The rapid spread of multidrug-resistant Gram-negative bacteria in hospital settings all over the world makes a demand for the new options to overcome antimicrobial resistance. Ceftazidime-avibactam is the first approved antibiotic that contains a new beta-lactamase inhibitor with unique properties. This review provides insight into the spectrum of activity, pharmacological characteristics, data on efficacy and safety of ceftazidime-avibactam obtained from the clinical trials and real clinical practice, as well as prospects for further studies and clinical application of this new antimicrobial agent.

Despite the presence of more than 100 different antibacterials in the therapeutic arsenal, beta-lactam antibiotics, in general, and the third-generation cephalosporins, in particular, remain the main option for the treatment of the most of infections in inpatients. At the same time, the widespread and oftentimes inappropriate use of the third-generation cephalosporins in Russian hospitals lead to the emergence and spread of antimicroabial resistance. The review covers the problems of antibiotic resistance to cephalosporins due to the production of beta-lactamases, the role of beta-lactamase inhibitors in overcoming this type of resistance, options for combinations of cephalosporins with beta-lactamase inhibitors, in vitro activity of cefotaxime/sulbactam and cefepime/sulbactam, the results of clinical studies, and the role of the above combinations in the treatment of infections in the hospital.

Recent studies have strongly confirmed the health benefits of a variety of probiotic microorganisms. However, some issues regarding the use of probiotics currently remain unresolved or ambiguous. This article highlights some controversial issues of probiotic use in clinical practice such as regulatory status of probiotics, co-administration of probiotics and antibiotics, potential impact of probiotics on antimicrobial resistance emergence and spread, dosing and duration of probiotic use, contraindications and some other debatable topics.

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.

Despite modern highly-effective treatment and preventive tools available to physicians, respiratory tract infections (RTIs) are still the most common reason for referral to pediatricians. A myriad of papers are published every year, however, there is a growing concern over this issue. This paper responds to seemingly simple questions that, however, are often challenging and controversial for physicians and pediatricians. These questions are the use of antibiotics for acute RTIs to prevent bacterial complications, the impact of antibiotic resistance of respiratory pathogens (Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae) on antibacterial treatment choice, current position of macro-lides in the treatment for RTIs and ENT infections, the prescription of aminopenicillins and inhibitor-protected aminopenicillins in specific clinical situations, dosage regimens of amoxicillin and amoxicillin/clavulanic acid in pediatrics, the position of peroral third-generation cephalosporins in the treatment for RTIs, and optimal antibacterial treatment duration in children. Pediatricians often face these issues in routine clinical practice.Keywords: pediatrics, respiratory tract infections, acute respiratory disorders, antibiotics, antibiotic resistance.For citation: Andreeva I.V., Stetsyuk O.U., Egorova O.A. Respiratory tract infections in pediatrics: difficult answers to simple questions. Russian Journal of Woman and Child Health. 2020;3(2):105–111. DOI: 10.32364/2618-8430-2020-3-2-105-111.