Introduction. In light of the available data on the unjustified use of antibiotics in children with acute respiratory viral infections, the frequency of prescribing antibacterial drugs to children with a new coronavirus infection in real clinical practice is of great practical and scientific interest.

The aim of the study was to study the frequency of antibiotic therapy and identify factors that increase the risk of needing antibiotics in children with coronavirus infection at the outpatient stage.

Materials and methods. A retrospective cross-sectional study was conducted on the basis of children's polyclinics in Samara from November 2021 to July 2022, which included a survey of parents and an analysis of outpatient records of 100 children who were under outpatient observation and treatment for COVID-19. An analysis was made of the frequency of prescribing antibiotics to them and potential factors predisposing to their prescribing to children with COVID-19. The obtained data were subjected to statistical processing using the IBM SPSS Statistics 25 program and a comparative analysis.

Results. The frequency of use of antibiotic therapy according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %). When analyzing the factors influencing the doctor's decision to prescribe an antibiotic to a child with coronavirus infection, the most important were a history of recurrent respiratory infections (children from the FIC group), as well as the presence of concomitant diseases and background conditions in children, primarily chronic bronchopulmonary diseases. and nervous system.

Discussion. The prescription of antibiotics for children with a new coronavirus infection at the outpatient stage remains empirical due to the limitations of the use of laboratory and instrumental methods for additional examination of the child, which objectifies the likelihood of a secondary bacterial infection. Despite this, the frequency of antibiotic use according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %), as well as the average frequency of antibiotic use for acute respiratory viral infections in children in the Russian Federation (21.5-23.3 %).

Objective. Evaluate the possibility of using a cream with 5 % filagrinol ("Admera") in children (0-18 years old) as an emollient in atopic dermatitis (AtD) and receive hardware measurements of skin hydration.

Materials and methods. Open interventional study in parallel groups of children with AtD 0-18 years old (n = 72, median age 6 [3.75; 7.0] years). 2 equal groups: group 1 received methylprednisolone cream 1 time daily on lesions for 14 days + Admera emollient on the other skin; group 2 received the same treatment + cream with filagrinol 5 % applied from day 5 on the lesions.

Results. Standard therapy with topical steroids and emollients was effective. The severity indices during steroid + emollient treatment decreased significantly: EASI 11.5 [6.0; 17.0] vs 2 [1; 3.8] scores, p < 0.001; skin lesion area from 17.5 % [10.0; 26.8 %] to 3.5 % [1.25; 6.0 %], p < 0.001; IGA score — 2 [2; 3] vs 1 [1; 2], p < 0.01.

The total itching score for AtD (max 10) became significantly lower with therapy: nocturnal itching decreased from 3 [1; 7] to 1 [1; 3] and daytime itching from 4 [3; 7] to 2.5 [1; 4] points, p < 0.01.

The mean values of hardware-measured skin hydration outside the lesion areas were 8 [6.0; 12.0] units at baseline. After 14 days of emollient, hydration of dry clear skin increased to 10 [8.0; 15.0] units (p = 0,017). The hydration of the skin on the affected areas increased significantly from 8 [6; 10] to 12.0 [8; 15] units (p = 0.001).

The patients' organoleptic evaluation of the cream was 4.48 (max 5). No serious or moderate adverse events (AEs) were reported in this study. In 11.3 % of cases, the skin itching was detected, but resolved rapidly without treatment.

Conclusion. The cream with 5 % filagrinol (“Admera”) significantly improved skin hydration, as measured instrumentally, in the area of dermatitis and dry skin without ones. The cream caused no significant adverse reactions and could be used together with topical steroids.

Introduction. Researching on pathogenesis and immunopathogenesis of acute respiratory infections in conjunction with recurrent episodes of acute laryngotracheitis and otorhinolaringological diseases (tonsillopharyngitis, rhinosinusitis, otitis) — is a high priority task for pediatrics, what is necessary to do to create an approach for preventing chronic illnesses.

The aim of the present work. Researching on clinical and immunological characteristics and efficiency of treatment with prescription of bacterial lysate (OM-85) for children with recurrent episodes of acute laryngotracheitis, acute respiratory infections (ARI), otorhinolaringological diseases.

Materials and methods. Fifty children 3-9 years old (32 children 3-6 years, 18 children 7-9 years old; 32 boys, 28 girls) in the initial period of monitoring, with recurrent episodes of acute laryngotracheitis (ALT), acute respiratory infections (ARI), otorhinolaryngological diseases were examined. The treatment in according with pediatric clinical practice guidelines, consultations with a pediatrician, otorhinolaryngologist, allergologist were provided to all children.

Twenty five children (subgroup I b) received bacterial lysate (OM-85, 4 courses in 3 years ) in complex treatment. Subgroups I a, I b were similar in clinical symptoms, gender and age related. Follow up period continued three years. The results were evaluated a year and three years after treatment. Experimental group was composed of 30 children 3-9 years old, additionally examined. This group had such characteristics as: frequency of acute respiratory infections 3-5 times in a year, absence of chronic respiratory diseases, of recurrent episodes of acute laryngotracheitis. Immunological survey included some parameters of innate immunity, serum immunoglobulins, chemiluminescence, interferons (IFN-alfa, IFN-gamma).

Results. In children with repeated episodes of ALT and ARI and otorhinolaryngological diseases the expression of TLR2 and TLR4 on CD14⁺ cells, receptors for IFN-γ (CD14⁺CD119⁺) is significantly higher than in children without ALT and with a frequency of ARI 3-5 times a year, which is accompanied by a decrease in the level of IFN-γ and IFN-α and is associated with the development of dysregulation of the immune system, which decreases with the administration of bacterial lysate (OM-86). Complex treatment of children within 3 years with the prescription of the drug significantly reduces the frequency of ARI — 2.6 times, tonsillopharyngitis — 1.8 times, rhinosinusitis — 2.2 times, the need for the prescription of antibiotics — 2.2 times. In the group treated by standards after 3 years, the need for antibiotics decreased by 1.6 times, the frequency of ARI exacerbations — by 1.2 times, tonsillopharyngitis — by 1.5 times, rhinosinusitis — by 1.8 times.