Scientists have formulated the principles of rational antibiotic treatment of children’s respiratory infections. The frequency of antibacterial therapy in children with uncomplicated SARS that do not require antibiotics, an average of 59.6%. The consequence of this is antibiotic resistance in children, which experts have calleda threat to national security.
The problem of unjustified frequent use of systemic antibiotics for respiratory infections in children leading Russian paediatricians, epidemiologists discussed at the round table the Principles of rational antibiotic therapy. Save antibiotics for future generations. According to the chief freelance specialist of the Ministry of health on epidemiology, head. the Department of epidemiology and evidence-based medicine of the First MGMU them. I. M. Sechenov, Nikolay Briko, the problem of antibiotic resistance strains of pathogens most common in children infectiontake is becoming a national threat.
The main individual risk factors to the presence of resistant flora in children was considered by the experts:
- antibiotics within the preceding three months
- visiting children’s preschool institutions, contact with children attending such institutions
- hospitalization within the previous 3 months
- accommodation in boarding schools, orphanages,
- conditions and diseases, accompanied by increased sensitivity to infection (and often antibiotics), such as immunodeficiency, use of glucocorticoids, cytostatics,
- diabetes, chronic respiratory diseases, treatment with dialysis
- recent travel.
According to the chief freelance specialist of the Ministry of health on childhood infectious diseases, Director of the Institute of children’s infections, academician Yuri Lobzin to restrain the growth of antibioticoresistance soblyudyeniyem rational antibiotic therapy.Peds is enough to observe simple rules: prescribe antibiotics only for bacterial infections to choose the drug, its dose, frequency and duration of administration in strict accordance with the standards and clinical guidelines, take into account the level of resistance in a specific region, as well as individual risk factors for infection with drug-resistant pathogens, said Lobzin.
Experts have formulated the main principles of rational antibacterial therapy of respiratory infections in children:
- as the starting of the drug in patients without risk factors for infection with drug-resistant vozbuditelei to amoxicillin;
- to limit the use of macrolides, assign them only for infections caused by atypical agents, or intolerance -lactams;
- do not use the oral cephalosporins of the III generation (cefixime) for the treatment of respiratory tract infections in children due to the high natural resistance of this pathogen to these drugs;
- as the starting of the drug in patients with risk factors for infection with drug-resistant pathogens and/or high probability of participation lactamaseproducing agents to use secure amoxicillin, is amoxicillin in combination with clavulanic acid.
Consequences of self-treatment
Promotes the emergence of resistant strains of microorganisms that become resistant to antibiotics and the reduction of antibacterial therapy, said the President of the Association of doctors to promote the advanced training of doctors-pediatricians, head. the Department of Pediatrics of the Russian medical Academy of postgraduate education (RMAPO) Irina Zakharova. As shown by polls were conducted by order of the Department aprorodite children up to 8 years, to medical treatment of children, the parents almost always pribegaya recommendations of pediatricians: the majority of mothers (88%) give the child antimicrobial drugs on prescription, 11% remember past experiences (a drug previously prescribed by a doctor). In General, the majority of the respondents mothers follow the doctor’s recommendations, but, nevertheless, each Chetvertaya finishes the cure of the child,allowing vozmojnostyah a course of antibiotics, with 23% of respondents inoldsmobile shorten the course of antibiotics, 3% do it always.
Irina Reznik