Діагностика та лікування позалікарняної пневмонії в дітей дошкільного віку: проблеми та дискусійні питання

Abstract

Community-acquired pneumonia remains one of the most common diseases in preschool children, but despite the intensive study of this pathology, in the practice of a primary care physician, the issue of differential diagnosis and treatment of viral and bacterial pneumonia causes certain problems. The aim of the study is to determine the problems existing in the practice of a primary care physician regarding the diagnosis and treatment of community-acquired pneumonia in preschool children, to determine ways to solve them, using data from domestic and foreign literature. Modern clinical guidelines for the diagnosis and treatment of community-acquired pneumonia in preschool children at the ambulatory stage were reviewed and analyzed. Med Line, Embase, Web of Science and Scopus databases were analyzed to search for literature sources. Modern epidemiological data on viral and bacterial pneumonia in preschool children are presented. The issue of the role of clinical manifestations and paraclinical research methods in their differential diagnosis is covered. In the context of the problem, an integrated approach to the diagnosis of viral and bacterial pneumonia, which is based on the determination of clinical signs and symptoms, is recommended. Special attention is paid to the issue of the treatment of community-acquired pneumonia in preschool children. A comparative description of the recommendations of national and foreign guidelines and generalized retrospective analyzes regarding the advisability of prescribing and cancelling antibiotics is given. Wider implementation of etiological examination using modern methods is recommended. Conclusions. The final decision regarding the diagnosis of viral or bacterial pneumonia in each specific case should be based on the totality of the anamnesis data, clinical signs and symptoms. The implementation of integrated management of preschool children into the practice of a primary care physician will allow determining the probability of the etiology of pneumonia without auxiliary methods of examination and prescribing empirical therapy during the initial examination. The authors declare no conflict of interest.