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General practice Terapia 2023, 1 ( 420 ) :  12  -  22

Recommendations for the management of community-acquired respiratory infections 2016 – are corrections needed? Part II. Acute infections of the lower respiratory airways in children

Summary: As presented in part I, the Recommendations for the Management of Community Respiratory Infections, developed on the initiative and under the direction of Professor Waleria Hryniewicz, were last updated in 2016. Important events (e.g. Covid-19 pandemic, introduction of universal pneumococcal vaccination) and new publications were the premises that prompted the authors to propose and discuss proposals for changes to the Recommendations. In this section, we present the arguments for modifying the recommendations for bronchial and lung infections. Acute bronchitis should be treated without the use of antibiotics. In prolonged productive cough, the suspicion of PCB is confirmed by improvement after treatment with amoxicillin (80–100 mg/kg/24 h) with clavulonic acid, lasting at least 14 days. Previously healthy children, vaccinated against pneumococci, with uncomplicated CAP can only be treated symptomatically. If antibiotic therapy is needed, the first choice is amoxicillin at high dose, administered orally for 5 days. Due to the high prevalence of pneumococcal resistance to macrolides, macrolide monotherapy should be used with caution.
Keywords: children, acute lower respiratory tract infections, acute bronchitis, persistent bacterial bronchitis, pneumonia

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