Should a child take Suprastin before the Mantoux test?

Who needs to take antihistamines before vaccination?

Of course, for children prone to allergies.
Predisposition to pathology is due to several factors:

• if mom or dad are allergic;
• if after any vaccination the appearance of a rash and redness has already been noted;
• if the child is sensitive to food.

For example, an inadequate reaction to chicken eggs or yeast may subsequently manifest as an allergy to a vaccine against measles, influenza, rubella, yellow fever, hepatitis B, or mumps.

In this case, an upset stomach in the absence of other reasons is also a sign of an allergy. DPT vaccination deserves special attention. It causes the most fear among parents. Indeed, the Russian version of the vaccine contains dead cells of pathogens.

Even in non-allergic children, in 15-20% of cases the following are observed:

• elevated temperature;
• swelling at the injection site;
• lethargy;
• lack of appetite;
• worsening mood.

The following serious consequences may also occur:

• rash;
• fever;
• Quincke's edema;
• inflammation of blood vessels;
• anaphylactic shock.

The foreign analogue of the vaccine (Pentaxim) consists of the protein of the whooping cough microorganism and derivatives of tetanus and diphtheria toxins with antigenic properties. It is usually easier to tolerate and asymptomatic.

The risk of allergies after vaccination is quite high. Therefore, you should not neglect taking antihistamines for preventive purposes. It definitely won't get any worse.

What side effects are possible?

From the moment of tuberculin administration until the result is assessed, 72 hours must pass. Usually this period proceeds easily, without any worries. However, in some cases, side effects are possible, so parents need to pay special attention to the child during this period of time and monitor the general condition of the child.

In some cases, there may be unpleasant sensations that can cause discomfort. We are talking about redness and itching of the skin at the site of tuberculin injection, sometimes there is slight swelling of the tissue.

The following reasons cause this reaction:

• individual intolerance to tuberculin, severe allergic reaction to the drug;
• unaccounted for contraindications for the test (the test was carried out against the background of an existing infection, or not enough time has passed since the illness);
• infection through an injection wound (when the test site was subjected to excessive mechanical stress - friction, scratching).

To reduce an excessive allergic reaction, the child can be given an antiallergic drug.

To prevent infection, you need to convince the child not to touch or scratch the injection site. Of course, a teenager will listen to advice in this regard, but if the baby is a year or two old, it is extremely difficult to explain this to him. In this case, an adult needs to pay special attention to the baby to prevent any impact on the hand. Long sleeves will also help with this.

If antiallergic drugs do not help, the symptoms do not go away, but, on the contrary, worsen, the child feels unwell, the temperature rises, the baby complains of pain in the arm on which the test was performed, it is necessary to urgently consult a doctor.

Taking Suprastin before a tuberculin test

To eliminate the risk of an incorrect reaction to the tuberculin test, Suprastin should be taken before Mantoux. As mentioned earlier, an antihistamine is used seven days before the tuberculin test. It is not recommended to take Suprastin for five days.

To detect the presence of a pathogenic microbe (Koch bacillus) or immunity to the tuberculosis bacillus in a child’s body, it is necessary to perform a test. Depending on the result it gives, we can talk about further actions. Tuberculin is an allergen. After injecting it into the skin at the injection site, unique lymphocytes are released from the circulatory system. They are responsible for cell immunity and are also sensitized to the tuberculosis pathogen. Because of this, an inflammatory process begins at the injection site.

Instructions

Suprastin before Mantoux should not be used in the following cases:

1. exacerbation of bronchial asthma;
2. bearing a fetus;
3. breastfeeding;
4. prophylaxis cannot be carried out with Suprastin in the form of tablets if the child is under three years old;
5. lack of lactose;
6. lactose intolerance;
7. glucose-galactose malabsorption syndrome;
8. hypersensitivity to drug components.

The dosage of drugs for children is as follows:

• for babies under one year of age, 1/4 tablet 2-3 times a day - always in powder form;
• children under six years of age: 1/4 tablet 3 times a day, or half a tablet twice a day;
• for children from six to fourteen years old, half a tablet 2-3 times a day.

Is it necessary to give antihistamines after Mantoux?

After Mantoux, antihistamines are most often recommended on the day of the skin test. Their pediatrician may prescribe them for severe itching and swelling at the injection site. For children with a tendency to allergic reactions, the drugs are used 3-5 days after the test with tuberculin.

If the child does not have any manifestations of nonspecific allergies, then antihistamines after Mantoux will not help in reducing the size of the papules.

We recommend reading about the dangers of the big Mantoux. From the article you will learn how to correctly assess the size of Mantoux, the reasons for enlarged Mantoux in a child, what to do with a large papule. And here is more about the real and imagined consequences of Mantoux.

Suprastin before Mantoux is used to eliminate the influence of allergies on the test result. Tablets are given 3 days before diagnosis, for itching and swelling - on the day of the test, for allergy sufferers and 3 days after.

Patients' opinions

Reviews from people using these drugs:

I am a mother of two children. And it so happened that both children (two and a half years age difference) have been suffering from atopic dermatitis and allergies since birth. With my first child, I tried quite a lot of different antiallergic drugs, from syrups to ointments, including Zyrtec, but practically nothing helped. Even the vaunted Zyrtec left nothing but negative emotions.

I don’t remember who, and in what circumstances, advised me to Zodak, a drug with the same active ingredient as Zyrtec. But I remember for sure that the transition from one means to another was spontaneous and not planned.

And after a very short time, I saw the long-awaited positive result, which not only relieves allergy symptoms, but completely relieves children from them.

In conclusion, I want to say that Zyrtec is an expensive and useless drug against atopic dermatitis.

Elena, 42 years old

When my child (8 years old) had a runny nose that did not go away for a long time, the ENT doctor prescribed Zyrtec drops. Arriving at the pharmacy, the pharmacist advised me to buy an analogue of this medicine called Zodak, which cost almost twice as much. The active ingredient of both the first and second drugs is cetirizine, which, in turn, contains cetrin.

On the advice of the pharmacist, I purchased the second option, and did not regret it at all. Already in the first days of treatment, it became much easier for the child to breathe.

A year and a half later, history repeated itself, I went to the pharmacy for a cheap Zodac, but it wasn’t there, and I had to buy Zyrtec. The effectiveness of the action was similar to the first case, only more expensive.

Christina, 40 years old

I have been suffering from seasonal allergies for a long time. On the recommendation of a doctor, I bought Zodak, and after a while its analogue. Both methods were effective

The only thing I noticed was the slight difference in price

Sergey, 31 years old

Contraindications and possible side effects

Zyrtec and its analogue Zodak are the latest means for the prevention and relief of allergies. The active element of the drug - cetirizine - is considered relatively safe, non-hormonal, anti-inflammatory.

The instructions spell out a number of negative effects. Among them:

• headache;
• drowsiness;
• malaise;
• insomnia;
• diarrhea;
• runny nose;
• problems with urination;
• rash, itching and many others.

The list is scary. However, according to reviews, these adverse reactions are usually not observed in patients. The main thing is to take the medicine exactly as prescribed.

Particular care should be taken with newborns. Zyrtec has a depressant effect on the central nervous system, which can result in sudden death of the infant

Provoking factors are considered:

• prematurity, low birth weight;
• if the mother is under 19 years old;
• smoking, taking drugs during pregnancy and after childbirth. Smoking people in the house;
• if one of your close relatives has had sleep apnea syndrome;
• if the child sleeps face down.

The manufacturer indicates that Zyrtec is contraindicated in children with:

• hypersensitivity to the components of the drug;
• galactose intolerance;
• up to 6 months of age.

The last point is not as clear as it seems. Taking anti-allergenic drugs in children with a high risk of developing complications after vaccination is in most cases justified.

Opinions about drugs

Reviews from people taking Zyrtec or Fenistil:

During pregnancy, I was diagnosed with atopic dermatitis. It is no secret to many that with a 90% probability it is passed on to the unborn child. Unfortunately, this is what happened. From the first months of her life, rashes and redness were observed on my daughter’s body. The doctor prescribed Fenistil. The gel did not negatively affect the child’s condition; the symptoms gradually subsided. For prevention, we took drops for up to four years.

After this, the manifestations became more acute and Fenistil helped, but not enough. I couldn’t watch the baby suffer, and decided to consult a doctor about a stronger drug. We were prescribed Zyrtec. Its effect was very fast, the baby also felt good and did not complain about anything. From time to time we took it for seven days, then took a break and came back again. It got a lot better.

Natalya, 25 years old

My daughter is 11 years old. My relatives recently arrived from Thailand and brought various goodies. The whole family was very happy and started trying. After some time, my daughter developed a rash, runny nose and itching on her body. We did not connect this with delicacies and thought that this was a manifestation of seasonal allergies; it was spring in full swing, everything was blooming. We decided to buy Zyrtec. She drank for a while and began to help immediately. After seven days she went outside and did not experience any discomfort.

There were still some sweets left, and after eating them my daughter felt sick again. We ran out of Zyrtec, so we decided to try Fenistil. It took a little longer to see the effect, but it helped. Therefore, both drugs are good if you follow all recommendations for use.

Olga, 30 years old

I suffer from allergic rhinitis. This is very unpleasant, from time to time it is difficult even to sleep at night. The doctor recommended Zyrtec tablets. The effect was felt almost instantly, but for work I had to go abroad for a while. I forgot my favorite pills, and a colleague advised me to try Fenistil, supposedly an analogue with a similar effect. She gave me the pack. True, the action was good, but I was really looking forward to coming home. At conferences, I wanted to sleep, couldn’t concentrate, and often in the evening I simply passed out, forgetting about most of the things I was doing.

Anastasia, 41 years old

Despite the fact that Zyrtec and Fenistil are very similar, they need to be approached individually. It is impossible to say which one copes better with allergy symptoms, because the reaction of each person’s body is different. To decide on your choice, you need to consult a doctor, who will advise based on your current health condition.

Preparation for the procedure

The main condition for conducting a test for tuberculosis is the exclusion of possible contraindications, such as:

• infectious diseases during the course, as well as a month and a half after the illness;
• skin diseases during exacerbation;
• allergies, atopic dermatitis;
• epilepsy;
• manifestation of a violent allergic reaction when the child is given the first test - in this case, alternative diagnostic methods will be used.

In addition, it is unacceptable to do a tuberculin test at the same time as other vaccinations.

If there are other diseases, including chronic diseases, the decision on the possibility of conducting the test is made by the doctor. Thus, hydronephrosis - a kidney disease - will not be a contraindication to Mantoux.

If there are no contraindications, then the question of how to prepare a child for Mantoux will not cause difficulties: it is enough to follow a number of simple recommendations:

1. A few days before the procedure, avoid visiting crowded places to avoid accidentally contracting a viral infection. It should be taken into account that the incubation period of the disease can last up to 10 days, and the Mantoux test against the background of the disease can provoke complications, in addition, it itself will most likely turn out to be uninformative. Immediately before the Mantoux test, the baby must be examined by a doctor and given permission to conduct the test.
2. The child should be well-fed and calm at the time of the procedure; the baby should be given a good night's sleep. The diet for the week before the test date should be familiar; you should not introduce new foods at this time; it is better to avoid the consumption of foods and drinks that can cause allergies. If you are allergic to pollen from flowering plants, it is better to postpone the test a month before or after the flowering period.
3. If a child is allergic, you need to make sure that at the time of the Mantoux reaction he does not have any allergic manifestations: the skin should be clean, without rashes and redness. For preventive purposes, such a patient can be given antihistamines 2-3 days before the tuberculin test (it is not recommended to use first-generation drugs, for example, suprastin; it is better to consult a pediatrician).
4. Constipation at the time of the procedure can cause side effects, so parents need to make sure that the child’s intestines are free. Lactose will help improve intestinal function.
5. On the day of the Mantoux reaction, it is necessary to minimize the child’s interaction with other children in the clinic. The best option is if the baby spends the waiting time on a walk. This measure is also aimed at preventing possible infection with acute respiratory infections or acute respiratory viral infections.
6. After administering tuberculin, you need to observe the baby’s reaction for half an hour; during this time it is better not to go far from the clinic: if the child experiences any alarming reaction during this time, you should immediately consult a doctor.
7. To avoid the child’s excessive attention to the injection site, it is recommended to choose clothes made from natural fabrics with long, loose sleeves. This will protect the “button” from unwanted friction and moisture.

After the Mantoux test is done, it is necessary to ensure the child a calm emotional state and a gentle daily routine, and avoid unnecessary physical and psychological stress. Nutrition should also remain familiar; it is better to prepare familiar food for the child without experimenting with the introduction of new products.

How do the drugs differ?

The differences between the drugs are presented in the table below.

If a child overdoses, the first thing you need to do is call an ambulance. Then cleanse your stomach and give you two tablets of activated charcoal to drink.

After this, doctors will determine the degree of risk and, if necessary, refer the child to the hospital for further measures.

If an increased dosage has caused a pathological condition in an adult, the first action should be gastric lavage and inducing vomiting.

Next, activated carbon or some other absorbent drug is also used.

Overdose can also manifest itself in central nervous system disorders. In this case, you should immediately call an ambulance, especially if you observe:

• convulsions;
• psychosis;
• breathing disorders.

First of all, an ambulance should be called in cases of even minor pathological conditions after an overdose in:

• children;
• pregnant women;
• elderly people.

This must also be done if, after first aid, the condition has not changed or has worsened, the person cannot control his condition, he becomes non-verbal, there is a high body temperature or fever, there are sharp jumps in blood pressure, and there are disorders of the urinary system.

Further treatment is carried out based on noticeable symptoms.

Medicines for children

Despite the fact that Zyrtec and Zodak are available in pharmacies without a prescription, treatment of children for allergic reactions with such medications should be carried out strictly as prescribed by a doctor. It is he who prescribes the dosage regimen and dosage during the consultation.

In addition, the course of treatment with these antiallergic drugs should be carried out strictly under medical supervision. This is explained by the fact that children’s immunity is not yet fully formed, and the effect of allergens on a fragile body can be unpredictable. This is especially true for children under five years of age.

Since both medications have the same active substance, they can be prescribed equally to young patients who suffer from the following diseases:

• food allergies;
• hay fever;
• atopic dermatitis;
• asthma.

Despite the same active substance, the drugs contain various auxiliary components, which also need to be taken into account when prescribing to children.
Thus, the Zodak consists of the following additional elements:

• metal parahydroxybenzoate;
• glycerol;
• propyl parahydroxybenzoate;
• propylene glycol;
• sodium saccharinate dihydrate;
• sodium acetate tridigrate;
• glacial acetic acid;
• purified water.

In turn, the composition of Zyrtec is distinguished by the presence of elements such as sodium acetate, methylparabenzene and propylparabenzene.

Therefore, before prescribing one of these medications to children, you need to make sure that they do not have hypersensitivity to these components.

When it comes to side effects, the two drugs may behave differently.

When taking Zodak, children may experience the following adverse reactions:

• lethargy or, conversely, excessive excitement;
• decreased psychomotor abilities, therefore, children taking this drug are not recommended to ride a bicycle or other children's mechanical device;
• the appearance of nausea, in rare cases vomiting;

Zyrtec, unlike its analogue, has fewer side effects, which appear exclusively in case of overdose and are expressed in the appearance of dry mouth or drowsiness.
The two antiallergic drugs have the same dosage, which is:

• for adults and adolescents over twelve years of age – 1 tablet or 20 drops of solution once a day;
• for children from six to twelve years old – half a tablet or 10 drops of solution twice a day;
• for children from two to six years old – a quarter of a tablet or 5 drops of a solution twice a day;

One should not lose sight of the fact that Zodak can be used in children over two years of age, while Zirtec can be prescribed in children over one year of age.

There are exceptions when the attending physician, in order to increase the medicinal properties of a particular drug, can reduce or increase the dose for each patient individually.

As can be seen from the above characteristics, both drugs are equally effective, and also have the same indications and dosage for use in children. However, Zyrtec has fewer side effects, and therefore it is prescribed by doctors more often than its counterpart.

Necessary measures for correct readings

In addition to the fact that it is necessary to use antihistamines, the following rules must also be observed:

1. Get examined by a pediatrician or phthisiatrician. He will help you decide whether you need to take antihistamines before Mantoux. He will also clarify on what days the test is taken.
2. It is necessary to follow a special diet to avoid causing an allergic reaction.
3. Before the tuberculin test, it is necessary to measure body temperature. It should not exceed normal.
4. Before the tuberculin test, you need to be examined again by a pediatrician.

If you follow all of the above measures, the Mantoux reaction will give the correct results.

How is a tuberculin test performed?

After the doctor examines the child and gives permission, the child is sent to the treatment room, where the procedure will take place. For young patients, the test is done in a clinic at their place of residence, for preschool children and school students - in an educational institution, without interrupting the learning process.

Tuberculin is injected subcutaneously, from the inside of the forearm. For injection, a syringe with a thin needle is used. For a skin test, 0.1 ml of the drug is sufficient. Immediately after administration, a small compaction, the so-called button, forms at the injection site, which resolves after some time.

72 hours after administration of the drug, the physician evaluates the resulting reaction.

There are four types of reaction:

• negative - when there is no redness or swelling at the injection site;
• doubtful or controversial - the size of the papule is no more than 4 mm, slight redness and hyperemia are possible;
• positive - can be mild, moderate or pronounced. The severity of the reaction is determined by the size of the papule: from 5 to 9 mm for mild ones and 15-16 mm for severe ones;
• excessive (hyperergic) - papule more than 16 mm, vesiculo-necrotic manifestations are possible.

It is also possible to obtain a false positive reaction. This happens most often if the rules of the procedure were violated.

In addition to the above indicators of the Mantoux reaction, there is also such a thing as the turn of the tuberculin test. This indicator indicates a sharp change in the test result compared to the result of previous years. Identification of a tuberculosis test, as well as a hyperergic reaction, serves as a reason to refer the patient for a consultation with a phthisiatrician.

If moderate and severe indicators of the Mantoux reaction have been observed for several years, consultation with an infectious disease specialist and a phthisiatrician is also necessary. The patient will be prescribed a repeat test and additional examinations: tests, x-rays of the lungs.

Any reaction should only be assessed by a qualified healthcare professional. A positive reaction does not mean that the patient definitely has tuberculosis. Additional examination is necessary.

Otseka Mantu

Allergies of a nonspecific nature, which are affected by Suprastin and other antihistamines, appear within a few minutes. It is in this regard that when these drugs are used on the first day, the tuberculin test is weak. But diagnostic indications are checked only three days after the injection. This occurs after a specific cell immune reaction has manifested itself. In this regard, taking antihistamine drugs does not affect the indications.

After the primary vaccination and revaccination with the Calmette-Guerin bacillus, lymphocytes appear in the baby’s body, which for a long time “remember” the pathogenic microbe initiator and are in eternal preparation for the next hit of the Koch bacillus. This is the resistance of the immune system to tuberculosis. The immune response to an infectious bacterium entering the body will be powerful and effective. It can instantly destroy the pathogenic microbe.

Mantoux - why and when?

Even in the maternity hospital, a newborn baby is given a BCG vaccination, the purpose of which is to develop immunity against tuberculosis. Why such urgency?

The fact is that the incidence of tuberculosis today is very high; you can encounter the tuberculosis bacillus, the causative agent of the disease, almost everywhere. The gender, age, and social status of people with tuberculosis break the stereotypes that this disease is the fate of disadvantaged sections of the population.

Mycobacterium tuberculosis is highly resistant to external factors, and therefore is able to survive and remain active in the external environment for a long time. And in order to protect a newborn child from infection, they are vaccinated with BCG, designed to develop a stable immunity to tuberculosis in the body.

And when the child reaches the age of 12 months, they begin to evaluate the acquired immunity using the Mantoux test. This measure also helps to identify the presence of tuberculosis in the early stages if infection does occur.

This is one of the few ways in which you can determine the development of tuberculosis at an early stage. After all, the disease begins without the manifestation of any symptoms, and without regular preventive diagnostics, it is possible to determine the disease at a rather advanced stage, which greatly complicates treatment. Therefore, this test should be carried out regularly, usually once a year, and in some cases every six months (for people at increased risk of contracting tuberculosis).

Mantoux is not a vaccine! It will not provoke the disease, nor is it capable of developing immunity to it. With its help you can only check the body's reaction to the pathogen.

So, to conduct the Mantoux test, the child is injected subcutaneously with tuberculin, a drug created from dead mycobacterium tuberculosis. In response, T-lymphocytes accumulate from the blood vessels of the skin at the injection site, but only those who have already “met” the causative agent of the disease, forming a compaction, the so-called papule. If Koch's bacillus is present in the body, there will be many such lymphocytes, and the papule will have an increased size.

The resulting reaction is estimated as:

• negative;
• doubtful;
• positive;
• false positive.

With this diagnostic method, a false negative response is excluded due to the 100% sensitivity of the test.

Since this diagnostic method involves the introduction of a drug into the body, side effects from this procedure cannot be excluded, most often associated with an individual allergic reaction to the drug. Proper preparation for Mantoux will help reduce the risk of such reactions: it is recommended to prepare for the procedure 2-3 days before the appointed date.