Initial antibacterial therapy for community-acquired pneumonia in children: results of a multicenter study
Authors:   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation, Dronov I.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Malakhov A.B. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Ermakova M.K. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   Izhevsk State Medical Academy, Izhevsk, Russian Federation, Tsarkova S.A. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   Ural State Medical University, Yekaterinburg, Russian Federation, Bashkina O.A. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   Astrakhan State Medical University, Astrakhan, Russian Federation, Pivikina T.M. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   Murom Children's Hospital, Murom, Russian Federation, Gaimolenko I.N. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   Chita Medical State Academy, Chita, Russian Federation, Bazhenova Yu.L. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   Ural State Medical University, Yekaterinburg, Russian Federation, Zinkevich A.P. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Gatsaeva A.Sh. ,   Russian Pediatric Respiratory Society, Kolomna, Moscow region, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Frolkova N.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: May 2021

Community-acquired pneumonia (CAP) is one of the leading reasons for background prescribing antibacterial therapy (ABT) in pediatric practice. In 2015, the Russian Pediatric Respiratory Society published a guideline on CAP in children. Objective. To assess compliance with the recommendations of starting ABT for CAP of pediatric inpatients in various regions of the Russia. Materials and methods. We reviewed the medical records of pediatric patients with CAP who were hospitalized in 2017–2018. The study was in 6 regions of the Russia. A total of 793 cases of CAP were studied in children aged 1 month to 16 years. We analyzed data from patients, such as demographic indicators, severity of the disease, the presence and nature of complications, and starting ABT. Results. The patient’s age ranged from 1 month to 16 years (average – 4.33 years). The amount of cases of severe CAP was 5.55%, in the remaining 94.45% of cases there was a moderate CAP. Complications were present among 3.91% of patients. The overwhelming majority of patients received parenteral ABT (more than 89%). In the majority of cases, third-generation cephalosporins (65.2%) were used as starting therapy. Amoxicillin was prescribed in only 4.04% of patients. The combination therapy was used in 13.27% of cases (beta-lactam with macrolides or aminoglycosides used most often). We found a significant discrepancy between the actual practice of the recommendations: excessive use of parenteral and combined ABT, private prescription of 3rd generation cephalosporins and rare prescription of amoxicillin, the use of aminoglycosides (including as monotherapy). Conclusion. The use of antibiotics for CAP in children in Russia is often incorrect, which can reduce the effectiveness of treatment and contribute to an increase in antimicrobial resistance. Increased education of pediatricians in ABT and the introduction of antibiotic control is required to address this problem. Key words: children, community-acquired pneumonia, antibiotic therapy