Eurasian Society for Infectious Diseases includes Polyoxidonium® in new recommendations for the treatment of ARVI in children

The Eurasian Society for Infectious Diseases (ESID) has published updated clinical guidelines titled "Immunotropic Treatment for Respiratory Infections in Children. Selected aspects" [ 1 ] . The document is intended for pediatricians, infectious disease specialists, and general practitioners, and defines current approaches to the use of immunotropic agents in acute respiratory viral infections (ARVI) in children. One of the medicines included in the updated recommendations is azoximer bromide (Polyoxidonium ® ), which is considered one of the medicines of choice for the treatment of intoxication syndrome and normalization of mucosal (local) immunity. ARVI remains the most common infectious disease in childhood: annual incidence in Russia reaches 17,000–18,000 cases per 100,000 children. Even though most episodes are mild, in some patients the infection becomes prolonged or complicated [ 2 ] . The updated recommendations separately identify high-risk groups, including frequently ill children, patients with chronic ENT diseases and atopic conditions, as well as young children aged 6 months to 3 years, in whom standard symptomatic therapy may be insufficient. For these patients, immunotropic treatment plays a particularly important role. Its goal is not to act directly on the virus, but rather to support and normalize the body’s immune response, reduce the risk of complications, and accelerate recovery. Such medicines may act either selectively on individual immune pathways or comprehensively, enhancing or suppressing the immune response depending on the clinical objective. In ARVI, this therapy is considered an adjunct to etiotropic treatment. The document specifically focuses on medicines that affect mucosal immunity of the respiratory tract and systemic inflammatory responses. According to the recommendations, azoximer bromide (Polyoxidonium ® ) is considered one of the medicines of choice for the treatment of intoxication syndrome in children with ARVI, as well as for supporting local immunity of the respiratory tract. Its effects on mucosal immunity parameters are noted, including the production of secretory immunoglobulin A (sIgA) and lysozyme [ 3 ] . The medicine is also included in the federal clinical guidelines of the Ministry of Health of Russia for the treatment of ARVI [ 4 ] and in methodological recommendations of the Federal Medical-Biological Agency of Russia (FMBA) [ 5 ] . "Detoxification-oriented therapy helps restore quality of life more rapidly in ARVI. Azoximer bromide works in two directions at once: it suppresses inflammation, stimulates phagocytosis, and reduces excessive formation of neutrophil extracellular traps (NETosis). In addition, due to its high-molecular-weight polymer structure, it sorbs and removes toxins from the body and, acting as a chelator, binds catalytically active iron ions (Fe²⁺), thereby blocking lipid peroxidation," explained Sergey L. Babak, Doctor of Medical Sciences, Professor of the Department of Pulmonology and Phthisiology at Moscow State University of Medicine and Dentistry [ 6 ] .

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