Modern approaches to the prevention and rehydration therapy of antibiotic-associated diarrhea affected by ARI in children

Abstract

The use of antibiotic drugs (ABDs) has significantly reduced the number of severe bacterial infectious diseases and mortality in children, especially in infants. But the widespread and unnecessary use of ABDs, including reserve antibiotics (the use of carbapenems increased by 45%, polymyxins – by 13%), to treat uncomplicated acute respiratory infections is open to many hazards, such as increased antibiotic resistance of pathogens. Antibiotic-associated diarrhea is one of the common complications of antibiotic therapy. According to various authors, the incidence of antibiotic-associated diarrhea is 6–80% among patients treated with antibiotics, on average 35% of patients (approximately every third patient) receiving antibiotics report symptoms of antibiotic-associated diarrhea. Disruptive changes in the qualitative and quantitative composition of the intestinal microbiota are accompanied by a decrease in the protective functions of the intestinal mucosa and contribute to the growth of pathogenic and opportunistic microorganisms (Clostridium spp., Candida spp., Salmonella spp., Staphyloccus aureus). The findings of most studies obtained on a large sample of paediatric population, as well as the clinical guidelines of the World Association of Gastroenterologists recommend the use of L. rhamnosus GGprobiotic strain (level of evidence 1) to prevent antibiotic-associated diarrhea in children. L. rhamnosus GGpresents chromosomal resistance to a range of antibiotics, which varies with species and strain. They do not contain plasmid DNA, which is dangerous for the spread of antibiotic resistance among other bacteria, which enables their wide therapeutic and prophylactic use. Clinical case studies of the course of antibiotic-associated diarrhea in children are presented to demonstrate the variability of clinical symptoms. Fever in children with ARI, particularly in tender-age infants, requires special attention from parents and doctors, as its main risk lies with a dehydration due to significant water loss during breathing, and especially increased sweating (including sweating induced by antipyretics). Therefore, oral rehydration therapy is an important method for treating infectious diseases in children. Complications that develop in patients, especially in children, after administration of antibiotics, diseases that can lead to water and electrolyte imbalance are life-threatening conditions that require immediate medical attention. Correction of water and electrolyte balance, timely restoration of intestinal microflora improve prognosis in such patients and promote faster recovery.