Optymalizacja antybiotykoterapii zakażeń dróg oddechowych w aspekcie programu ochrony antybiotyków

*Piotr Albrecht, Andrzej Radzikowski

Streszczenie
Theses paper pointed out to increasing problem of antibiotic resistance of bacteria responsible for respiratory tract infections. Actions being supposed to optimize the antibiotic treatment in the aspect of the conservation programme of antibiotics. They concentrated on two being infection with the reason of biggest unnecessary and inappropriate use of antibiotics – for sore throat and acute inflammation of the middle ear. Diagnosing the streptococcal sore throat should be based on a spot Centor//McIssac scale assessments of the probability of Streptococcus pyogenes infection and antigen fast test or culture of a throat swab. The principle of streptococcal tonsillitis therapy is eradication of bacteria therefore the first choice therapy is to apply phenoxymethylpenicillin orally by 10 days. As an alternative it is possible to apply on one dose of benzylpenicillin intramuscularly. In second choice (corrected) therapy is making advances cefadroksyl. Makrolides (erythromycin, clarythromycin, azytromycin), on account of the quickly increasing Streptococcus pyogenes resistancy to this group of antibiotics, should be reserved only in the case of immediate allergy on betalactams and giving them should precede the determination of Streptocoocal resistancy on erythromycin. In acute otitis media watchful waiting strategy is recommended and giving such medicines as paracetamol or the ibuprofen. This principle doesn´t concern children on 6 month of age, children with high fever and the vomiting, children below 2 of year of live, with double-sided otitis media and sick persons with otorrhoea which the antibiotic should be applied immediately. In first choice therapy is making advances amoxycillin in the high dose through 5-10 days. In corrected therapy (second choice) he is making advances aksetyl cefuroxime or ceftriaxon.

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