Antibiotic therapy of community-acquired pneumonia in children: comparison of international guidelines and current practice in Ukraine
Background. Respiratory diseases are a serious medical and social problem in pediatrics. The aim of the study was to research the current scientific sources for the treatment of community-acquired pneumonia in children, to conduct a comparative analysis of the recommendations of the leading countries on antibiotic therapy (ABT) of the community-acquired pneumonia and ABT principles in children with community-acquired pneumonia in Lviv. Materials and methods. We used content analysis, method of systemic and comparative analysis regarding ABT in children with community-acquired pneumonia as well as a retrospective analysis of medical records of children with community-acquired pneumonia. Results. We compared the guidelines of the Pediatric Infectious Diseases Society — Infectious Diseases Society of America (PIDS-IDSA), the British Thoracic Society (BTS) and the World Health Organization (WHO) on ABT of community-acquired pneumonia in children. WHO recommends ABT of non-severe community-acquired pneumonia for 5 days, and BTS recommendations do not indicate the duration of treatment. According to PIDS-IDSA experts, the 10-day ABT courses are best studied. According to all guidelines, oral administration of amoxicillin is a choice-therapy for outpatient cases. For inpatient incidences WHO recommends treatment of ampicillin and gentamicin combination. BTS recommends oral antibiotic therapy of amoxicillin, and PIDS-IDSA suggests starting treatment with administration of ampicillin or penicillin G in the cases of a fully vaccinated child and III generation cephalosporin in case the child is not fully vaccinated. We analyzed 260 medical records of children with community-acquired pneumonia of the Pediatric Department 2 of Lviv City Children’s Clinical Hospital in 2017. Third generation cephalosporins were most often prescribed to children with pneumonia in the hospital. The average duration of antibiotic treatment was 7 days. Conclusions. Based on the analyzed sources, we can conclude that the question of the antibiotic therapy duration and sometimes the choice of antibacterial agent is quite controversial and requires further study.
Full Text:PDF (Українська)
World Health Organization. Pneumonia. Available from: https://www.who.int/news-room/fact-sheets/detail/pneumonia. Accessed: November 7, 2016.
Usonis V, Ivaskevicius R, Diez-Domingo J, et al. Comparison between diagnosis and treatment of community-acquired pneumonia in children in various medical centres across Europe with the United States, United Kingdom and the World Health Organization guidelines. Pneumonia (Nathan). 2016 May 2;8:5. doi: 10.1186/s41479-016-0005-y.
Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):e25-76. doi: 10.1093/cid/cir531.
Harris M, Clark J, Coote N, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct;66 Suppl 2:ii1-23. doi: 10.1136/thoraxjnl-2011-200598.
Thorburn K, Harigopal S, Reddy V, Taylor N, van Saene HK. High incidence of pulmonary bacterial co-infection in children with severe respiratory syncytial virus (RSV) bronchiolitis. Thorax. 2006 Jul;61(7):611-5. doi: 10.1136/thx.2005.048397.
Mokiia-Serbina SA, Litvinova TV, Plohinov GA. Community-acquired pneumonia in children: current approaches to the duration of antibiotic therapy. Zdorov'e rebenka. 2016;(70):138-141. doi: 10.22141/2224-05220.127.116.116.73837. (in Russian).
Greenberg D, Givon-Lavi N, Sadaka Y, Ben-Shimol S, Bar-Ziv J, Dagan R. Short-course antibiotic treatment for community-acquired alveolar pneumonia in ambulatory children: a double-blind, randomized, placebo-controlled trial. Pediatr Infect Dis J. 2014 Feb;33(2):136-42. doi: 10.1097/INF.0000000000000023.
The resolution of roundtable participants on rational antimicrobial therapy of common childhood diseases from 24 February 2010. Zdorov'e rebenka. 2010;(23). Available from: http://www.mif-ua.com/archive/article/12747. Accessed: August 11, 2010. (in Russian).
Copyright (c) 2019 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019