Acute rhinosinusitis in pediatrics. How to reduce the antibacterial load?

A.S. Polyakova, D.P. Polyakov

1) National Medical Research Center for Children’s Health, Moscow, Russia; 2) National Medical Research Center for Otolaryngology, Federal Medical and Biological Agency of Russia, Moscow, Russia; 3) Pirogov Russian National Research Medical University, Moscow, Russia

Acute rhinosinusitis (ARS) is an inflammation of the mucous membrane of the nasal cavity and paranasal sinuses (PNS) of both viral and bacterial genesis. Therefore, acute respiratory viral infection (ARVI), accompanied by rhinitis, is also one of the variants of ARS. Uncomplicated cases of the disease, according to modern recommendations, are diagnosed clinically, including by anterior rhinoscopy, and do not require additional examination. Therefore, for quite a long time, foreign consensus documents devoted to this problem have been recommended not only for otolaryngologists, but also for pediatricians, general practitioners, therapists, and infectious disease specialists. The prevalence of ARS in pediatrics is high, and pediatricians’ awareness of the issues of diagnosis and treatment of ARS is often insufficient, which justifies discussions of this topic in the pediatric community.
Despite the fact that most ARS have a viral etiology and require only symptomatic therapy, this is one of the diseases for which systemic antibiotics are most often irrationally prescribed. Solution to the problem of overdiagnosis of bacterial rhinosinusitis partly consists in considering the principles of treatment, the place of topical and symptomatic therapy, which can be sufficient and successfully cope with most cases of ARS, including bacterial ones. 

For citations: Polyakova A.S., Polyakov D.P. Acute rhinosinusitis in pediatrics. How to reduce the antibacterial load? Farmateka. 2025;32(1 suppl. 1):26-33. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.1-s1.26-33

Authors’ contribution: Polyakova A.S. – study and selection of material, writing the text of the article. Polyakov D.P. – analysis, editing the text of the article. All authors made an equivalent contribution to the preparation of the publication.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.

Keywords

About the Authors

Anastasia S. Polyakova, Pediatrician, Cand. Sci. (Med.), Leading Researcher, Scientific and Methodological Department of Planning and Development, Associate Professor at the Department of Pediatrics and Public Health, National Medical Research Center for Children’s Health, Moscow, Russia; darmanyan@nczd.ru, ORCID: https://orcid.org/0000-0003-4655-3375 (corresponding author)
Dmitry Petrovich Polyakov, Cand. Sci. (Med.), otolaryngologist, Head of the Pediatric Otolaryngology Department, National Medical Research Center for Otolaryngology, Federal Medical and Biological Agency of Russia; Associate Professor of the Otolaryngology Department, Institute of Continuous Education and Professional Development, Pirogov Russian National Research Medical University, Moscow, Russia, Moscow, Russia; ORCID: https://orcid.org/0000-0002-6368-648Х

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