Karpenko G. Clinical and immunological rationale for a differentiated approach to the prevention of bacterial complications of acute respiratory viral infections in children

A clinical trial was conducted, in which 214 children aged 3 to 18 years old were enrolled, in a period of URTI complicated with bacterial acute otitis media (AOM) or bacterial rhinosinusitis (BRS). Significant medical and biological factors were identified that are associated with the recurrent course of bacterial complications of URTI in children. We performed anassessment of the dynamics of lactoferrin, lysozyme, human catelecidin and sIgA concentrations in oropharyngeal secretions in different disease periods in these children and have revealed the deficiency of local non-specific immunity, which deepens at the beginning of the development of the bacterial process. High frequency of unsuccessful identification of causative agent of AOM and BRS in children with recurrent bacterial complications of URTIs has been established. H. parainfluenzae and St. aureus colonization was shown to be associated with a change in the typical direction of the local immune response to bacterial infection in children. Amoxicillin susceptibility of local strains of S. pneumoniae and H. paranfluenzae remains at a sufficiently high level (90 ‒ 100%). In children with recurrent bacterial complications of URTIs, the efficacy of 20 mg lysozyme hydrochloride in the complex therapy of URTIs clinically manifested by a decrease in the frequency of bacterial complications and shortening the overall duration of the disease.