OUR EXPERIENCE OF USING TARGETED EMPIRICAL ANTIBACTERIAL THERAPY FOR NOSOCOMIAL PNEUMONIA IN CHILDREN

Аннотация

Lower respiratory tract infections include bronchitis, bronchiolitis and pneumonia [2]. In children, they usually occur acutely, in some cases, especially in young children (up to 3 years old), they are complicated by bronchoobstructive syndrome of varying severity [1-4]. Since the etiological structure of lower respiratory tract infections differs primarily by the nature of the environment surrounding the patient, from a practical point of view, the most significant is the division of these infections into community-acquired ("outpatient") and nosocomial (hospital, nosocomial), regardless of the severity of the disease [5-8]. Nosocomial pneumonia is considered to be those that manifested clinically and radiologically 48-72 hours after hospitalization, excluding infections that could be in the incubation period at the time of admission to the hospital [9-13].

The etiological structure of community-acquired and nosocomial bacterial infections of the lower respiratory tract differs significantly [14-18]. Pathogens of community-acquired infections are usually characterized by a higher sensitivity of strains to antibiotics, and nosocomial pathogens in the bulk are significantly more resistant to antibiotic therapy and cause a more severe course of infection, which requires parenteral administration of antibiotics in combinations [19-22].

The diagnosis of acute pneumonia is an absolute indication for antibacterial therapy, which is etiotropic and is necessarily carried out in parallel with pathogenetic and symptomatic treatment. Rational antibiotic therapy is the basis for effective treatment of pneumonia [23-27]. Depending on the patient's condition, it is performed on an outpatient basis or in a hospital, but in the vast majority of cases, due to the underdevelopment of express methods of bacteriological diagnosis, antibiotics are prescribed empirically.