ANTIBACTERIAL THERAPY IN OUTPATIENT TREATMENT OF RESPIRATORY TRACT INFECTIONS IN CHILDREN

The study was aimed at analyzing prescriptions of antibacterial drugs for outpatient treatment of respiratory tract infections in children. Patients and methods. The study involved patients with acute respiratory tract infections: 158 children were undergoing outpatient treatment, whereas 30 children were being treated at the polyclinic day hospital. The children aged from 3 months to 15 years. Acute rhinopharyngitis, acute laryngitis, acute bronchitis, tonsillitis and pneumonia were registered in 66.5, 2.6, 18.1, 11.7 and 1.1% of cases. We appraised indications for antibacterial therapy, prescription terms, therapy duration and choice of an antibacterial drug. Results. Antibacterial therapy prescription was found unreasonable in 44.0% of acute rhinopharyngitis cases, 41.1% of acute bronchitis cases and 60.0% of acute laryngitis cases. In the first day of diagnosis establishment, antibiotics were prescribed in 63.8 and 100% of cases at pediatric divisions and day hospitals, respectively. The unreasonable antibiotic prescription rate in infants was 66.7% - significantly higher than in 1-7-year-old children (p < 0.05). The most frequently (66.4%) prescribed class of antibacterial drugs at pediatric divisions was penicillins (amoxicillin, amoxicillin clavulanate); at day hospitals, they were prescribed in 23.3% of cases (p < 0.01). Use of cephalosporin antibiotics as the initial therapy was significantly higher at day hospitals than at pediatric divisions (P < 0.01); the drug was administered parenterally in 90% of cases. Antibiotic prescription courses did not exceed 5 days in most cases (60.1%). Conclusions. We revealed high rate of unreasonable antibiotic use for outpatient treatment of acute rhinopharyngitis, laryngitis and acute bronchitis, especially at day hospitals and in infants.

1. Tatochenko V. K. Bolezni organov dykhaniya u detei: prakticheskoe rukovodstvo [Respiratory Tract Diseases in Children: Practical Guidance]. Moscow, Pediatr"". 2012. 480 p.

2. Outpatient use of antibiotics in children. Practical recommendations. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical microbiology and antimicrobial chemotherapy. 2007; 9 (3): 200–210.

3. Ponomareva Yu. V. Lekarstvennyi vestnik = Pharmaceutical bulletin. 2011; 1 (41): 19–27.

4. Namazova L. S., Botvin'eva V. V., Torshkhoeva P. M. et al. Pediatricheskaya farmakologiya = Pediatric pharmacology. 2005; 2 (1): 3–7.

5. Likhoradochnye sindromy u detei. Rekomendatsii po diagnostike i lecheniyu (seriya «Klinicheskie rekomendatsii dlya pediatrov») [Fever Syndromes in Children. Recommendations on Diagnosis and Treatment (Edition “Clinical Recommendations for Pediatricians”)]. Moscow, Union of Pediatricians of Russia, 2011. 288 p.

6. Ostrye respiratornye zabolevaniya u detei: lechenie i profilaktika. Nauchno-prakticheskaya programma Soyuza pediatrov Rossii [Acute Respiratory Diseases in Children: Treatment and Prevention. Theoretical and practical program of the Union of Pediatricians of Russia]. Moscow, 2002. 69 p.

7. Namazova L.S., Tatochenko V.K.,Bakradze M.D., Volkov K.S. et al. Meditsinskii sovet = Medical advice. 2007; 1: 20–24.