Principles of antibiotic
Antibacterial drugs should be used only for infections caused by bacteria. In the hospital for severe and life-threatening infectious diseases (such as meningitis — inflammation of the meninges, of pneumonia — inflammation of the lungs, etc.) responsible for the selection of the correct medication rests entirely on a physician, which is based on the observation of the patient (clinical) and the results special studies.
For mild infections occurring in the "home" (outpatient) conditions, the situation is fundamentally different. The doctor examines the child and prescribe medication, sometimes accompanied by explanations and answers to questions, sometimes — not. Often, parents are asking doctors prescribe antibiotics. In such situations, the pediatrician sometimes psychologically easier to write a prescription than to risk their reputation and take the time to explain the purpose of this inexpedient.
In any case, the doctor must follow two main principles of antibiotic therapy:
- Fast assignment of the most effective drugs in cases where their effect is inconclusive.
- The maximum reduction in antibiotic use in all other cases.
Reliable outward signs or simple and inexpensive laboratory methods to distinguish between viral and bacterial origin of respiratory tract infections, unfortunately, no. At the same time, we know that acute rhinitis (runny nose), andsharp bronchitis (inflammation of the mucous membrane of the bronchi) are almost always caused by viruses, and tonsillitis (inflammation of the tonsils and pharynx) sharp otitis (Inflammation of the ear) and sinusitis (inflammation of the mucous membranes of the paranasal sinuses) to a large proportion of cases — bacteria.
It is natural to assume that the approaches to antibiotic therapy of individual acute upper respiratory tract infections should be slightly different.
Runny nose and bronchitis
In acute rhinitis (runny nose) and bronchitis antibiotics are not shown. In practice it occurs
If the condition is not getting worse, but not significantly improved, the apparent reason for the appointment of antibacterial drugs is not. However, during this period, some parents do not stand up and start giving drugs to children "just in case".
It should be emphasized that a very popular destination criterion antibiotics for viral infections — saving an elevated temperature for
A typical sign of a virus infection is persistent cough in the background of improving the general condition and the normalization of body temperature. Keep in mind that antibiotics are not antitussives. The parents in this situation, there is ample scope for the use of people's antitussives. Coughing is a natural protective mechanism disappears and the last of all the symptoms of the disease. However, if a child has an intense cough persists
In acute otitis media tactics antibiotic therapy is different, because the probability of bacterial origin of the disease reaches
Practice shows that for acute otitis media is characterized by intense pain in the first
What will happen to the rest of
There are currently developed new tactics to use antibiotics for acute otitis. Antibacterials appropriate to prescribe to all children under the age of 6 months, even with a questionable diagnosis of acute otitis media (to find out that a young child's ear ache is not that simple).
At the age of 6 months to
Of course, in this case the parents are increased requirements. First of all, you need to discuss with your doctor when to give antibiotics, and to clarify what the signs of the disease should pay attention to. The main thing is to be able to objectively assess the dynamics of pain, its gain or reduction, and the time to notice the signs of the emergence of new diseases — cough, rash, etc. Parents should be able to contact the doctor on the phone, and be available for a prescription for an antibiotic.
In children older than 2 years of waiting and watching for 48 hours is the preferred tactic, except in cases of severe (temperature above 390C, intense pain) disease.
When the diagnosis of pneumonia or serious suspicions of this pathology tactics antibiotic therapy is different from the previous two cases.
For different age groups of children characterized by certain features of the prevailing pathogens. Thus, under
s of pneumonia can be caused by viruses. At older ages, the probability of viral pneumonia is significantly reduced and the role of bacteria (pneumococci) in the development of pneumonia. However, in all age groups common cause of the disease is Streptococcus pneumoniae, which causes severe course of the disease. It is therefore Pneumonia is an absolute indication for antibiotic therapy.