medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-035medsovet-9870Research ArticleБРОНХОПУЛЬМОНОЛОГИЯ И ОТОЛАРИНГОЛОГИЯBRONCHOPULMONOLOGY, OTORHINOLARYNGOLOGYБактериальные синуситы как междисциплинарная проблемаBacterial sinusitis as an interdisciplinary problemhttps://orcid.org/0000-0001-8149-7669ДелягинВ. М.DelyaginV. M.

Делягин Василий Михайлович - д.м.н., профессор, ведущий научный сотрудник, отдел междисциплинарной онкологии, кафедра педиатрии и организации здравоохранения.

117198, Москва, ул. Саморы Машела, д. 1

Vassily M. Delyagin - Dr. Sci. (Med.), Professor, Leading Researcher, Department of Interdisciplinary Oncology, Department of Pediatrics and Healthcare Organization, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology.

1, Samora Mashel St., Moscow, 117997

delyagin-doktor@yandex.ruНациональный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия РогачеваРоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and ImmunologyRussian Federation20262403202601104110Copyright © Делягин В.М., 20262026Делягин В.М.Delyagin V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9870

Вирусный риносинусит регистрируется у 6–7% детей с острыми респираторно-вирусными инфекциями (ОРВИ), из них у 5–10% трансформируется в бактериальный. Проблема РС нередко воспринимается как банальная. Но с учетом частоты ОРВИ в популяции, вероятности трансформации вирусного РС в бактериальный, необходимости дифференциальной диагностики с состояниями, при которых РС является вторичным (аллергия, дефекты иммунитета, синдром нарушенного мерцания ресничек и многие другие), местных и системных осложнений требуется постоянное внимание врача и его готовность к раннему выявлению РС, уточнению его причин и степени тяжести, персонифицированному выбору терапии, своевременному формированию междисциплинарной команды. Бактериальный риносинусит может осложняться орбитальной, внутричерепной или костной инфекцией, системными процессами. Необходимо всегда учитывать такие варианты инфекции, особенно если состояние пациентов не улучшается при стандартном симптоматическом и/или медикаментозном лечении, что требует активной антибиотикотерапии. В статье проанализированы и систематизированы данные полнотекстовых публикаций из поисковых систем scholar.google.ru, researchgate.net, MEDLINE и научных электронных библиотек PubMed и eLIBRARY.RU о развитии и лечении риносинусита у детей и взрослых. Проанализировано более 40 статей ведущих международных и отечественных специалистов в области оториноларингологии и педиатрии. Получены данные современных представлений о течении заболевания и выборе терапии, включая роль антибактериальной терапии. С учетом распространенности резистентных форм флоры оправданно назначение современных антибактериальных препаратов широкого спектра действия, например цефалоспорина III поколения цефиксима. Препарат широко используется в амбулаторных и клинических условиях, доказав свою эффективность и хорошую переносимость. Применение диспергируемой формы позволяет избежать инъекций и повышает комплаентность к лечению как у самого ребенка, так и у его семьи.

Viral rhinosinusitis is reported in 6–7% of children with acute respiratory viral infections (ARVI), of which 5–10% develop into bacterial rhinosinusitis. The problem of RS is often perceived as trivial. However, given the frequency of ARVI in the population, the likelihood of viral RS transforming into bacterial rhinosinusitis, the need for differential diagnosis with conditions in which RS is secondary (allergies, immune deficiencies, incomplete ciliary syndrome, and many others), and local and systemic complications, constant physician attention and a commitment to early detection of RS, clarification of its causes and severity, personalized treatment selection, and timely formation of a multidisciplinary team are essential. Bacterial rhinosinusitis can be complicated by orbital, intracranial, or bone infections, as well as systemic processes. These infection variants must always be considered, especially if the patient’s condition does not improve with standard symptomatic and/or drug treatment, requiring active antibiotic therapy. This article analyzes and systematizes data from full-text publications from the search engines scholar.google.ru, researchgate.net, MEDLINE, and the scientific electronic libraries PubMed and eLIBRARY.RU on the development and treatment of rhinosinusitis in children and adults. More than 40 articles by leading international and Russian specialists in otolaryngology and pediatrics were analyzed. Data on current understanding of the disease course and treatment options, including the role of antibacterial therapy, were obtained. Given the prevalence of resistant forms of flora, the use of modern broad-spectrum antibacterial agents, such as the third-generation cephalosporin cefixime, is justified. This drug is widely used in outpatient and clinical settings, having proven its efficacy and good tolerability. The use of a dispersible form allows one to avoid injections and increases compliance with treatment both in the child and in his family.

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The authors declare that there are no conflicts of interest present.