DOI: 10.32364/2618-8430-2020-3-2-105-111
Respiratory tract infections in pediatrics: difficult answers to simple questions
I.V. Andreeva, O.U. Stetsyuk, O.A. Egorova
Smolensk State Medical University, Smolensk, Russian Federation
Despite modern highly-effective treatment and preventive tools available to physicians, respiratory tract infections (RTIs) are still the most common reason for referral to pediatricians. A myriad of papers are published every year, however, there is a growing concern over this issue. This paper responds to seemingly simple questions that, however, are often challenging and controversial for physicians and pediatricians. These questions are the use of antibiotics for acute RTIs to prevent bacterial complications, the impact of antibiotic resistance of respiratory pathogens (Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae) on antibacterial treatment choice, current position of macrolides in the treatment for RTIs and ENT infections, the prescription of aminopenicillins and inhibitor-protected aminopenicillins in specific clinical situations, dosage regimens of amoxicillin and amoxicillin/clavulanic acid in pediatrics, the p osition of peroral third-generation cephalosporins in the treatment for RTIs, and optimal antibacterial treatment duration in children. Pediatricians often face these issues in routine clinical practice.
Keywords: pediatrics, respiratory tract infections, acute respiratory disorders, antibiotics, antibiotic resistance.
For citation: Andreeva I.V., Stetsyuk O.U., Egorova O.A. Respiratory tract infections in pediatrics: difficult answers to simple questions. Russian Journal of Woman and Child Health. 2020;3(2):105–111. DOI: 10.32364/2618-8430-2020-3-2-105-111.
References
1. Baranov A.A., Strachunsky L.S. The use of antibiotics in children in outpatient practice. (Practical recommendations). Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2007;3:200–210 (in Russ.).
2. Meropol S.B., Localio A.R., Metlay J.P. Risks and benefits associated with antibiotic use for acute respiratory infections: a cohort study. Ann Fam Med. 2013;11(2):165–172. DOI: 10.1370/afm.1449.
3. Kozlov R.S., Krechikova O.I., Muravyov A.A. et al. Results of a study of the prevalence of community-acquired pneumonia and acute otitis media in children under 5 years of age (PAPIRUS) in Russia. The role of S. pneumoniae and H. influenza in the etiology of these diseases. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2013;15(4):246–260 (in Russ.).
4. Jain S., Williams D.J., Arnold S.R. et al. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015;372(9):835–845. DOI: 10.1056/NEJMoa1405870.
5. Spinks A., Glasziou P.P., Del Mar C.B. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013;2013(11):CD000023. DOI: 10.1002/14651858.CD000023.pub4.
6. Thompson P.L., Gilbert R.E., Long P.F. et al. Effect of antibiotics for otitis media on mastoiditis in children: a retrospective cohort study using the United Kingdom general practice research database. Pediatrics. 2009;123(2):424–430. DOI: 10.1542/peds.2007–3349.
7. Petersen I., Johnson A.M., Islam A. et al. Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ. 2007;335(7627):982. DOI: 10.1136/bmj.39345.405243.
8. Kenealy T., Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013;2013(6):CD000247. DOI: 10.1002/14651858.CD000247.pub3.
9. Smith S.M., Fahey T., Smucny J. et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2017;6(6):CD000245. DOI: 10.1002/14651858.CD000245.pub4.
10. Marsland B.J., Gollwitzer E.S. Host-microorganism interactions in lung diseases. Nat Rev Immunol. 2014;14(12):827–835. DOI: 10.1038/nri3769.
11. Wypych T.P., Wickramasinghe L.C., Marsland B.J. The influence of the microbiome on respiratory health. Nat Immunol. 2019;20(10):1279–1290. DOI: 10.1038/s41590–019–0451–9.
12. Huffnagle G.B., Dickson R.P. The bacterial microbiota in inflammatory lung diseases. Clin Immunol. 2015;159(2):177–182. DOI: 10.1016/j.clim.2015.05.022.
13. Sha Q., Truong-Tran A.Q., Plitt J.R. et al. Activation of airway epithelial cells by toll-like receptor agonists.3 Am J Respir Cell Mol Biol. 2004;31(3):358–364. DOI: 10.1165/rcmb.2003–0388OC.
14. Kuzmenkov A.Yu., Trushin I.V., Avramenko A.A. et al. AMRmap: Internet platform for monitoring antibiotic resistance. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2017;19(2):84–90 (in Russ.).
15. Torumkuney D., Mayanskiy N., Edelstein M. et al. Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Russia. J Antimicrob Chemother. 2018;73(suppl_5):v14–v21. DOI: 10.1093/jac/dky065.
16. Svistushkin V.M., Grinev I.A., Stetsyuk O.U., Andreeva I.V. Guidelines for the management of adult patients with acute rhinosinusitis: is consensus achievable? Lechashchiy vrach. 2012;11:90–96 (in Russ.).
17. Svistushkin V.M., Andreeva I.V., Stetsyuk O.U. A review of current recommendations on the management of patients with acute bacterial rhinosinusitis in pediatric practice. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2012;14(3):176–190 (in Russ.).
18. Martinez Campos L., Albañil Ballesteros R., de la Flor Bru J. et al. Consensus document on the aetiology, diagnosis and treatment of sinusitis. An Pediatr (Barc). 2013;79(5):330.e1–330.e12. DOI: 10.1016/j.anpedi.2013.04.027.
19. Kaplan A. Canadian guidelines for acute bacterial rhinosinusitis: clinical summary. Can Fam Physician. 2014;60(3):227–234.
20. Chiappini E., Mazzantini R., Bruzzese E. et al. Rational use of antibiotics for the management of children’s respiratory tract infections in the ambulatory setting: an evidence-based consensus by the Italian Society of Preventive and Social Pediatrics. Paediatr Respir Rev. 2014;15(3):231–236. DOI: 10.1016/j.prrv.2013.11.011.
21. Clinical recommendations. Acute sinusitis. Ministry of Health of the Russian Federation. National Medical Association of Otolaryngologists. 2016 (in Russ.).
22. Resolution of the Expert Council “Principles of rational antibiotic therapy of respiratory infections in children. Preserving antibiotics for future generations”. Pediatriya (Pril. k zhurn. Consilium Medicum). 2018;3:10–14 (in Russ.).
23. Hazir T., Qazi S.A., Bin Nisar Y. et al. Comparison of standard versus double dose of amoxicillin in the treatment of non-severe pneumonia in children aged 2–59 months: a multi-centre, double blind, randomised controlled trial in Pakistan. Arch Dis Child. 2007;92(4):291–297. DOI: 10.1136/adc.2005.092494.
24. Matho A., Mulqueen M., Tanino M. et al. High-dose versus standard-dose amoxicillin/clavulanate for clinically-diagnosed acute bacterial sinusitis: A randomized clinical trial. PLoS One. 2018;13(5):e0196734. DOI: 10.1371/journal.pone.0196734.
25. Jacobs M.R., Felmingham D., Appelbaum P.C. et al. Alexander Project Group. The Alexander Project 1998–2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents. J Antimicrob Chemother. 2003;52(2):229–246. DOI: 10.1093/jac/dkg321.
26. WHO Model List of Essential Medicines for Children. March 2017, amended August 2017. (Electronic resource). URL: https://apps.who.int/iris/bitstream/handle/10665/273825/EMLc-6-eng.pdf?ua=1. Access date: 06.03.2020.
27. Dronov I.A., Meshcheryakov V.V., Elkina T.N. et al. Testing results for pediatricians on antibacterial therapy for respiratory tract infections. Voprosy prakticheskoy pediatrii. 2018;13(2):44–48 (in Russ.).
28. Shulman S.T., Bisno A.L., Clegg H.W. et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):1279–1282. DOI: 10.1093/cid/cis847.
29. Clinical recommendations. Acute tonsillopharyngitis. Ministry of Health of the Russian Federation. National Medical Association of Otolaryngologists. 2016 (in Russ.).
30. Agarwal G., Awasthi S., Kabra S.K. et al. Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial. BMJ. 2004;328(7443):791. DOI: 10.1136/bmj.38049.490255.DE.
31. Sutijono D., Hom J., Zehtabchi S. Efficacy of 3-day versus 5-day antibiotic therapy for clinically diagnosed nonsevere pneumonia in children from developing countries. Eur J Emerg Med. 2011;18(5):244–250. DOI: 10.1097/MEJ.0b013e328344fd90.
32. Haider B.A., Saeed M.A., Bhutta Z.A. Short-course versus long-course antibiotic therapy for non-severe community-acquired pneumonia in children aged 2 months to 59 months. Cochrane Database Syst Rev. 2008;(2):CD005976. DOI: 10.1002/14651858.CD005976.pub2.
33. Russian respiratory society; Interregional Pediatric Respiratory Society; Federation of Pediatricians of the CIS countries; Moscow Society of Pediatric Doctors. Community-acquired pneumonia in children. Clinical recommendations. M.: Original-maket; 2015 (in Russ.).
2. Meropol S.B., Localio A.R., Metlay J.P. Risks and benefits associated with antibiotic use for acute respiratory infections: a cohort study. Ann Fam Med. 2013;11(2):165–172. DOI: 10.1370/afm.1449.
3. Kozlov R.S., Krechikova O.I., Muravyov A.A. et al. Results of a study of the prevalence of community-acquired pneumonia and acute otitis media in children under 5 years of age (PAPIRUS) in Russia. The role of S. pneumoniae and H. influenza in the etiology of these diseases. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2013;15(4):246–260 (in Russ.).
4. Jain S., Williams D.J., Arnold S.R. et al. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015;372(9):835–845. DOI: 10.1056/NEJMoa1405870.
5. Spinks A., Glasziou P.P., Del Mar C.B. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013;2013(11):CD000023. DOI: 10.1002/14651858.CD000023.pub4.
6. Thompson P.L., Gilbert R.E., Long P.F. et al. Effect of antibiotics for otitis media on mastoiditis in children: a retrospective cohort study using the United Kingdom general practice research database. Pediatrics. 2009;123(2):424–430. DOI: 10.1542/peds.2007–3349.
7. Petersen I., Johnson A.M., Islam A. et al. Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ. 2007;335(7627):982. DOI: 10.1136/bmj.39345.405243.
8. Kenealy T., Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013;2013(6):CD000247. DOI: 10.1002/14651858.CD000247.pub3.
9. Smith S.M., Fahey T., Smucny J. et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev. 2017;6(6):CD000245. DOI: 10.1002/14651858.CD000245.pub4.
10. Marsland B.J., Gollwitzer E.S. Host-microorganism interactions in lung diseases. Nat Rev Immunol. 2014;14(12):827–835. DOI: 10.1038/nri3769.
11. Wypych T.P., Wickramasinghe L.C., Marsland B.J. The influence of the microbiome on respiratory health. Nat Immunol. 2019;20(10):1279–1290. DOI: 10.1038/s41590–019–0451–9.
12. Huffnagle G.B., Dickson R.P. The bacterial microbiota in inflammatory lung diseases. Clin Immunol. 2015;159(2):177–182. DOI: 10.1016/j.clim.2015.05.022.
13. Sha Q., Truong-Tran A.Q., Plitt J.R. et al. Activation of airway epithelial cells by toll-like receptor agonists.3 Am J Respir Cell Mol Biol. 2004;31(3):358–364. DOI: 10.1165/rcmb.2003–0388OC.
14. Kuzmenkov A.Yu., Trushin I.V., Avramenko A.A. et al. AMRmap: Internet platform for monitoring antibiotic resistance. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2017;19(2):84–90 (in Russ.).
15. Torumkuney D., Mayanskiy N., Edelstein M. et al. Results from the Survey of Antibiotic Resistance (SOAR) 2014–16 in Russia. J Antimicrob Chemother. 2018;73(suppl_5):v14–v21. DOI: 10.1093/jac/dky065.
16. Svistushkin V.M., Grinev I.A., Stetsyuk O.U., Andreeva I.V. Guidelines for the management of adult patients with acute rhinosinusitis: is consensus achievable? Lechashchiy vrach. 2012;11:90–96 (in Russ.).
17. Svistushkin V.M., Andreeva I.V., Stetsyuk O.U. A review of current recommendations on the management of patients with acute bacterial rhinosinusitis in pediatric practice. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2012;14(3):176–190 (in Russ.).
18. Martinez Campos L., Albañil Ballesteros R., de la Flor Bru J. et al. Consensus document on the aetiology, diagnosis and treatment of sinusitis. An Pediatr (Barc). 2013;79(5):330.e1–330.e12. DOI: 10.1016/j.anpedi.2013.04.027.
19. Kaplan A. Canadian guidelines for acute bacterial rhinosinusitis: clinical summary. Can Fam Physician. 2014;60(3):227–234.
20. Chiappini E., Mazzantini R., Bruzzese E. et al. Rational use of antibiotics for the management of children’s respiratory tract infections in the ambulatory setting: an evidence-based consensus by the Italian Society of Preventive and Social Pediatrics. Paediatr Respir Rev. 2014;15(3):231–236. DOI: 10.1016/j.prrv.2013.11.011.
21. Clinical recommendations. Acute sinusitis. Ministry of Health of the Russian Federation. National Medical Association of Otolaryngologists. 2016 (in Russ.).
22. Resolution of the Expert Council “Principles of rational antibiotic therapy of respiratory infections in children. Preserving antibiotics for future generations”. Pediatriya (Pril. k zhurn. Consilium Medicum). 2018;3:10–14 (in Russ.).
23. Hazir T., Qazi S.A., Bin Nisar Y. et al. Comparison of standard versus double dose of amoxicillin in the treatment of non-severe pneumonia in children aged 2–59 months: a multi-centre, double blind, randomised controlled trial in Pakistan. Arch Dis Child. 2007;92(4):291–297. DOI: 10.1136/adc.2005.092494.
24. Matho A., Mulqueen M., Tanino M. et al. High-dose versus standard-dose amoxicillin/clavulanate for clinically-diagnosed acute bacterial sinusitis: A randomized clinical trial. PLoS One. 2018;13(5):e0196734. DOI: 10.1371/journal.pone.0196734.
25. Jacobs M.R., Felmingham D., Appelbaum P.C. et al. Alexander Project Group. The Alexander Project 1998–2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents. J Antimicrob Chemother. 2003;52(2):229–246. DOI: 10.1093/jac/dkg321.
26. WHO Model List of Essential Medicines for Children. March 2017, amended August 2017. (Electronic resource). URL: https://apps.who.int/iris/bitstream/handle/10665/273825/EMLc-6-eng.pdf?ua=1. Access date: 06.03.2020.
27. Dronov I.A., Meshcheryakov V.V., Elkina T.N. et al. Testing results for pediatricians on antibacterial therapy for respiratory tract infections. Voprosy prakticheskoy pediatrii. 2018;13(2):44–48 (in Russ.).
28. Shulman S.T., Bisno A.L., Clegg H.W. et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):1279–1282. DOI: 10.1093/cid/cis847.
29. Clinical recommendations. Acute tonsillopharyngitis. Ministry of Health of the Russian Federation. National Medical Association of Otolaryngologists. 2016 (in Russ.).
30. Agarwal G., Awasthi S., Kabra S.K. et al. Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial. BMJ. 2004;328(7443):791. DOI: 10.1136/bmj.38049.490255.DE.
31. Sutijono D., Hom J., Zehtabchi S. Efficacy of 3-day versus 5-day antibiotic therapy for clinically diagnosed nonsevere pneumonia in children from developing countries. Eur J Emerg Med. 2011;18(5):244–250. DOI: 10.1097/MEJ.0b013e328344fd90.
32. Haider B.A., Saeed M.A., Bhutta Z.A. Short-course versus long-course antibiotic therapy for non-severe community-acquired pneumonia in children aged 2 months to 59 months. Cochrane Database Syst Rev. 2008;(2):CD005976. DOI: 10.1002/14651858.CD005976.pub2.
33. Russian respiratory society; Interregional Pediatric Respiratory Society; Federation of Pediatricians of the CIS countries; Moscow Society of Pediatric Doctors. Community-acquired pneumonia in children. Clinical recommendations. M.: Original-maket; 2015 (in Russ.).
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