АНАЛИЗ СХЕМ ДИАГНОСТИКИ И ЛЕЧЕНИЯ ОСТРЫХ ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ ВЕРХНИХ ДЫХАТЕЛЬНЫХ ПУТЕЙ ПО ДАННЫМ ПОЛИКЛИНИК УПРАВЛЕНИЯ ДЕЛАМИ ПРЕЗИДЕНТА РФ

Abstract

The main objective of treatment of acute respiratory diseases of the upper respiratory tract (URT) is to reduce symptoms severity, prevent the development of complications, and improve the quality of life of sick children. Objective of the research: to analyze the actual tactics of diagnosis and treatment of patients with acute nasopharyngitis (AN) in children according to the data of the clinics of the Administrative Department of the President of the Russian Federation. Materials and methods: a retrospective analysis of 499 outpatient case histories of patients (mean age 8,0±2,5 years) who were on outpatient treatment with a diagnosis of AN for the period from March 2018 to April 2019 was performed. Inclusion criteria: the patient's visit within 1–3 days from the onset of the disease, observation period – at least 7 days, compliance by patients and/or their parents/legal representatives with medical recommendations based on informed consent. Results were processed using the standard package of statistical programs IBM SPSS Statistics 23.0. Results: bacteriological examination of nasal cavity and oropharynx microflora was performed in 27 (5,4%) children with AN, the results mainly showed Staphylococcus aureus. Systemic antibiotics, most often (96,5%) pill form of protected penicillins, were taken by 28 (5,6%) children. Homeopathic medicines were prescribed in 11% of cases (55 children), antihistamines – in 36,8% (194), intranasal glucocorticosteroids (GCS) – in 39,5% (197), immunotropic drugs – in 12,4 % (62). In most AN topical drugs were recommended for sanitizing the oropharynx and nasal cavity (in 89% and 86%, respectively). Rinsing with antiseptic solutions was prescribed in 43,3% of all cases (216 children), half of them (50,5% – 109 children) – miramistin, less often (21,6% – 108 children) – phytopreparations. Decongestants were prescribed to AN patients in 70,7% (353 children) of cases, topical preparations for the nasal cavity containing antiseptics or antibiotics – in 32,3% (161 children). Conclusion: in the system of children's outpatient service of the Presidential Administration of the Russian Federation in the majority of cases, topical drugs were prescribed for AN treatment. Bacteriological study of nasopharyngeal microbiome in AN is not informative and was carried out in 5,4% of cases to exclude bacterial pathogens. The use of intranasal corticosteroids (39,5%), immunotropic drugs (12,4%), antihistamines (36,8%) and homeopathic (11%) drugs should be considered unreasonable.