[Clinical significance of fungal and microbial associations and antibacterial therapy for treatment of chronic inflammatory respiratory tract diseases in children].
Microbiological examination applied to 270 children with chronic inflammatory and relapsing respiratory tract diseases revealed that by the frequency of the etiologically significant organisms the main pathogens isolated from the bronchial secretion belonged to Haemophilus influenzae, then followed Streptococcus pneumoniae and the less frequent isolates belonged to Branhamella catarrhalis characterized by high susceptibility to the 2nd and 3rd generation cephalosporins, erythromycin and azithromycin. Mycological investigation of the oral mucus and sputum from the patients revealed high frequency of Candida, mainly C.albicans. The fungi were most frequent and abundant in the children with chronic pulmonary diseases and congenital immune deficiency and in the children with bronchial asthma and asthmatic bronchitis, as well as in the children with exacerbation of the chronic disease, especially with bronchial obstruction. The antibacterial therapy with semisynthetic penicillins, cephalosporins and macrolides led to an increase in the number of the Candida carriers and in the biological material contamination level. The fungal contamination of the host was mainly observed after the use of the penicillins and cephalosporins. Chronic Candida carriers were detected among the patients with chronic inflammatory diseases of the lungs. The diseases in such patients were particularly severe. There were also detected children with colonization resistance to Candida. In the latter cases the chronic process was more favourable. The data made it possible to recommend a more differential use of the antibacterial and antimycotic drugs in the treatment of children with chronic inflammatory diseases of the bronchopulmonary system.
Platonova
M M
MM
Research Institute of Pediatry, Russian Academy of Medical Sciences, Moscow.
Sereda
E V
EV
Katosova
L K
LK
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D002511:Cephalosporins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D001936:Moraxella catarrhalis / Q000187:drug effects / Q000302:isolation & purification; D012140:Respiratory Tract Diseases / Q000188:drug therapy* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D004917:Erythromycin; D017963:Azithromycin