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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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: 10.22141/2224-05188.8.131.526.73837. (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).
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