N–Acetylcysteine: drug with clinical effectiveness during some respiratory tract diseases

Ekaterine Chkhartishvili*, Lia Jorjoliani**, Rusudan Karseladze**

*Children’s Clinical Hospital #1, Tbilisi, Georgia;
**S/R Institute of Pediatrics, Tbilisi, Georgia

Mucolytic agents are well known and frequently prescribed drugs in children with different respiratory tract disorders. But their role in the treatment is still controversial. As it is proved that N-acetylcysteine reduces viscosity and adhesiveness of mucous sputum, facilitates expectoration of thick mucus as well as prevents accumulation and penetration of infection in sputum and hence, increases effectiveness of other agents, we carried out the study to find out whether N-acetylcysteine has some beneficial clinical effect in children with respiratory tract diseases. To evaluate the clinical effectiveness of N–acetylcysteine (ACС; HEXAL, Germany), an open type clinical observation study of 50 patients was carried out during 2002 – 2005 years period, from 22 months to 15 years old. Among them 15 (30%) [I group] were the patients with acute obstructive bronchitis, 15 (30%) [II group] with recurrent obstructive bronchitis and 20 (40%) [III group] with bronchial asthma. All patients received relevant treatment according to disease management. As an adjunctive drug for mucolytic capacity ACС was included for 8 ± 2days, three times a day, after meal. After first signs of clinical improvement the dosage were reduced to half doses. All patients underwent routine laboratory testing; for bronchial asthma patients Lung Function Test was obligatory as well. In study groups, for children with AСC prescription, treatment was associated with adrenergic agents: Salbutamol (? -2 agonist) either per os, by Nebulizer (particularly, Fenoterol) or via dose inhaler, in relevant age and mass dosage. Control group consisted of 22 months – 15 years old children with the same diagnoses, which was compromised as a homogenous group according to the basic treatment, sex and age distribution in groups by disease. Inclusion of N–acetylcysteine in the complex treatment of some respiratory tract disorders have positive influence on general conditions of patients. Its effectiveness is expressed mainly toward: 1. Children did not refuse to take the medicine, due to its good taste and water solubility. 2. For patients was much more easy to expectorate less viscid sputum. 3. The relatively short period of acute phase of illness and increased effectiveness of other drugs. 4. Side effects of ACC were minimal when used in combination with adrenergic agents. 5. Wide availability and cost – effectiveness of the treatment.

Keywords:  obstructive bronchitis, bronchial asthma, mucolytic agents and mucus plug