Current approaches to the treatment of acute rhinosinusitis in children in outpatient practice

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

This article briefly describes the main etiological factors, development mechanisms, and traditional approaches to the treatment of rhinosinusitis in children. The emergence of antibiotic-resistant microorganisms is a serious clinical problem associated with more severe disease progression. Acute rhinosinusitis remains a common cause of unnecessary systemic antibacterial therapy. In most cases, antibiotics can be considered overtreatment, as they are completely inappropriate for the treatment of viral infections. When determining the indications for antibacterial therapy, as well as when choosing a specific drug, it is necessary to follow current national clinical guidelines. This article discusses the general principles of rational antibacterial therapy for the treatment of rhinosinusitis in children, the criteria for the selection and use of cephalosporins, in particular cefixime in a dispersible form, which has particular advantages in treating children and ensures high patient compliance due to its high efficacy against most respiratory pathogens, favorable safety profile, convenient administration, and the ability to be administered once daily.

全文:

受限制的访问

作者简介

Elena Karpova

Russian Medical Academy of Continuous Professional Education

编辑信件的主要联系方式.
Email: nzayceva@bionika-media.ru
ORCID iD: 0000-0002-8292-9635

Dr. Sci. (Med.), Professor, Head of the Department of Pediatric Otolaryngology named after Professor B.V. Shevrygin

俄罗斯联邦, Moscow

Vladimir Belov

Russian Medical Academy of Continuous Professional Education; Pirogov Russian National Research Medical University

Email: nzayceva@bionika-media.ru
ORCID iD: 0000-0002-2955-2015

Cand. Sci. (Med.), Assistant Professor, Department of Pediatric Otolaryngology named after Professor B.V. Shevrygin, Russian Medical Academy of Continuous Professional Education; Head of the Otolaryngology Department, Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery, Pirogov Russian National Research Medical University

俄罗斯联邦, Moscow; Moscow

Alan Asmanov

Pirogov Russian National Research Medical University

Email: nzayceva@bionika-media.ru
ORCID iD: 0000-0002-3116-6447

Cand. Sci. (Med.), Head of the Department of Acute and Chronic Ear, Nose, and Throat Pathology, Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery, Pirogov Russian National Research Medical University; Assistant Professor, Otolaryngology Department, Faculty of Pediatrics, Pirogov Russian National Research Medical University

俄罗斯联邦, Moscow

Denis Tulupov

Russian Medical Academy of Continuous Professional Education; Filatov Children’s City Clinical Hospital

Email: nzayceva@bionika-media.ru
ORCID iD: 0000-0001-6096-2082

Cand. Sci. (Med.), Associate Professor, Shevrygin Pediatric Otolaryngology Department, Russian Medical Academy of Continuous Professional Education; Otolaryngologist, Otolaryngology Department, Filatov Children’s City Clinical Hospital

俄罗斯联邦, Moscow; Moscow

Oleg Naumov

Russian Medical Academy of Continuous Professional Education; Filatov Children’s City Clinical Hospital

Email: nzayceva@bionika-media.ru
ORCID iD: 0000-0002-8243-8385

Cand. Sci. (Med.), Associate Professor, Shevrygin Department of Pediatric Otolaryngology, Russian Medical Academy of Continuous Professional Education; Otolaryngologist, Otolaryngology Department, Filatov Children’s City Clinical Hospital

俄罗斯联邦, Moscow; Moscow

参考

  1. Клинические рекомендации. Острый синусит. Министерство здравоохранения Российской Федерации. Национальная медицинская ассоциация оториноларингологов. 2024. [Clinical guidelines. Acute sinusitis. Ministry of Health of the Russian Federation. National Medical Association of Otolaryngologists. 2024. (In Russ.)]. URL: https://cr.minzdrav.gov.ru
  2. Геппе Н.А., Карпова Е.П., Тулупов Д.А. и др. Консенсус по затрудненному дыханию у детей. Назальная обструкция – мультидисциплинарная проблема. Резолюция совета экспертов. Вопросы практической педиатрии. 2021;16(6):149–160. [Geppe N.A., Karpova E.P., Tulupov D.A., et al. Consensus on difficulty breathing in children. Nasal obstruction is a multidisciplinary problem. Resolution of the expert council. Voprosy prakticheskoy pediatrii. 2021;16(6):149–160. (In Russ.)].
  3. Белов В.А., Карпова Е.П., Заплатников А.Л. и др. Острые инфекции органов дыхания: современные клинические рекомендации. В фокусе – вопросы фитотерапии. Русский медицинский журнал. Медицинское обозрение. 2022;6(7):376–386. [Belov V.A., Karpova E.P., Zaplatnikov A.L., et al. Acute respiratory infections: current clinical guidelines. Focus on herbal medicine. Russian Medical Journal. Medical Review. 2022;6(7):376–386. (In Russ.)]. https://doi.org/10.32364/2587-6821-2022-6-7-376-386
  4. Fokkens W.J., Lund V.J., Hopkins C., et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464. https://doi.org/10.4193/Rhin20.6003
  5. Карпова Е.П., Тулупов Д.А., Наумов О.Г. и др. Назальные сосудосуживающие препараты в лечении острой воспалительной патологии риносинусотубарного комплекса у детей. Практика педиатра. 2024;1:40–45. [Karpova E.P., Tulupov D.A., Naumov O.G., et al. Nasal vasoconstrictors in the treatment of acute inflammatory pathology of the rhinosinusotubular complex in children. Praktika pediatra. 2024;1:40–45. (In Russ.)].
  6. Turner R.B. Epidemiology, pathogenesis, and treatment of the common cold. Ann Allergy Asthma Immunol. 1997;78(6):531–539. https://doi.org/10.1016/S1081-1206(10)63213-9
  7. Finley C.R., Chan D.S., Garrison S. et al. What are the most common conditionsin primary care? Systematic review. Can Fam Physician. 2018;64(11):832–840.
  8. Orlandi R.R., Kingdom T.T., Smith T.L. et al. International Consensus Statement on Allergy and Rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021;11(3):213–739. https://doi.org/10.1002/alr.22741
  9. Bittner C.B., Plach M., Steindl H. et al. Prevalence of antibiotic p prescription in patients with acute rhinosinusitis trated by general practitioners and otolaryngologists in Germany- a retrospective cohort study. Antibiotics (Basel). 2022;11(11):1576. https://doi.org/10.3390/antibiotics11111576
  10. Баранов А.А., Лобзин Ю.В., Намазова-Баранова Л.С. и др. Острая респираторная вирусная инфекция у детей: современные подходы к диагностике и лечению. Педиатрическая фармакология. 2017;14(2):100–108. [Baranov A.A., Lobzin Yu.V., Namazova-Baranova L.S., et al. Acute respiratory viral infection in children: modern approaches to diagnosis and treatment. Pediatricheskaya farmakologiya. 2017;14(2):100–108. (In Russ.)]. https://doi.org/10.15690/pf.v14i2.1724
  11. Федотова М.М., Акперов Э.Г., Елисеев В.Ю. и др. Антибиотикотерапия при острых респираторных вирусных инфекциях у детей: что знают родители об антибиотиках и антибиотикорезистентности? Вопросы практической педиатрии. 2022;17(2):85–92. [Fedotova M.M., Akperov E.G., Eliseev V.Yu., et al. Antibiotic therapy for acute respiratory viral infections in children: what do parents know about antibiotics and antibiotic resistance? Voprosy prakticheskoy pediatrii. 2022;17(2):85–92. (In Russ.)]. https://doi.org/10.20953/1817-7646-2022-2-85-92
  12. Ferme S., Piednoir E., Delestre M., et al. Evaluation of antibiotic treatment initiation and duration practices in primary care. Cross-sectional study in two French multi-professional health centers. PLoS One. 2024;19(12):e0315128. https://doi.org/10.1371/journal.pone.03151287
  13. Popovych V.I., Koshel I.V. Delayed prescription of antibiotics and the capabilities of herbal medicine when used in respiratory infections. Clin Phytosci. 2024;10:1. https://doi.org/10.1186/s40816-023-00364-5
  14. Kalil J., Bowes J., Reddy D., et al. Pediatric inpatient antimicrobial stewardship program safely reduces antibiotic use in patients with bronchiolitis caused by respiratory syncytial virus: a retrospective chart review. Pediatr Qual Saf. 2019;4(5):e211. https://doi.org/10.1097/pq9.0000000000000211
  15. Fleming-Dutra K.E., Hersh A.L., Shapiro D.J., et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864–1873. doi: 10.1001/jama.2016.4151
  16. van Houten C.B., Cohen A., Engelhard D., et al. Antibiotic misuse in respiratory tract infections in children and adults – a prospective, multicentre study (TAILORED Treatment). Eur J Clin Microbiol Infect Dis. 2019;38(3):505–514. https://doi.org/10.1007/s10096-018-03454-25
  17. Hashimoto H., Matsui H., Sasabuchi Y., et al. Antibiotic prescription among outpatients in a prefecture of Japan, 2012–2013: a retrospective claims database study. BMJ Open. 2019;9(4):e026251. https://doi.org/10.1136/bmjopen-2018-026251
  18. Arcimowicz M. Rational treatment of acute rhinosinusitis in the context of increasing antibiotic resistance. Otolaryngol Pol. 2024;78(6):1–11. https://doi.org/10.5604/01.3001.0054.7506
  19. World Health Organization, Antimicrobial resistance. URL: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance (19.09.2025).
  20. Яковлев С.В., Рафальский В.В., Сидоренко С.В. и др. Рациональная антибактериальная терапия инфекций респираторного тракта у детей в амбулаторной практике (клинические рекомендации). Русский медицинский журнал. 2015;23(3):115–117. [Yakovlev S.V., Rafal’skiy V.V., Sidorenko S.V., et al. Rational antibacterial therapy of respiratory tract infections in children in outpatient practice (clinical guidelines). Russian Medical Journal. 2015;23(3):115–117. (In Russ.)].
  21. Popovych V.I., Beketova H.V, Koshel I.V. et al. An open-label, multicentre, randomized comparative study of efficacy, safety and tolerability of the 5 plant –extract BNO 1012 in the Delayed Antibiotic Prescription Method in children,aged 6 to 11 years with acute viral and post-viral rhinosinusitis. Am J Otolaryngol, 2020;41(5):102564. https://doi.org/10.1016/j.amjoto.2020.102564
  22. Nocon C.C., Baroody F.M. Acute Rhinosinusitis in children. Curr AllergyAsthma Rep. 2014;14(6):443. https://doi.org/10.1007/s11882-014-0443-7
  23. Torretta S., Guastella C., Marchisio P. et al. Sinonasal-related orbital infections in children: a clinical and therapeutic overview. J Clin Med. 2019;8(1):101 doi: 10.3390/jcm8010101
  24. Никифорова Г.Н., Свистушкин В.М. Алгоритм использования фитопрепаратов в лечении риносинуситов. Русский медицинский журнал 2014;9:650-654. [Nikiforova G.N., Svistushkin V.M. Algorithm for the use of herbal remedies in the treatment of rhinosinusitis. Russian Medical Journal 2014;9:650–654. (In Russ.)].
  25. Косяков С.Я., Атанесян А.Г., Цаголова К.С. Современные подходы в лечении острых риносинуситов: взвешенный подход к назначению антибиотиков. Consilium medicum, 2014;3:45–48. [Kosyakov S.Ya., Atanesyan A.G., Tsagolova K.S. Modern approaches to the treatment of acute rhinosinusitis: a balanced approach to prescribing antibiotics. Consilium medicum, 2014;3:45–48. (In Russ.)].
  26. Baroody F.M. Nasal and paranasal sinus anatomy and physiology. Clin Allergy Immunol. 2007;19:1–21.
  27. Пискунов Г.З., Пискунов С.3. Воспаление слизистой оболочки. М.: Колос, 2008. 34 с. [Piskunov G. Z., Piskunov S. Z. Inflammation of the mucous membrane. Moscow: Kolos, 2008. 34 p. (In Russ.)].
  28. Пискунов Г.З., Пискунов С.З. Клиническая ринология. М.: Медицинское информационное агентство, 2006. 560 с. [Piskunov G.Z., Piskunov S.Z. Clinical Rhinology. Moscow: Medical Information Agency, 2006. 560 p. (In Russ.)].
  29. Ah-See K.W., Evans A.S. Sinusitis and its management. BMJ. 2007;334(7589):358–361.
  30. Белов В.А., Белова О.И. Рациональная антибактериальная терапия острого риносинусита у детей. Медицинский совет. 2015;1:28–31. [Belov V.A., Belova O.I. Rational antibacterial therapy of acute rhinosinusitis in children. Medical Council. 2015;1:28–31. (In Russ.)].
  31. Brook I. Microbiology of sinusitis. Proc Am Thorac Soc. 2011;8(1):90–100. https://doi.org/10.1513/pats.201006-038RN
  32. Карпова Е.П., Тулупов Д.А. Антибактериальная терапия острых риносинуситов у детей. Фарматека. 2014;11:16–19. [Karpova E.P., Tulupov D.A. Antibacterial therapy of acute rhinosinusitis in children. Farmateka. 2014;11:16–19. (In Russ.)].
  33. Brook I. Microbiology and antimicrobial management of sinusitis. Otolaryngologic Clinics of North America. 2004;37(2):253–266.
  34. Lin C.Y., Cheng P.H., Fang S.Y. Mucosal changes in rhinitis medicamentosa. Ann Otol Rhinol Laryngol. 2004;113(2):147–151. https://doi.org/10.1177/000348940411300213
  35. Finley C.R., Chan D.S., Garrison S. et al. What are the most common conditionsin primary care? Systematic review. Can Fam Physician. 2018;64(11):832–840.
  36. Hoffmans R., Wagemakers A., van Drunen C., et al. Acute and chronic rhinosinusitis and allergic rhinitis in relations to comorbidity,ethnicity and environment. PLoS One. 2018;13(2):e0192330. https://doi.org/10.1371/journal.pone.0192330
  37. American Academy of Pediatrics. Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis. Pediatrics. 2001 Sep;108(3):798-808. https://doi.org/10.1542/peds.108.3.798
  38. Casanueva R., Villanueva E., Llorente J.L., Coca-Pelaz A. Management options for orbital complications of acute rhinosinusitis in pediatric patients. Am J Otolaryngol. 2022;43(3):103452. https://doi.org/10.1016/j.amjoto.2022.103452
  39. Simmen D. Konservative und chirurgische Behandlung der oberen Atemwege [Medical and surgical treatment options in the management of upper airway diseases]. Ther Umsch. 2008;65(3):175–180. (In German). https://doi.org/10.1024/0040-5930.65.3.175
  40. McDermott S.M., Onwuka A., Elmaraghy C., Walz P.C. Management patterns in pediatric complicated sinusitis. Otolaryngol Head Neck Surg. 2020;163(4):814–821. https://doi.org/10.1177/0194599820918832
  41. Torumkuney D., Mayanskiy N., Edelstein M., Set al. Results from the Survey of Antibiotic Resistance (SOAR) in Russia. J Antimicrob Chemother. 2018;73(suppl 5):14–21.
  42. Крюков А.И., Гуров А.В., Шадрин Г.Б. и др. Современная фармакотерапия острого бактериального синусита: результаты открытого рандомизированного клинического исследования терапевтической эквивалентности препаратов «Цефиксим ЭКСПРЕСС» и «Супракс Солютаб». Вестник оториноларингологии. 2024;89(3):48–56. Kryukov A.I., [Gurov A.V., Shadrin G.B., et al. Modern pharmacotherapy of acute bacterial sinusitis: results of an open-label, randomized clinical trial of the therapeutic equivalence of Cefixime EXPRESS and Suprax Solutab. Vestnik Otorinolaringologii. 2024;89(3):48–56. (In Russ.)]. https://doi.org/10.17116/otorino20248903148
  43. Кочетков П.А., Щенникова, Е.С., Шабанова З.О. Особенности антибактериальной терапии при остром синусите. Медицинский совет. 2024;18(7):172–176. [Kochetkov P.A., Shchennikova E.S., Shabanova Z.O. Features of antibacterial therapy for acute sinusitis. Medical Council. 2024;18(7):172–176. (In Russ.)]. https://doi.org/10.21518/ms2024-143
  44. Крюков А.И., Гуров А.В., Шадрин Г.Б. и др. Современная фармакотерапия острого бактериального синусита: результаты открытого рандомизированного клинического исследования терапевтической эквивалентности препаратов «Цефиксим ЭКСПРЕСС» и «Супракс Солютаб». Вестник оториноларингологии. 2024;89(3):48–56. [Kryukov A.I., Gurov A.V., Shadrin G.B., et al. Modern pharmacotherapy of acute bacterial sinusitis: Results of an open-label, randomized clinical trial of therapeutic equivalence of Cefixime EXPRESS and Suprax Solutab. Vestnik Otorinolaringologii. 2024; 89(3):48–56. (In Russ.)].
  45. Крюков А.И., Гуров А.В., Шадрин Г.Б. и др. Результаты открытого рандомизированного клинического исследования по изучению терапевтической эквивалентности препаратов «Цефиксим ЭКСПРЕСС» и «Супракс Солютаб» в терапии затяжных форм бактериального синусита. Российская ринология. 2024;32(2):40–48. [Kryukov A.I., Gurov A.V., Shadrin G.B., et al. Results of an open-label, randomized clinical trial of therapeutic equivalence of Cefixime EXPRESS and Suprax Solutab in the treatment of protracted bacterial sinusitis. Rossiiskaya Rinologiya. 2024;32(2):40–48. (In Russ.)].

补充文件

附件文件
动作
1. JATS XML

版权所有 © Bionika Media, 2025