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.
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