Initial etiotropic therapy of acute bacterial respiratory tract infections in children in the context of current clinical guidelines

The implementation of clinical guidelines in daily practice has not made the desired progress as yet and is restrained by various factors, a significant part of which are subjective. The leading factor among them is that the doctors underestimated the practical benefits of their use in clinical settings. Antibiotic indications for the most common acute bacterial infectious and inflammatory respiratory diseases, such as acute streptococcal tonsillitis/pharyngitis, acute purulent otitis media, community-acquired pneumonia, acute bacterial sinusitis, are presented in the context of current clinical guidelines. The article discusses the principles of choice of first-line antibiotics, the mode of administration and recommended dosage regimens, taking into account the class of recommendations and the level of evidence. Amoxicillin and amoxicillin/clavulanate are the main antibacterial drugs for the treatment of these diseases, which in these cases should be used orally in accordance with clinical guidelines. However, taking into account the availability of these antibiotics in many dosage forms (dispersible tablets; film-coated tablets; powder for suspension), it is advisable to pay attention to a variety of advantages of drugs that are available as dispersible tablets. Again, we emphasise that due to the implementation of clinical guidelines into everyday clinical practice, the rational initial antibiotic therapy will not only significantly increase the effectiveness of treatment of acute bacterial respiratory infections, but will also contribute to solving one of the global challenges facing healthcare right now i.e. reduction of the rate of development of antibiotic-resistant strains. All these considerations require paediatricians to pay close attention to the mandatory implementation of clinical guidelines in addressing the issues of prescribing antibiotics when treating acute respiratory infections in pediatric patients, which has become the essence of this publication.

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