Changsha Evening News, Changsha, December 15 (Quan** reporter Peng Fang, correspondent Li Na) Recently, respiratory infectious diseases such as influenza and Mycoplasma pneumoniae infection have entered a high incidence season. Due to changes in respiratory and immune function during pregnancy, pregnant women are at higher risk and more severe of respiratory tract infections than the general population. Many pregnant women are concerned about whether they can get relevant vaccines during pregnancy, and how to use drugs if they are infected with respiratory infectious diseases. Today, Xiao Di, pharmacist in charge of the Department of Pharmacy of Xiangya Hospital of Central South University, answered these questions.
It is recommended to start taking oseltamivir within 48 hours of the onset of the flu.
The clinical presentation of influenza in pregnant women is similar to that of the general population, but symptoms are usually more severe. Typical initial manifestations are chills, sudden fever, dry cough, and myalgia. The temperature of fever is usually 378℃～40.0 , accompanied by sore throat, nausea, headache, etc.
At present, the anti-influenza virus drugs that pregnant mothers can use are neuraminidase inhibitors, including oseltamivir (oral preparation), zanamivir (inhaled preparation), and peramivir (intravenous preparation), which are effective against influenza A and B. Oseltamivir is the most widely used anti-influenza virus drug for pregnant women because it is easy to take orally. The administration is 75 mg each time, 2 times a day, for 5 days. Severe patients can adjust the dose and course of treatment according to the doctor's instructions. It is recommended to start within 48 hours of the onset of illness, and early initiation can reduce flu complications, reduce the risk of severe disease, and shorten the length of hospital stay. Patients with severe disease who have had more than 48 hours of onset may still benefit from antiviral**.
Azithromycin is the first choice for Mycoplasma pneumoniae infection in pregnant women.
Mycoplasma pneumoniae is a common respiratory pathogen. Upper respiratory tract infections and acute bronchitis are common manifestations of Mycoplasma pneumoniae infection, and pneumonia can also occur. Respiratory symptoms are most prominent in dry cough, which often lasts for more than 4 weeks, and is often accompanied by obvious sore throat, occasional chest pain, and blood in the sputum. Most of the systemic symptoms are mainly low-grade fever and fatigue, and some patients may have sudden high fever accompanied by obvious headache, myalgia and nausea and other systemic poisoning symptoms.
Macrolides are the drugs of choice for Mycoplasma pneumoniae infection in pregnant women, such as azithromycin, erythromycin, and roxithromycin. Among them, azithromycin is currently the most widely used drug in pregnant women due to its relatively low resistance rate, good safety and low administration frequency among similar drugs. The recommended usage is 05 grams, once a day, for 3 days. It is also possible to use the first day 05 g, 2nd 5 day 025 grams, once a day, for 5 days. Severe patients can follow the doctor's advice to extend the course of treatment appropriately.
Respiratory infections are "common symptoms" with this medication.
The "common symptoms" that may occur in respiratory tract infections include fever, chills, headache, body aches, nasal congestion, runny nose, sore throat, cough, etc. In response to these common symptoms, Xiao Di gave medication recommendations for pregnant women (pictured).
Influenza vaccine can be given at any stage of pregnancy, and it can be given as early as possible.
Pregnant women should do a good job in the prevention of respiratory infections, mainly wearing masks, washing hands frequently, ventilating more, and gathering lessAvoid contact with people with respiratory infections;Balanced nutrition, adequate water intake, sleep and warmth. As soon as symptoms of respiratory infection appear, seek medical attention as soon as possible to determine the type of infection.
The antiviral drug oseltamivir can be used prophylactically if a pregnant woman has been in close contact with someone with suspected or confirmed influenza A infection (1 day before symptom onset and 1 day after resolution of fever). The dosage is 75 mg once a day for 7 to 10 days. There is insufficient evidence to suggest that pregnant women exposed to Mycoplasma pneumoniae infection require antibiotic prophylaxis.
Many people are concerned about whether they can get vaccinated during pregnancy. Xiao Di introduced that in order to reduce the risk of influenza and serious complications in pregnant women, the "Technical Guidelines for Influenza Vaccination in China (2023-2024)" recommends that pregnant women can receive influenza vaccine at any stage of pregnancy, and can be vaccinated as soon as possible. The influenza vaccines approved for marketing in China include trivalent inactivated vaccine (IIV3), trivalent live attenuated vaccine (LAIV3) and quadrivalent inactivated vaccine (IIV4), and pregnant women can choose trivalent or quadrivalent inactivated vaccine. Live-attenuated vaccines contain live, attenuated influenza and are contraindicated in pregnant women. There is currently no vaccine for the prevention of Mycoplasma pneumoniae infection.
Xiao Di especially reminded that women of childbearing age should avoid using a drug called "ribavirin" regardless of whether they are trying to conceive or not. This drug is used for viral pneumonia and bronchitis caused by syncytial virus, and has definite reproductive toxicity. Women should avoid pregnancy during ribavirin** and for 9 months after discontinuation, and female partners of male patients taking ribavirin** should avoid pregnancy for 6 months.