The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.

Амоксициллин, согласно как международным, так и отечественным рекомендациям, является препаратом выбора для лечения большинства внебольничных инфекций респираторного тракта у детей. Тем не менее практика назначения антибиотиков на догоспитальном этапе в разных странах демонстрирует низкий уровень следования стандартам лечения внебольничных пневмоний и острого среднего отита (ОСО). Цель исследования: изучить спектр антибиотиков, назначаемых на амбулаторном этапе детям с пневмонией и ОСО, а также оценить их эффективность. Методы. Дизайн работы — наблюдательное исследование когорты детей, госпитализированных с диагнозом внебольничной пневмонии (n = 261) и ОСО (n = 225) в 2008–2015 гг. Результаты. Амоксициллин был назначен только 4,5% детей с типичной внебольничной пневмонией и 1% — с ОСО; вместе с парентеральными цефалоспоринами и амоксициллином/ клавуланатом в адекватных дозировках стартовая терапия была начата всего в 34 и 25% случаев соответственно. Остальные дети лечились оральными цефалоспоринами 3-го поколения и макролидами с крайне низкой эффективностью (19 и 10% соответственно). Ввиду выраженного несоответствия спектра антибиотиков и их доз современным рекомендациям неэффективные стартовые назначения были сделаны при типичной пневмонии в 72%, а при ОСО — в 69% случаев. При атипичных пневмониях макролиды были назначены всего 19% больным. Заключение. Поскольку амоксициллин остается основным препаратом для лечения инфекций, вызванных Streptococcus pneumoniae и Streptococcus pyogenes в эпоху роста их резистентности, он должен использоваться в качестве стартового препарата при типичных пневмониях и ОСО. Дозы амоксициллина, в т. ч. защищенного, не должны быть ниже 45 мг/кг в сут, а при риске устойчивости пневмококков — 80–100 мг/кг в сут. Следует также повышать знания педиатров в дифференциальной диагностике атипичных пневмоний.

Acute tonsillitis and pharyngitis are common infectious diseases of upper respiratory tract causing significant discomfort and various complications in patients. This article covers all the issues of tonsillitis and pharyngitis etiology, pathogenesis, classification. Modern clinical guidelines focus on optimizing the diagnosis, management, and prevention of these conditions, ensuring high quality of medical care.Centor, McIsaac, or FeverPAIN scores can be used for differential diagnosis of viral and streptococcal tonsillopharyngitis. Particular attention is given to the management tactics of patients with these diseases, including the antibiotic therapy for streptococcal tonsillitis. Modern clinical guidelines emphasize the need for individual approach for every patient considering their age, concomitant diseases, and infection course aspects. These guidelines implementation in practice can increase the treatment efficacy, reduce the risk of any complications, and improve the quality of life of patients with acute tonsillitis and pharyngitis.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with acute respiratory viral infection. The term “acute respiratory viral infection” (ARVI) combines following nosological forms: acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, upper respiration tract infection (unspecified). The issues of epidemiology, diagnosis, treatment, and prevention have been considered in detail.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on the management of children with acute obstructive laryngitis and epiglottitis. Croup is the most common cause of acute upper respiratory obstruction in children aged from 6 months to 6 years. Usually respiratory viruses are the pathogenic agents of the disease. The etiological factor of epiglottitis is Haemophilus influenzae type b in the vast majority of cases (> 90%). However, nowadays, epiglottitis caused by this pathogen agent is more common in adults in countries with mass immunization against hemophilic infection. This article considers in detail etiology, pathogenesis, and classification issues. Special attention is given to diagnosis, differential diagnosis, and therapy (via evidence-based approach) of acute obstructive laryngitis in children.

Experts of The Union of Pediatricians of Russia have developed current clinical guidelines for management of children with community-acquired pneumonia, which were approved by the Scientific and Practice Council of Ministry of Public Health of the Russian Federation in January 2022. Particular attention is paid to the etiological structure, modern classification, diagnostic tests and flagship approaches to antibacterial therapy of community-acquired pneumonia in children based on the principles of evidentiary medicine.