A.M. Milovanova (1, 2), M.D. Bakradze (1, 2), V.K. Tatochenko (1)

1) FSAI “National Scientific and Practical Center for Children’s Health”, Moscow; 2) FSBEI HE “Russian National Scientific Medical University n.a. N.I. Pirogov” of RMH, Moscow
An increase in the inflammatory marker levels is usually associated with the bacterial etiology of the disease, leading to the appointment of antacterial therapy. The study was aimed to the analysis the inflammatory markers levels – C-reactive protein (CRP) and procalcitonin –
in a viral disease, because incorrect interpretation of their increased levels can serve as the basis for the unjustified use of antibacterial drugs. A retrospective analysis of 250 case histories of children aged 12 days to 17 years 11 months hospitalized with acute respiratory viral disease in the Department of Diagnosis and Rehabilitation of the SCCH in 2016. Leukocytosis more than 15×109/l was detected in 13% of children, more often – in children with adenoviral tonsillitis (29%) and mononucleosis-like syndrome (23%). The CRP levels more than 30 mg/l was also more frequent in adenoviral tonsillitis (57% of cases) and tonsillitis caused by the Ebstein-Barr virus (50%). Among remaining ARVIs, an increase in the CRP levels was observed only in 10% of cases. The increase in the procalcitonin levels more than 2 ng/ml occurred only in 10% of the patients. In the clinic, antibacterial therapy was carried out only in 25 patients, including due to the increase in inflammatory marker levels against the background of fever (13 patients) and with the duration of fever more than 5 days (9 patients). The course of the disease in children who were prescribed and not prescribed an antibacterial drug was similar. Thus, in children with viral diseases, an increase in the inflammatory marker levels is possible, most often in the presence of tissue inflammation (tonsillitis). In case of a viral disease, the appointment of antibacterial drugs according to the indices of leukocytosis and CRP levels is ineffective.

About the Autors

Corresponding author: А.М. Milovanova – FSAI «National Scientific and Practical Center for Children’s Health», FSBEI HE RNSMU n.a. N.I. Pirogov of RMH, Moscow; e-mail:

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