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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2020-10-144-150</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5733</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ШКОЛА ПЕДИАТРА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PEDIATRICIAN SCHOOL</subject></subj-group></article-categories><title-group><article-title>Возможности применения комбинированного антибактериального препарата амоксициллина/клавуланата у детей</article-title><trans-title-group xml:lang="en"><trans-title>Therapeutic potential of combination antimicrobial drug amoxycillin/clavulanate in children</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0535-2916</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дроздов</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Drozdov</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дроздов Владимир Николаевич, д.м.н., профессор, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Vladimir N. Drozdov, Dr. of Sci. (Med), Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991</p></bio><email xlink:type="simple">vndrozdov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9562-0864</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ермакова</surname><given-names>Д. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Ermakova</surname><given-names>D. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ермакова Дарья Денисовна, клинический ординатор кафедры клинической фармакологии и пропедевтики внутренних болезней</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Daria D. Ermakova, Clinical resident of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7163-7119</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сереброва</surname><given-names>С. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Serebrova</surname><given-names>S. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сереброва Светлана Юрьевна, д.м.н., главный научный сотрудник, Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации; профессор кафедры клинической фармакологии и пропедевтики внутренних болезней, Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2127051, Москва, Петровский б-р, д. 8, стр. 2 </p></bio><bio xml:lang="en"><p>Svetlana Yu. Serebrova, Dr. of Sci. (Med), Chief Researcher, Federal State Budgetary Institution “Scientific Center of Expertise of Medical Devices” of the Ministry of Health of the Russian Federation; Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Federal State Autonomous Educational Institution of Higher Education “I.M. Sechenov First Moscow State Medical University” of the Ministry of Health of the Russian Federation (Sechenov University)</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991Bldg. 2, 8, Petrovskiy boulevard, Moscow, 127051 </p></bio><email xlink:type="simple">svetaserebrova@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5621-2721</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Комиссаренко</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Komissarenko</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Комиссаренко Ирина Арсеньевна, д.м.н., профессор кафедры поликлинической терапии</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1</p></bio><bio xml:lang="en"><p>Irina A. Komissarenko, Dr. of Sci. (Med), Professor of the Department of Polyclinic Therapy</p><p>20, Bldg. 1, Delegatskaya St., Moscow, 127473</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6589-7654</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ших</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shikh</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ших Евгения Валерьевна, д.м.н., профессор, заведующая кафедрой клинической фармакологии и пропедевтики внутренних болезней</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Evgenia V. Shikh, Dr. of Sci. (Med), Chair of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991</p></bio><email xlink:type="simple">chih@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9842-4503</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стародубцев</surname><given-names>А. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Starodubtsev</surname><given-names>A. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Стародубцев Алексей Константинович, д.м.н., профессор, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Alexey K. Starodubtsev, Dr. of Sci. (Med), Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8974-4457</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Марин</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Marin</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Марин Татьяна Висентьевна, к.м.н., доцент, доцент кафедры клинической фармакологии и пропедевтики внутренних болезней</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Tatiana V. Marin, PhD (Med), Assistant professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет); Научный центр экспертизы средств медицинского применения</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University); Scientific Center of Expertise of Medical Devices</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Московский государственный медико-стоматологический университет им. А.И. Евдокимова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A.I. Yevdokimov Moscow State University of Medicine and Dentistry</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>29</day><month>07</month><year>2020</year></pub-date><volume>0</volume><issue>10</issue><fpage>144</fpage><lpage>150</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дроздов В.Н., Ермакова Д.Д., Сереброва С.Ю., Комиссаренко И.А., Ших Е.В., Стародубцев А.К., Марин Т.В., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Дроздов В.Н., Ермакова Д.Д., Сереброва С.Ю., Комиссаренко И.А., Ших Е.В., Стародубцев А.К., Марин Т.В.</copyright-holder><copyright-holder xml:lang="en">Drozdov V.N., Ermakova D.D., Serebrova S.Y., Komissarenko I.A., Shikh E.V., Starodubtsev A.K., Marin T.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/5733">https://www.med-sovet.pro/jour/article/view/5733</self-uri><abstract><p>Впервые комбинация полусинтетического антибиотика амоксициллина/клавуланата появилась на фармацевтическом рынке в 1977 г. и до сих пор с успехом применяется для лечения инфекций различной локализации и этиологии как у взрослых, так и у детей. Присоединение к амоксициллину молекулы клавулановой кислоты позволило эффективно бороться с микроорганизмами, механизм резистентности которых к бета-лактамным антибиотикам состоит в продукции специфических бактериальных ферментов – бета-лактамаз. Несмотря на глобальную проблему антибиотикорезистентности, амоксициллин/клавуланат до сих пор сохраняет активность в отношении возбудителей инфекций у детей. Высокий уровень чувствительности основного респираторного патогена St. pneumoniae к амоксициллину в комбинации с клавулановой кислотой сохраняется более 40 лет. По результатам многоцентрового исследования антимикробной резистентности пневмококков, гемофил, группы А стрептококков, моракселл (ПеГАС) I–III, эффективность амоксициллина/клавуланата в отношении пневмококка на территории РФ незначительно снизилась: со 100 до 99,6% в период с 1993 по 2009 г. В систематическом обзоре с метаанализом, опубликованном в 2019 г., чувствительность гемофильной палочки и моракселлы к амоксициллину/клавуланату при лечении острого среднего отита составляла 98%. В статье описан механизм действия ингибитора бета-лактамаз – клавулановой кислоты, обоснован приоритет применения антибиотиков в форме суспензии в педиатрии, приведен спектр активности комбинированного препарата амоксициллина/клавуланата на основании результатов клинических исследований и метаанализов, рассмотрены возможности его применения в клинической практике у детей.</p></abstract><trans-abstract xml:lang="en"><p>Combination of amoxicillin/clavulanate firstly occurred on a pharmacological market in 1977 and it is still has been used successfully for treatment of infections in children and adults. Clavulanic acid provides an opportunity to fight microorganisms that produce specific enzymes – beta-lactamases. Despite the global antibiotic resistance problem, amoxicillin/clavulanate is still active against different infections in children. The level of susceptibility to amoxicillin/clavulanate of St. pneumonia is high for a period of 40 years. Based on the multicenter study of the antimicrobial resistance of pneumococci, haemophilus, group A streptococci, moraxella PeGAS I-III findings, susceptibility to amoxicillin/clavulanate of St. Pneumoniae in Russian Federation has been changed slightly from 100% to 99.6% over a period of 1993 – 2009 y. The systematic review with meta-analysis published in 2019 showed that the sensitivity of hemophilic bacillus and moraxella to amoxicillin/clavulanate in the treatment of acute otitis media accounted for 98% each. The article presents data on clavulanic acid action mechanism, spectrum of amoxicillin/clavulanate activity on the ground of clinical trials and meta-analyses, priority of suspension usage in pediatric practice is explained. Possibilities of using in pediatric practice were also viewed.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>амоксициллин</kwd><kwd>клавуланат</kwd><kwd>клавулановая кислота</kwd><kwd>инфекции лор-органов</kwd><kwd>укусы животных</kwd><kwd>укусы человека</kwd><kwd>инфекции мочевыводящих путей</kwd></kwd-group><kwd-group xml:lang="en"><kwd>amoxicillin</kwd><kwd>clavulanate</kwd><kwd>clavulanic acid</kwd><kwd>ENT-organs infections</kwd><kwd>animal bites</kwd><kwd>human bites</kwd><kwd>urinary tract infections</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Gilbert D.N., Chambers H.F., Eliopoulos G.M., Saag M.S., Pavia A.T. The Sanford Guide to Antimicrobial Therapy. 50 th ed. 2020.</mixed-citation><mixed-citation xml:lang="en">Gilbert D.N., Chambers H.F., Eliopoulos G.M., Saag M.S., Pavia A.T. 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