Amoxicillin in the treatment of pediatric acute otolaryngological pathology: An anachronism or a modern effective drug?

This article presents a brief account of the problem and clinical case reports of the use of modern aminopenicillins in the treatment of upper respiratory diseases in children. Respiratory viruses are the main factor behind acute upper respiratory diseases. However, opportunistic bacteria also play a significant role in the etiology of such most common nosological entities as acute otitis media, acute tonsillitis, and acute rhinosinusitis. The most common of these are Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes. Amoxicillin has kept the same spectrum of activity as ampicillin against major respiratory bacterial pathogens. Streptococcus pyogenes retains 100% sensitivity to amoxicillin, as it does to all _β-lactams. At the time of its invention, the vast majority of Streptococcus pneumoniae and Haemophilus influenzae strains were highly susceptible to amoxicillin. However, the level of acquired resistance to penicillin drugs in general and to amoxicillin in particular has increased over the past 40 years. The growth rates of resistant Streptococcus pneumoniae proportion are particularly alarming. Among the challenges associated with the growth of acquired antibiotic resistance, practicing physicians should adhere to existing indications and approved algorithms for systemic antibacterial therapy of common conditions such as acute rhinosinusitis and acute otitis media. The use of amoxicillin as a drug of initial therapy in systemic antibacterial therapy regimens for the most common acute upper respiratory diseases, such as acute tonsillitis, acute otitis media, and acute rhinosinusitis still holds relevance as noted in the current clinical guidelines. Inhibitor-protected amoxicillin should not be used unreasonably instead of pure amoxicillin due to the high risk of adverse drug reactions.

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