"Simple Rules" For Pediatricians

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"Simple Rules" For Pediatricians
"Simple Rules" For Pediatricians
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"Simple rules" for pediatricians

Scientists have formulated the principles of rational antibiotic therapy for childhood respiratory infections. The frequency of antibiotic therapy in children with uncomplicated ARVI, which does not require antibiotic prescription, averages 59.6%. The consequence of this is antibiotic resistance in children, which experts already call a threat to national security.

"Simple rules" for pediatricians
"Simple rules" for pediatricians

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Scientists have formulated the principles of rational antibiotic therapy for childhood respiratory infections. The frequency of antibiotic therapy in children with uncomplicated ARVI, which does not require antibiotic prescription, averages 59.6%. The consequence of this is antibiotic resistance in children, which experts already call a threat to national security.

Leading Russian pediatric epidemiologists discussed the problem of unjustified frequent use of systemic antibacterial drugs for respiratory infections in children at the round table “Principles of rational antibiotic therapy. We will preserve antibiotics for future generations. " According to the chief freelance specialist of the Ministry of Health on epidemiology, head. Department of Epidemiology and Evidence-Based Medicine of the First Moscow State Medical University. THEM. Sechenov Nikolay Briko, the problem of antibiotic resistance of the pathogens of the most common infections in children is gradually acquiring the scale of a national threat.

The experts attributed the main individual risk factors for the presence of resistant flora in children:

taking antibiotics within the previous three months,

  • visiting preschool institutions, contact with children attending such institutions,
  • hospitalization within the previous 3 months,
  • accommodation in boarding schools, orphanages,
  • conditions and diseases accompanied by an increased sensitivity to infection (and frequent prescription of antibiotics), such as immunodeficiencies, the use of glucocorticoids, cytostatics,
  • diabetes mellitus, chronic respiratory diseases, hemodialysis treatment
  • recent travel.

According to the chief freelance specialist of the Ministry of Health for pediatric infectious diseases, director of the Research Institute of Pediatric Infections, Academician of the Russian Academy of Sciences Yuri Lobzin, adherence to the principles of rational antibiotic therapy can curb the growth of antibiotic resistance. “Pediatricians just need to follow simple rules: prescribe antibiotics only for bacterial infections, choose a drug, its dose, frequency and duration of administration strictly in accordance with the standards and clinical guidelines, take into account the level of resistance in a particular region, as well as individual risk factors for infection with drug-resistant pathogens ", - said Lobzin.

The experts formulated the basic principles of rational antibiotic therapy for respiratory infections in children:

use amoxicillin as a starting drug in patients without risk factors for infection with drug-resistant pathogens;

  • limit the use of macrolides, prescribe them only for infections caused by atypical pathogens, or with intolerance to β-lactams;
  • do not use third-generation oral cephalosporins (cefixime) for the treatment of respiratory tract infections in children due to the high natural resistance of pneumococcus to these drugs;
  • use protected amoxicillin, that is, amoxicillin in combination with clavulanic acid, as a starting drug in patients with risk factors for infection with drug-resistant pathogens and / or a high probability of the involvement of β-lactamase-producing pathogens.
  • The consequences of self-medication

    Contributes to the emergence of resistant strains of microorganisms that become resistant to antibiotics, and an independent reduction in the course of antibiotic therapy, said the president of the "Association of Physicians to Assist in Advanced Training of Pediatricians", head. Irina Zakharova, Chair of Pediatrics, Russian Medical Academy of Postgraduate Education (RMAPO). As shown by a survey of parents of children under 8 years old conducted by VTsIOM on the order of the department, parents almost always resort to drug treatment of children on the recommendation of pediatricians: most mothers (88%) give their child antimicrobial drugs as prescribed by a doctor, another 11% recall their past experience (the drug, previously prescribed by a doctor). In general, the majority of mothers surveyed follow the doctor's recommendations, but, nevertheless, one in four does not complete their child's care,admitting the possibility of an incomplete course of antibiotics: 23% of respondents sometimes independently reduce the course of antibiotics, 3% always do it.

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