children without asthma.

Causes of errors in the use of IRS-19

Any of the drugs mentioned IRS-19, Imudon, Broncho-munal, Broncho-Vaksom, Ribomunil etc.) contains an extensive set of antigens of several types of bacteria (for example, IRS-19 contains 18 species and types of bacteria). This is a huge antigenic load (stimulation) on the body's immune system. Further, I will write about all bacterial lysates using the example of IRS-19, since it is the most popular and more known than others for lack of effect or complications.

During the use of IRS-19 or an analogue, complications arise for 2 reasons:

1) IRS-19 is applied too often and/or in too high a dose.

According to the instructions, IRS-19 is prescribed 1 dose of the drug (1 short press on the nebulizer) in each nasal passage 2-5 times a day. In my opinion, even 2 times a day is a lot about. At first, just 1 dose in each nasal passage at night is enough, every day or even every other day. There is no hurry here. Too high doses or frequent use of IRS-19 overstimulates the immune system, which is manifested by a flu-like condition or toxic syndrome:

• an increase in body temperature to 39 ° C and above for no apparent reason (remember the review at the beginning of the article?),
• weakness, malaise,
• nausea, vomiting, abdominal pain, diarrhea,
• rhinopharyngitis, sinusitis, laryngitis, bronchitis (failure of local immunity).

It is safer to lengthen the lysate treatment than to shorten it. Compare the instructions for IRS-19 with the instructions for the staphylococcal vaccine:

The course of treatment for adults and children from 7 years of age [with staphylococcal medicinal liquid vaccine] consists of single daily injections according to the following scheme:

• 1st day - 0.2 ml,
• 2nd - 0.3 ml,
• 3rd - 0.4 ml,
• 4th - 0.5 ml,
• 5th - 0.6 ml,
• 6th - 0.7 ml,
• 7th - 0.8 ml,
• 8th - 0.9 ml,
• 9th - 1 ml.

See how slowly increase the dose staph vaccine? I am more than sure that if IRS-19 is used according to a similar scheme with a slow increase in dose, there will be several times less negative reviews on it.

2) IRS-19 is applied during the acute period of an infectious disease.

Any infectious disease is a powerful antigenic load on the body. With acute respiratory infections, viruses and (or) bacteria multiply massively in the mucous membranes of the respiratory tract, from where they enter the internal environment of the macroorganism in large quantities, and our immune system is obliged to respond to this. An especially powerful antigenic load occurs during acute infections and at elevated temperatures (for example, periods of mass release of the pathogen from the cells into the internal environment of the host lead to fever - a classic example is malaria). High temperature is a protective reaction of the body, indicating the mobilization of the immune system (the higher, the stronger). If at this moment we begin to actively treat the child with any bacterial lysate ( IRS-19, Broncho-munal, Broncho-Vaksom, Ismigen, Imudon etc.), thereby adding antigens to which you need to respond, then the immune system may not be able to cope (especially in a child). There will be a breakdown in adaptation with the inevitable deterioration of the condition and the possible addition of new respiratory infections.

From here conclusions:

1. never apply IRS-19, Broncho-munal, Broncho-Vaxom, Ribomunil, Ismigen, Imudon during the period high temperature,
2. with great care, bacterial lysates are used when normal temperature body during an acute infectious disease or during an exacerbation of a chronic infectious disease,
3. lysates can be relatively safely(IRS-19 - no more than 1 time per day) apply only during remission (disappearance of symptoms) of a chronic disease or after recovery for prevention.

The fundamental difference between chemical and mechanical lysis

(and 3rd cause of complications when using IRS-19 and many lysates)

Most bacterial lysates ( IRS-19, Broncho-munal, Broncho-Vaksom, Imudon) created by chemical lysis. At chemical lysis the killed bacteria are divided into small parts with the help of a strong alkali. In this case, folding (disturbance of the structure, denaturation) of proteins, damage to bacterial antigens, and the formation of unnatural products of bacterial lysis occur. In other words, chemical lysis does not quite properly break up bacterial cells and contribute to formation of toxic substances. This is the third reason for the inefficiency and bad reviews of the IRS-19.

However, science does not stand still, and scientists have managed to develop a new, more progressive way of lysing bacterial cells - mechanical lysis. Using ultrasound, a bacterial cell is crushed without significant changes in its structural components. It is also possible to separate the ballast (antigen-inactive) and toxic parts of the microbial cell. As a result, mechanical lysates show higher efficiency and better tolerability(fewer side effects).

Bacterial lysates obtained with mechanical lysis and available in pharmacies, while few:

• registered in Russia ,
• in Ukraine - ,
• and in Belarus there is nothing at all.

To create a general picture, I will retell 2 clinical studies comparing chemical and mechanical lysates from the breast cancer website, link Bacterial lysates. New drugs.

1) Research La Mantia et al. (2007)

120 children aged 4–9 years with repeated nasopharyngitis/otitis media/pharyngotonsillitis divided into 3 groups of 40 people. All children were simultaneously observed for 3 months of treatment (bacterial lysate was given for 10 days every month) and 5 months after treatment, and parents kept diaries and recorded adverse effects.

Results:

• in the control group ( did not receive bacterial lysates) for 3 months. 22.5% of children did not get sick with infections, after another 5 months. didn't get sick at all 5% children;
• in the group receiving chemical lysate(name not specified), for 3 months. 37.5% did not get sick, after another 5 months. - 15% children;
• in the mechanical lysate group , did not get sick 67.5% and 27.5% children, respectively.

2) Research Rossi S., Tazza R. (2004)

69 adults with chronic lower respiratory disease received antibiotics and standard therapy. They were divided into 3 groups of 23 person:

• in the control group did not receive anything additional, exacerbation occurred in 22 of 23 patients (95.7%), of which 21 people needed antibiotics;
• chemical bacterial lysate(name not specified), exacerbation occurred in 16 (69.6%), of which 14 required antibiotics;
• in the group that received additional , exacerbation occurred in 5 patients (21.7%), of which 4 required antibiotics.

Case studies show that mechanical lysates (particularly ) are much more effective than chemical ones.

Why are lysates effective when taken orally?

If you notice, only IRS-19 is splashed into the nasal cavity, and all other bacterial lysates ( Imudon, Ismigen, Respibron, Broncho-munal, Broncho-Vaxom) are dissolved in the mouth or taken orally. Not even the previously mentioned bacterial lysate Uro-Vaksom for the prevention of recurrence of urinary infections (especially cystitis) is taken orally.

Question: what do you think, through which organ of the body does the immune system most actively contact the external environment?

• Leather? No. The skin area is relatively small and in an adult is 2 m 2. We also regularly wash ourselves with soap and wash bacteria from the body, which does not lead to the serious violations of the immune system that one might expect.
• Lungs? Also no. Although the area of ​​the inner surface of the alveoli is much larger than the area of ​​the skin and ranges from 40 m 2 to 120 m 2, bacteria do not live in the alveoli. 96% of inhaled bacteria linger in the upper respiratory tract, and bacteria that have entered the alveoli are destroyed there in a matter of hours. Due to its actual sterility, the surface of the lungs also cannot serve as the main point of contact of the immune system with the external environment.
• Remains gastrointestinal tract in which there are accumulations of lymphoid tissue.

Lymphoid tissue serves for the formation and "training" of lymphocytes, which acquire the ability to respond to specified antigens (B-lymphocytes will be able to produce antibodies, T-lymphocytes - to detect and destroy cells affected by the virus). Lymphoid tissue is located in lymph nodes, spleen, thymus(thymus) and tonsils. It is also present in the gastrointestinal tract.

Lymphoid system of the gastrointestinal tract contains:

1) lymphoepithelial pharyngeal Pirogov–Waldeyer ring. It is located around the pharynx and handles both respiratory and digestive antigens.

The ring consists of:

• two palatine tonsils
• two tubal tonsils (in the area of ​​\u200b\u200bthe auditory tubes, which serve to communicate the middle ear and pharynx),
• nasopharyngeal tonsil,
• lingual tonsil,
• lymphoid granules and lateral lymphoid ridges on the posterior pharyngeal wall.

Drawing from the presentation of the Department of ENT diseases of the Tashkent Medical Academy

If the palatine tonsils (due to chronic tonsillitis) or the nasopharyngeal tonsil (due to adenoiditis) are removed in childhood, the patient will be more likely to get colds and respiratory infections. And the sooner they are removed, the more it will hurt.

2) Peyer's patches of the small intestine- group accumulations of small (1-3 mm) lymphoid nodules (follicles) in the wall of the ileum. As a person ages, their number decreases from 50 (in children) to 16 (after 60 years).

3) Appendix(vermiform appendix) also has accumulations of lymphoid tissue. According to some reports, in people with a removed appendix, the intestinal microflora after intestinal infections is restored more slowly.

The surface area of ​​the intestine due to folds, villi and microvilli (up to 3 thousand microvilli per epithelial cell) reaches 200-300 m2. Due to the acidic environment, quite a few bacteria live in the stomach (10 3 in 1 ml = 1 thousand/ml), and as you move towards the anus, their number gradually increases to the level of 10 11 in 1 g of feces ( 100 billion/year). Lives in the human intestine 2-3 kg bacteria and there are 300-1000 of their species (usually 400-500). The intestinal microflora has great importance for health person.

Folds, villi and microvilli of the intestine

Increased intestinal surface area due to folds, villi and microvilli

It is the intestines that is the most important point of contact of the immune system with the external environment. Microbial antigens of saliva, nasal and bronchial secretions are partially processed in the pharyngeal ring of Pirogov-Waldeyer, and partially swallowed and enter the lymphoid tissue of the intestine for processing. Therefore, resorption / dissolution in the mouth ( Imudon, Ismigen, Respibron) or ingestion ( Broncho-Vaksom, Broncho-munal) has a protective effect on the mucous membranes of the respiratory tract.

In recent decades, there is increasing evidence that the correct intestinal microflora is a protective factor against a number of infectious, allergic and autoimmune diseases (although not all):

• The administration of probiotics during pregnancy or at the 1st year of life prevents the development of atopic dermatitis (risk reduction by 20%),
• Probiotic B. lactis Bb-12 is effective in the prevention of respiratory tract infections in children of the 1st year of life (reduction in the number of respiratory tract infections by 31%),
• The effectiveness of symbiotic in the prevention of common infections in children aged 3-7 years in the winter (risk reduction by 25%),
• The effect of probiotics on the incidence and duration of cold symptoms in children aged 3-5 years (for all studied indicators, a decrease from 27% to 70%),
• Crohn's disease is based on a global change in the composition of the intestinal microflora in favor of pathogenic bacteria (and antibiotic therapy enhances microbial dysbiosis and thus worsens the condition of patients)
• The development of rheumatoid arthritis may be associated, among other things, with the composition of the intestinal microflora, in particular, with the bacterium Prevotella copri
• Bacteria in the gut play a big role in protecting against type 1 diabetes
• The composition of microbes in the intestines of mice directly affects the amount of body fat

Why don't lysates always help?

The use of even the best bacterial lysates does not guarantee that the child will completely stop getting colds and respiratory infections. Remember: the main purpose of using lysates is only prevention of purulent bacterial complications ORZ.

Prevention of all acute respiratory viral infections and acute respiratory infections is simply impossible for the reason that 90% of childhood acute respiratory infections are caused by viruses(viral acute respiratory infections are called SARS), and bacterial lysates do not contain any viral antigens.

ORZ causative agents:

• 90% - viruses (influenza and parainfluenza viruses, respiratory syncytial virus, adeno-, rhino-, corona-, enteroviruses),
• 10% - bacteria or viral-bacterial associations. In most cases, a bacterial infection begins as a complication of a viral infection.

The total number of respiratory viruses and their serotypes reaches 180. What does it mean? Serotype(from lat. serum - serum), or serovar(from the word option), is a group of microorganisms (viruses, bacteria) of the same species, which has a common antigenic structure in the shell, which can be distinguished from other serotypes using antibodies. For example, rhinoviruses are the cause of 25-40% of all SARS and cause a runny nose (rhinitis). Rhinoviruses have 113 serotypes. In a child who has become infected with one of these serotypes, antibodies to rhinoviruses of this serotype will appear in the blood serum 2 weeks after infection. But these antibodies will not bind (interact) with antigens of other serotypes due to their different antigenic structure and therefore will not be able to protect the child from infection with other serotypes of rhinoviruses. A child could potentially get rhinovirus infection another 112 times. Of course, it is absolutely unrealistic to meet all 180 respiratory viruses and serotypes in childhood, but this explains why children often begin to get sick in the first year of attending kindergarten, where other children with a "learning" immune system share new respiratory viruses among themselves more actively than toys.

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Source: http://bono-esse.ru/blizzard/Deti1/ORVI/03.html

Although the lysates do not contain viral antigens, indirectly they still reduce the number of acute respiratory viral infections due to the general stimulation of the immune system. Also, lysates do not contain antigens of causative agents of atypical respiratory infections ( mycoplasma, chlamydia = chlamydophila and etc.). "Atypical" bacteria usually do not lead to the development of purulent inflammation, and the diseases they cause in the clinical picture resemble something between viral and classic bacterial infections.

How is Galavit useful for infectious diseases?

Galavit- Russian immunomodulator with a proven anti-inflammatory effect. Galavit is a promising treatment for infectious diseases (especially those accompanied by fever):

1. Galavit normalizes antigen-presenting and regulatory function of macrophages(reduces high and increases low). Macrophages play a key role in triggering the immune response to infection. Fever, weakness, insomnia These are symptoms of an overactive immune system. Since so many processes in the body are associated with inflammation, Galavit has an effect on many infectious, autoimmune and surgical diseases.
2. raises bactericidal activity of neutrophils. Neutrophils begin to destroy bacteria faster and more efficiently.
3. improves the quality of antibodies (avidity, affinity).

Earlier, I wrote 2 articles about Galavita:

What is Galavit capable of with infections? Here are the results of clinical studies of Galavit in influenza and typhoid fever.

In a comprehensive flu treatment Galavit accelerates recovery:

• normalizes the temperature on the 2nd day of influenza in 15% (0% in the control group) and on the 5th day in 95% (84% in the control),
• clear positive dynamics already from the 2nd day of treatment ( improved well-being, reduced weakness, improved sleep and appetite),
• by the time of discharge, there were no complaints of weakness, normalization of the level of leukocytes and ESR (in the control group, leukocytosis and elevated ESR remained, 50% had severe symptoms of intoxication and asthenia).

Galavit shows the greatest efficiency precisely at. For example, when typhoid fever in children adding Galavit to the treatment gave the following results:

• in 84% of children, the temperature returned to normal by the end of 2-3 days versus 17 ± 3 days in the control group,
• weakness stopped in a maximum of 1 week versus 2 weeks in control,
• loss of appetite, nausea, abdominal pain disappeared 2-3 times faster,
• reducing the length of stay in the hospital by 10-12 days,
• in general, Galavit gave an excellent effect in 93% of children,
• the optimal result is given by the early appointment of Galavit (the duration of the disease is reduced, there is no early recurrence of typhoid fever).

The appointment of Galavit for infections is a good replacement antipyretic and anti-inflammatory drugs from the group of NSAIDs (, ibuprofen, aspirin and etc.):

• Galavit does not give side effects (although an allergy is theoretically possible, I have not yet heard of it),
• effective both in bacterial infections (especially purulent), and in viral,
• the action of Galavit begins 1-2 hours after administration,
• compatible with all drugs, enhances the action of antibiotics,
• improves mood if it has been suppressed by inflammation (among indications also asthenic conditions, neurotic and somatoform disorders),
• can be taken by healthy people with reduced physical performance (including athletes),
• it is not required to make an immunogram before starting the reception, it is sold without a prescription,
• if necessary, treatment with Galavit can be repeated after 2 months.

The more stressed the immune system ( fever, weakness etc.), the more noticeable the Galavit effect will be for the patient.

Two flaws Galavita:

1. The safety of the drug has not been tested in children under 6 years old, although it is they who most often get sick with a high temperature, and mothers almost lose their minds in search of help for the child;
2. Galavit can only be bought in Russia, Ukraine, Uzbekistan, Kyrgyzstan, Armenia and Azerbaijan(in Azerbaijan also called Salvirin). Galavit is not sold in Belarus and other countries.

Galavita tablets easier, more convenient and safer to use than intramuscular injections or rectal suppositories. Tablets are only 25 mg, others are not available. They are sublingual (taken under the tongue until completely dissolved), but the drug well absorbed in the gastrointestinal tract, therefore, it is permissible to take it inside, however, with pharyngitis and tonsillitis to obtain additional local effects, it is more effective to dissolve the tablets.

Galavit's regimens for various diseases are given in the instructions. There is also a schema Three fives”, According to which Galavit is taken on the following days:

• from 1st to 5th day,
• then 7, 9, 11, 13, 15th day,
• then 18, 21, 24, 27, 30 days.

For a full course according to the "Three Fives" scheme, you will need 3 packs of Galavit tablets of 20 pieces.

Dosages:

• adults and children over 12 years old: daily dose 100 mg taken 1 tablet 25 mg 4 times a day on the days of admission (under the tongue or inside);
• children 6 to 12 years old: daily dose 50 mg. Since the tablets have a dosage of 25 mg, they are taken in 1/2 tab. 4 times a day. or 1 tablet 2 times a day. Instead of tablets, you can use 1 rectal suppository of 50 mg 1 time per day (although they are now difficult to find). The instructions for the tablets indicate a contraindication for children under 12 years old, but this does not matter much, because there is no “children's” dosage of tablets. The main thing is to correctly calculate the daily dose (half of the adult);
• children up to 6 years: Strictly speaking, Galavit is not recommended for children under 6 years of age, since its safety has not been tested in them. However, Galavit is a highly safe drug and does not give side effects, therefore, starting from the age of 4-5 years, it is quite acceptable to try (in agreement with the pediatrician) in a daily dose 2 mg/kg.

In difficult cases, Galavit can be additionally apply topically or externally in the form of drops. To do this, a bottle of Galavita is diluted according to the instructions, as for injections, and the resulting solution is instilled, for example, into the nose. Each time you need to use a clean pipette, and store the bottle in the refrigerator in a dark place (Galavit is prone to destruction in the light). The solution can be used as long as it is clean and clear, which means there is no mass growth of microbes inside. I remind you that only a freshly diluted solution can be used for injections - it is strictly forbidden to administer in the form of injections stored in the refrigerator due to possible non-sterility.

• tablets 25 mg 20 pieces - 400-450 rubles,
• rectal suppositories 100 mg - 850-950 rubles,
• rectal suppositories 50 mg - absent,
• vials of 100 mg - 950-1100 rubles,
• vials of 50 mg - 500-550 rubles.

Why do I recommend the scheme "first a course of Galavit, then a course of bacterial lysate"

As explained above, lysates should not be used during an acute infection or during an exacerbation of a chronic infection - the patient's condition can worsen if the immune system cannot withstand the additional antigenic load. During the period of any infection, it is better to apply the Galavit course, and only after its completion, start a course of bacterial lysate.

During the epidemiological season from October to December 2011, in organized groups of children in 4 boarding schools in Moscow, 279 children aged 12-18, most of them belonged to the group of frequently ill children or had a history of chronic diseases. Children were randomly divided into groups and subgroups:

• main (197 people):
  • the first subgroup (99 people): vaccination first against influenza, after 2 weeks - taking Galavit 50 mg / day (children's dose) for 5 days daily.
  • second subgroup (98 people): first reception of Galavita 50 mg/day every other day for 10 days, then vaccination.
• control (81 people): vaccination only.

All children were observed for 30 days.

• In the control group there were 4 patients with ARVI (4.9%). Diseases were recorded from the 8th to the 29th day of observation.
• In the first subgroup (first vaccination, then a course of Galavit) there were 9 cases (9.2%). Cases of acute respiratory viral infections were recorded 16-18 days after the end of Galavit's intake. The duration of illness in the main group was 2 days less than in the control group.
• In the second subgroup (first a course of Galavit, then vaccination), no one got sick.

It can be assumed that Galavit normalizes the state of the immune system and increases the effectiveness of any subsequent vaccine (for example, bacterial lysate or).

If you are prescribed a bacterial lysate ( IRS-19, Broncho-munal, Broncho-Vaxom, Uro-Vaxom, Ismigen, Imudon etc.), if possible, first take a course of Galavita (preferably in tablets):

• in case of an acute or chronic disease, a full course of Galavit for 3 weeks (according to the instructions) or the Three Fives scheme for 30 days is recommended;
• if a person is healthy, a short course of Galavit is sufficient: 100 mg (adults and children over 12 years old) or 50 mg (children from 6 to 12 years old) every other day within 10 days(days of admission: 1-, 3-, 5-, 7-, 9th). For an adult, this is 1 pack of the drug.

Galavit has a pharmacological effect on cells for 72 hours. 5-7 days after the end of the Galavit course, you can make a vaccine or start a course of bacterial lysate. There are also observations that during the period of taking Galavit, people fall ill with ARVI less.

One last review about Galavit, who was sent by the patient at the end of November:

As I promised, I am reporting the results (a week ago I finished the monthly course of Galavita). For several years I struggled with tonsillitis, namely with plugs in the gaps. No matter how much I tried to get them out, no washings helped, including the Tonsillor apparatus. After the course of Galavit, they disappeared, I am in shock, there are no words to even describe how happy I am. I also wrote that last year I had 7 times a sore throat. While the ORZ bypasses me, let's see what happens next.

Of course, not everyone is so lucky - for most, the Galavit effect will be more modest. Observations show that Galavit has little effect on purulent rhinitis(runny nose), although the general condition of the patient is still improving.

Is Galavit compatible with bacterial lysates?

Question: Is it possible to take Galavit and bacterial lysate at the same time? It is undesirable to simultaneously use 2 drugs that affect the immune system: an immunomodulator (Galavit) and an immunostimulant (lysate), especially in the first 10-15 days of taking Galavit. The immune system must first recover, which is facilitated by Galavit.

In the event of a prolonged purulent runny nose (yellow-green copious discharge from the nose), if the monthly course of Galavit (the “Three Fives” scheme) does not give a pronounced effect, after the end of the course of Galavit or in the last week of its administration, you can add spraying into the nose of IRS-19 for 2 weeks at the rate of 1 time per day, 1 dose in each nostril at night after cleansing the nose. If there is a deterioration in the condition, the use of IRS-19 should be discontinued (however, Galavit reliably protects the immune system from antigenic overload). And we must remember that abundant purulent discharge from the nose occurs not only with a runny nose, but also with sinusitis (inflammation of the maxillary sinus) and other sinusitis.

Symptoms of sinusitis and other sinusitis:

• pulling headache in the front of the face(in the area of ​​the affected sinuses), especially in the evening and when the face is tilted forward,
• feeling of fullness, pressure in the area of ​​​​the inflamed sinus,
• decreased sense of smell
• possible fever, weakness.

The first 2 symptoms are most important, especially against the background of fever. If you suspect sinusitis, you should see an ENT doctor for an examination and x-ray of your sinuses. In the case of sinusitis, the image will show a shadow or fluid level in the area of ​​the affected sinus. Galavit can be used for any sinusitis, and IRS-19 and other lysates are acceptable only in the absence of general symptoms of inflammation (temperature, weakness) in consultation with the attending physician.

Brief characterization of individual lysates

More details on the use of each lysate are described in the instructions. It is generally recommended to repeat courses of bacterial lysates several times a year.

IRS-19 is chemical lysate in the form of a nasal spray. It is splashed into the nose (which is very convenient) and has a pronounced effect on the nasal mucosa. It is most often used to prevent infections of the nose and nasopharynx. When spraying, it is important to hold the bottle upright so that the drug does not spill past.

IRS-19 contains 18 types of bacterial lysates: Staphylococcus aureus, 6 types of pneumococcus and other streptococci, Neisseria, Klebsiella, Moraxella, Haemophilus influenzae, Acinetobacter, Enterococci. A significant proportion (9.99 ml of a total volume of 43.27 ml) is occupied by lysate, for this reason IRS-19 is used for. It is impossible to completely get rid of staphylococcus in the nose with the help of IRS-19, but it is possible to reduce the amount of staphylococcus in the nasal cavity and prevent purulent exacerbations.

Reasons for the inefficiency of the IRS-19:

• a huge number of antigens that can overstimulate the immune system,
• it is a chemical lysis preparation instead of a safer mechanical one,
• too intensive use (in the instructions for IRS-19 it is recommended to use from 1 to 5 times a day, which is excessive, in my opinion - 1 time per day is always enough),
• lack of a dispenser, which, when pressed for a long time, allows excess lysate to be splashed into the nose.

How to use IRS-19 safely:

• do not use in the first 1-2 weeks of acute infections and exacerbations of chronic infections,
• it is better to use after the course of Galavita,
• do not use more than 1 time per day (if there was no Galavit course before the lysate course, then in the first few days it is better to use IRS-19 every other day),
• if the patient's condition worsens, suspend or cancel the use of IRS-19,
• if treatment of the nasal mucosa is not required (infectious rhinitis or sinusitis), then it is better to replace IRS-19 with a mechanical bacterial lysate ( or ).

• 1 dose of the drug in each nasal passage 1 time per day at night for 2-3 weeks. Before going to bed, a little in each nostril of the cleansed nose. The first few days can be applied not daily, but every other day. With normal tolerance, switch to daily intake.

I myself have been using IRS-19 since about 2003-2004, when I learned about the drug at a medical exhibition and decided to try it for myself. After a few days, I noticed that my inflamed blackheads had turned pale and significantly reduced in size. On reflection, I came to the conclusion that this improvement is due to the staphylococcus lysate in IRS-19, because the inflammation in acne is caused mainly by 2 bacteria:. Now I use IRS-19 as a preventive measure 1-2 times a week. I am satisfied with the effect - I have not had bacterial complications such as sinusitis, pneumonia, purulent rhinitis for a long time. With ARVI, I can take Galavit for 2-3 days, and this is usually enough.

The first work on its clinical trial IRS-19 was published back in 1967. In the 1980s, several studies were published in Eastern European countries with varying conclusions ranging from negative to modestly positive. Now IRS-19 is used mainly in the CIS countries, in the rest of the world it is almost never used.

IRS-19, which are sold in Russia, are manufactured in France and packaged in Russia (JSC Pharmstandard-Tomskhimfarm).

Broncho-munal P intended for children from 6 months up to 12 years, contains P 1/2 dose of Broncho-munal (for adults and children over 12 years of age). Both drugs are used to prevent and treat recurrent infections of the upper and lower respiratory tract.

A set of lysates in Bonhomunal:

• Streptococcus pneumoniae (pneumococcus),
• Haemophilus influenzae (haemophilus influenzae),
• Klebsiella pneumoniae,
• Klebsiella ozaenae,
• Moraxella catarrhalis.

Bronomunal is taken orally in the morning on an empty stomach. The daily dose is 1 capsule. If the patient cannot swallow the capsule, it should be opened and the contents mixed with a small amount of liquid (tea, milk or juice). For the prevention of infectious diseases of the respiratory tract, the drug is used three 10-day courses with 20 day intervals in between. Undesirable effects are rare.

• Broncho-munal P 30 capsules - 1000-1100 rubles,
• Broncho-munal 30 capsules - 1150-1300 rubles.

Instructions for Broncho-munal:

Used for the prevention and treatment of inflammatory diseases of the oral cavity and pharynx(including for the treatment of chronic tonsillitis).

Imudon contains bacterial lysates: Staphylococcus aureus, 2 streptococci, 2 enterococci, Klebsiella, corynebacterium, fusobacterium, 4 species of lactobacilli. Imudon even has fungus lysate candida albicans causing candidiasis (thrush).

Designed for adults and children from 3 years old and older. Tablets dissolve(without chewing) in the oral cavity with an interval of 1-2 hours. Children from 3 to 6 years of age should dissolve the tablets in the mouth under the supervision of an adult! You can rinse your mouth no earlier than 1 hour after ingestion, otherwise the effect is reduced. Usually prescribed from 6 to 8 tablets per day for a course of 10-20 days.

Broncho-Vaksom

There are adults and children from 6 months up to 12 years old). Broncho-Vaxom for children contains half the adult dose. Both are used to prevent and treat recurrent respiratory tract infections and exacerbations of chronic bronchitis.

Broncho-Vaxom contains bacterial lysates Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Klebsiella pneumoniae, Klebsiella ozaenae, Staphylococcus aureus, Moraxella catarrhalis.

Take 1 capsule daily in the morning. The course of Broncho-Vaxom includes 3 cycles of 10 days with breaks of 20 days. If the capsule is difficult to swallow, it should be opened and the contents mixed with a drink.

• Broncho-Vaksom children's capsules 30 pieces - 950-1100 rubles,
• Broncho-Vaksom adult capsules 30 pieces - 1000-1100 rubles.

The only one currently available in Russia mechanical bacterial lysate. This is a more effective and safe preparation compared to chemical lysates. The cost is at the level of other lysates, so I recommend using it. I have no personal experience with Ismigen.

It is used for the treatment and prevention of acute and subacute infections of the upper and lower respiratory tract ( bronchitis, tonsillitis, pharyngitis, laryngitis, rhinitis, sinusitis, otitis and etc.). In terms of composition and indications, Ismigen is similar to Broncho-munal (Broncho-munal P), but there are differences in the method of administration ( just under the tongue!) and minimum age (allowed from 3 years old).

Ismigen contains mechanical lysates of bacteria:

• Staphylococcus aureus (Staphylococcus aureus),
• Streptococcus pyogenes (pyogenic streptococcus),
• Streptococcus viridans (green streptococcus),
• Streptococcus pneumoniae - pneumococcus (types TY1/EQ11, TY2/EQ22, TY3/EQ14, TY5/EQ15, TY8/EQ23, TY47/EQ 24),
• Klebsiella pneumoniae,
• Klebsiella ozaenae,
• Haemophilus influenzae b (Haemophilus influenzae),
• Neisseria catarrhalis.

In general, a typical set of bacteria for drugs in this group.

Ismigen is taken on an empty stomach and only under the tongue, where the tablet is kept until completely dissolved ( cannot be absorbed, chew, swallow). Children 3-6 years of age during each dose, until the tablet is completely dissolved in the mouth, should be under adult supervision.

• Acute and subacute infections of the upper and lower respiratory tract - 1 table / day until the symptoms of the disease disappear (at least 10 days).
• Recurrent infections of the upper and lower respiratory tract, prevention of exacerbations of chronic respiratory diseases - 1 tab./day for 10 days.
• The prophylactic course includes 3 cycles of 10 days with 20-day intervals between them. A preventive course should be carried out no more than 1-2 times a year. If you miss taking the next dose, do not double it at the next dose.

Side effects are very rare. Despite the higher safety of Ismigen compared to IRS-19, I would recommend taking at least a short 10-day course of Galavit before prescribing Ismigen (taking Galavit only on even numbers or only on odd numbers). This will increase the efficiency and safety of Ismigen.

Ribomunil is not strictly a bacterial lysate, but it can be well attributed to this group of drugs. It is used for the prevention and treatment of recurrent infections of the ENT organs ( otitis media, sinusitis, rhinitis, pharyngitis, laryngitis, tonsillitis) and respiratory tract ( chronic bronchitis, tracheitis, pneumonia, infectious-dependent bronchial asthma) in adults and children older than 6 months.

Ribomunil contains:

• ribosomes of Klebsiella pneumoniae, Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae,
• membrane proteoglycans (including Klebsiella pneumoniae).

Ribosomes are cell organelles in which proteins are synthesized from amino acids based on the genetic information of RNA.

accepted inside in the morning 1 time per day on an empty stomach Allowed from 6 months. A single dose (regardless of age) is 0.75 mg. Available in granules for solution and tablets.

Is mechanical bacterial lysate. Respibron can only be bought in Ukraine. It is not registered in Russia and Belarus.

Each tablet contains 6 billion units of bacteria of each type:

• Staphylococcus aureus,
• Streptococcus viridans,
• Streptococcus pyogenes,
• Klebsiella pneumoniae,
• Klebsiella ozaenae,
• haemophilus influenzae,
• Neisseria catarrhalis,
• Diplococcus pneumoniae (1 billion units of 6 types each: TY1/EQ11, TY2/EQ22, TY3/EQ14, TY5/EQ15, TY8/EQ23, TY47/EQ24).

Approved for adults and children from 2 years old. It is taken under the tongue, where it is held until completely dissolved. Children are allowed to crush the tablet and dissolve in a small amount of drinking water (about 10-15 ml). Usually used 1 tablet per day for 10 days. Prophylactically, 3 courses of administration are carried out for 10 days with an interval of 20 days.

The price of Respibron in Kyiv December 7, 2015: 130-550 UAH (large price range) for 10 tablets.

Mechanism of action and prospects for lysates

This section is complex and is for reference only. It can be skipped.

First, let's see what's different mechanism of action on immunity bacterial vaccines and bacterial lysates.

Bacterial vaccines form acquired (specific) immunity to given antigens with the formation of memory cells (a type of long-lived B-lymphocytes capable of producing a large number of antibodies in a short time). Vaccines are administered mainly parenterally (by injection) and at long intervals (months or years). This is a system of fine and fine tuning of the immune system, which takes about 2-3 weeks for the mass production of antibodies.

Macrophage triggers an immune response

Microorganisms and their particles are captured, absorbed, rendered harmless and "digested" by professional cells-devourers - macrophages. This process is called phagocytosis(from Greek phagos - devour). Having digested particles of foreign substances and completing phagocytosis, macrophages expose the effigy of a defeated enemy, foreign antigens of bacteria on their membrane and, using the release of chemicals (cytokines), loudly inform other cells of the immune system: “ Here is our enemy!". Scientifically it is called antigen presentation. At the same time, macrophages present their own "passport" -. Macrophages play a key role in triggering the immune response to infection. They trigger various complex reactions of selection, reproduction and selection of cells of humoral and cellular immunity, and also stimulate the formation of antibodies of classes M (IgM appear at the first meeting with a new antigen), G (IgG - the main type of antibodies in the body) and A (IgA) to antigens that have been previously displayed on macrophages. Already after 2-3 weeks, upon a second meeting with the carrier of these antigens, the immune system very quickly recognizes and neutralizes them due to the specific antibodies produced, freely floating in the internal environment of the body and secreted to the surface of the mucous membranes (only IgA are secreted to the surface of the mucous membranes). When combined with an antigen, the antibody becomes a bright marker for all interested cells of the immune system, which now accurately and accurately see the enemy. Scientifically, this process of “gluing” an antibody to an antigen to facilitate phagocytosis is called opsonization. And then the enemy, which is marked with labels - opsonins, quickly destroy all immune cells with the appropriate powers (such cells are called immunocompetent).

The rate of formation of antibodies in the primary and secondary immune response

Bacterial lysates differ from vaccines by daily administration topically or orally. They stimulate first innate (nonspecific) immunity but also increase the synthesis of IgA surface antibodies. Every person has a nonspecific immune system. since birth. With the help of receptors on immune cells, the innate immune system detects certain stable structures of bacteria, viruses, fungi. These immutable microbial structures called PAMP(pathogen-associated molecular patterns) and have common properties:

1. PAMP synthesized only by microbes, their synthesis is absent in human cells; therefore, any recognition of PAMP by the host's cellular receptors is a signal of the presence of an infection in the macroorganism;
2. PAMP are vital for survival and pathogenicity microbe, so these structures are little subject to evolutionary changes. And if changes do occur in them, then usually the microbe loses its pathogenicity;
3. certain types of PAMP are characteristic for entire classes and types of microbes, for example:
   • bacterial lipopolysaccharide is found in all gram-negative bacteria,
   • lipoteichoic acids - in gram-positive bacteria,
   • peptidoglycan - in gram-negative and gram-positive bacteria,
   • RNA in viruses
   • glucans - in mushrooms, etc.

Several are now known innate immune system receptors:

1. endocytic(inside the cytoplasm of macroorganism cells) - the end result of the activation of these receptors is the formation of specific (acquired) immunity (for example, the formation of antibodies to vaccine antigens),
2. signal(on the surface of cells) - 11 types of TLR receptors (from TLR-1 to TLR-11) and 2 NOD receptors (NOD1 and NOD2) are now known.

The 10 types of TLR receptors of the innate immune system recognize almost all known PAMPs of Gram-positive and Gram-negative bacteria, viruses, and fungi. The end result of activation of the signaling (surface) receptors of the innate immune system is synthesis of pro-inflammatory cytokines (interleukin-1, interleukin-2, -6, -8, -12, tumor necrosis factor alpha, interferon gamma), acute-phase proteins, inflammatory enzymes, etc. As a result, all cells of the immune system enter an activated state with stimulation of their functions, and phagocytosis and destruction of microbes also increase.

The most interesting thing is that the preparations (containing 18 species and serotypes of bacteria) and Broncho-munal(containing 8 species of bacteria) act only on 5 receptors of the innate immune system (TLR-2, -4, -9 and NOD1-2). Thus, all bacterial lysates contain many unnecessary and even toxic substances, which increases the cost of the drug and increases the risk of side effects. In the future, drugs will be developed that act only on the required receptors (TLR and NOD) and do not contain foreign substances. For example, a drug has been developed and used Likopid, which acts only on NOD2 receptors. Likopid consists of a natural disaccharide ( glucosaminylmuramyl) and a synthetic dipeptide attached to it ( L-alanyl-D-isoglutamine). These structures are part of the peptidoglycan of all known Gram-positive and Gram-negative bacteria.

Speaking in this section about the differences between vaccines and lysates, I briefly recounted.

My opinion is: chemical lysates are already being replaced by more efficient and safer mechanical ones. However, a complete replacement of bacterial lysates with a set of preparations such as Likopid will not happen soon. Lysates activate not only the innate immune system, but also specific immunity. This is confirmed by the increased synthesis of surface immunoglobulins (antibodies) of class A (IgA), which protect the mucous membranes from infection. At the moment, I do not see an alternative to bacterial lysates.

General conclusions

1. Bacterial lysates according to the production method are chemical (IRS-19, Imudon, Broncho-munal, Broncho-Vaxom) and mechanical (Ismigen, Respibron). Separately worth .
2. In mechanical lysates, bacterial cells are more correctly fragmented, so mechanical lysates show higher efficiency and safety. Children fall ill with acute respiratory infections much less frequently.
3. The bacterial lysates described above are used for the prevention and treatment of recurrent diseases of the respiratory tract and ENT organs ( rhinitis, sinusitis, pharyngitis, tonsillitis, laryngitis, tracheitis, bronchitis and etc.). Purpose of application - prevention of purulent bacterial complications of acute respiratory infections. I recommend using or , and with prolonged purulent rhinitis - .
4. Bacterial lysates can be contraindicated in autoimmune diseases because they are immunostimulants. They can be used for allergic diseases, if there is no allergy to the lysate itself.
5. The condition of the child or adult may worsen ( fever, increased symptoms), if during the period of an acute infectious disease one begins to actively use a bacterial lysate and thereby overload the immune system with antigens.
6. Immunomodulator Galavit normalizes the state of the immune system and improves the quality of antibodies, accelerating recovery from any infection. In case of an infectious disease, a course of Galavit is desirable for 2-3 weeks or 30 days. If the patient is healthy, before prescribing the lysate, a short 10-day course of Galavit is sufficient. Tablets are preferred as the most convenient, simple and safe way to administer Galavit.
7. Do not use bacterial lysates in early days of infection or exacerbations. They can be used only when the patient's condition is stable, when there is no fever and when there is no obvious dynamics of the disease for several days (it does not get better or worse).
8. The use of probiotics and prebiotics (drugs that restore intestinal microflora) can reduce the number of SARS by 25%, but this is a topic for a separate article.