No 1 (2011)

Amoxicillin/clavulanate is widely used in clinical practice for 30 years. This drug has highly stable activity against the major bacterial pathogens of the respiratory system and ENT-organs in children: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Due to the high level of resistance of pneumococcus to penicillin, the use of high-dose amoxicillin (80-90 mg/kg/day) is recommended in a number of countries. Currently, amoxicillin/clavulanate at a dose of 40-45 mg/kg/day (per amoxicillin) is possible to use in Russia. Administration of amoxicillin/clavulanate with a high content of amoxicillin is reasonable only in patients with risk of infection by penicillin-resistant pneumococcus.

Migraine is diagnosed by neurologists in almost half of children with headache. Topiramate is effective drug used in the treatment of migraine without aura and migraine with aura at doses lower than in the treatment of epilepsy. The results of study of the efficacy of topiramate in the preventive therapy of migraine in children with frequent bouts of migraine are presented. It was found that the use of topiramate was effective in patients with migraine with and without aura. The best results were recorded in the presence of aura. Against the background of therapy with topiramate, normalization of the electroencephalogram in addition to clinical improvement was observed in all patients.

The article is dedicated to the modern data for the clinical use of therapeutic bacteriophage preparations; their antimicrobial action is due to replication of the phage genome in a sensitive bacterial cell with subsequent lysis and release of a new generation of virions into the environment. The advantages of therapeutic bacteriophages are ability to affect sensitive and polyantibiotic-resistant cells of causative pathogen and cascade ability to repeated selective lysis of cells of causative pathogen in the focus of inflammation, which lasts until their total elimination without disturbances in normal microbiota. In order to select an effective therapeutic preparation, the importance of identification of causative agent and determination of its sensitivity to bacteriophage is noted.

The article emphasizes the importance of ENT infectious diseases in children. Sequelae of unreasonable and irrational use of antimicrobial agents, including the problem of antibiotic resistance, are presented. The principles of rational choice of antibiotics for treatment of sinusitis, otitis, and tonsillopharyngitis are considered. Rational use of antibiotics prevents the development of microbial resistance to antibiotics, reduces the duration of inflammatory diseases of ENT organs, and prevents their complications.

In children, chronic diarrhea (CD) represents a serious diagnostic problem, requiring broad knowledge of the physician and significant technical capabilities of the medical facility. In most cases, CD is pathogeneticaly associated with a syndrome of disturbed intestinal absorption, which is often congenital. Differential diagnosis includes analysis of data from medical history, results of standard clinical examination, and selecting special techniques to confirm or reject the preliminary diagnosis. The article presents the basic principles of differential diagnosis of chronic diarrhea in children and some general principles of its correction.

In recent years, variety of immunomodulatory drugs is widely used in the treatment of infectious diseases in children. Insufficient knowledge about drug-induced non-specific immune reactions, lack of determined indications provide the need to development of modern approaches to evaluation of effect of immunotropic drugs on adaptive processes. This is especially important in children in the case of acute infectious disease that is accompanied by not only endogenous intoxication, but immunity disadaptation condition. The authors have conducted multidisciplinary study of adaptogenic properties of metabolic prebiotic Hilak forte in acute respiratory infections (ARI) in children and evaluated its clinical, microbiological efficacy, and ability to modify non-specific resistance of the organism. The data represents the advisability of use of Hilak forte in the complex treatment of acute respiratory disease in children, as a means providing an adaptive effect and recovery of gastrointestinal microbiota.