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The infections of the upper respiratory tract in children

F Bonsignori1, E Chiappini, M De Martino

  • 1Department of Paediatrics, University of Florence, Anna Meyer University Children's Hospital, Florence, Italy.

International Journal of Immunopathology and Pharmacology
|February 16, 2010
PubMed

Insights

Pediatric upper respiratory infections like AOM, ARS, and AP often resolve on their own. Amoxicillin is the preferred antibiotic for bacterial cases, with alternatives for treatment failure or specific conditions.

Area of Science:

  • Pediatric infectious diseases
  • Otolaryngology
  • Pharmacology

Background:

  • Upper respiratory tract infections (URTIs) are frequent in children, encompassing acute otitis media (AOM), acute rhinosinusitis (ARS), and acute pharyngitis (AP).
  • Management strategies vary based on the specific condition, age, and severity.

Purpose of the Study:

  • To outline current management guidelines for common pediatric URTIs.
  • To specify first-line and alternative antibiotic therapies.
  • To highlight diagnostic criteria for bacterial infections.

Main Methods:

  • Review of clinical guidelines and evidence for pediatric URTI management.
  • Analysis of diagnostic criteria for AOM, ARS, and AP.
  • Identification of recommended antibiotic choices and treatment durations.

Main Results:

  • Observation is an option for uncomplicated pediatric AOM in children over 2 with follow-up; otherwise, amoxicillin is first-line.
  • Amoxicillin is also first-line for mild ARS, with amoxicillin/clavulanate or ceftriaxone for persistent/worsening symptoms.
  • Bacterial pharyngitis requires microbiological confirmation; amoxicillin or amoxicillin/clavulanate are first-line treatments in Europe.

Conclusions:

  • Antibiotic selection for pediatric URTIs should be guided by diagnosis, severity, and potential for follow-up.
  • Amoxicillin remains a cornerstone therapy for bacterial URTIs in children.
  • Accurate diagnosis, including microbiological testing for pharyngitis, is crucial for appropriate antibiotic use.

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