Actual issues of etiology, diagnosis and therapy of community-acquired pneumonia in children
S.V. Zaitseva, O.V. Zaitseva, E.E. Lokshina
A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
Up to date, community-acquired pneumonia (CAP) has remained a common cause of morbidity and mortality in children. Streptococcus pneumoniae and Haemophilus influenzae retain their leading position in the etiology of CAP in children under 5 years of age. The unreasonable use of antibacterial drugs in previous decades has led to an increase in the antibiotic resistance of these pathogens to β-lactams and macrolides. This was the reason for the correction of the strategy for starting antimicrobial therapy for CAP: the pediatrician must take into account not only the etiology of the pathogen, but also the presence of risk factors for infection with antibiotic-resistant strains, the current situation with pathogen resistance in the patient’s region of residence, and other factors. Currently, oral amoxicillin remains the first-line drug in the treatment of CAP; in the presence of risk factors for antibiotic resistance, inhibitor-protected penicillins should be the starting drugs. Given the increasing resistance of S. pneumoniae to macrolide antibiotics, this group of drugs should now be considered as a second-line therapy. Thus, modern medical advances with the introduction of new methods of etiological diagnostics, data from epidemiological studies, as well as specific prophylaxis of the main causative agents of pneumonia in children, have changed the old paradigms in the etiotropic treatment of CAP, which must be taken into account in practical healthcare.
About the Autors
Corresponding author: Olga V. Zaitseva, MD, Professor, Head of the Department of Pediatrics, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; e-mail: firstname.lastname@example.org
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