[Antibiotic therapy in bronchopulmonary diseases in children]

With a wide-spectrum antibiotic the results obtained are not as satisfactory as those obtained with an aimed antibiotic therapy. It is for this reason that a physician must always keep up to date on all the antibiotics and their field of action. Apart the antituberculosis drugs we can currently count on three large families, the penicillins, the cephalosporins, the aminoglycosides, and on a polymorph group made up of erythromycin, chloramphenicol, vancomycin and trimethoprim-sulfamethoxazole (TMP-SMZ). Of all the lung diseases, pneumoniae is without doubt the disease in which the choice of the antibiotic is most difficult and also most determinant. Using a scheme made up of three successive stages could be useful. In the first stage we exploit our knowledge of the prevalence of certain infectious agents in single age group. In the first two months of life gram negative rods, B and D Streptococci and Pneumococcus are the most probable agents, therefore an association of ampicillin and aminoglycoside is recommended. In the pre-school age we find a predominance of Haemophilus influenzae and Pneumococcus and therefore the antibiotic of choice is amoxicillin. In the school age there remains only the Pneumococcus so that the first choice antibiotic is now penicillin. All of this is true for those clinical situations that do not present peculiar characteristics. When this is not the case, we pass on to the second stage which consists of suspecting, on the basis of clinical and instrumental data, of a certain etiologic agent and in choosing an appropriate antibiotic.(ABSTRACT TRUNCATED AT 250 WORDS)