ANTIBIOTIC RESISTANCE IN CHILDREN AND STRATEGIES FOR RATIONAL ANTIBIOTIC THERAPY

Abstract

This scientific article analyzes the relevance of the growing problem of antibiotic resistance (antimicrobial resistance) in pediatric practice, which is largely driven by irrational and unjustified use of antibiotics, as well as its etiological factors and clinical-epidemiological consequences. In recent years, antibiotics have frequently been prescribed in pediatrics for conditions such as respiratory tract infections, acute otitis media, tonsillopharyngitis, bronchitis, and intestinal infections, often without laboratory confirmation and even in cases where viral etiology is highly probable. Such an approach promotes the emergence of resistant microbial strains, reduces treatment effectiveness, increases the duration and recurrence of disease, contributes to a higher rate of complications, and raises the need for inpatient management. The article highlights the pathogenetic mechanisms of antibiotic resistance, including β-lactamase production, modification of bacterial cell wall and ribosomal structures, activation of efflux pumps, and biofilm formation, from a scientific perspective. Furthermore, modern strategies for rational antibiotic therapy in children are discussed in detail, including an etiology-based approach, strict adherence to clinical guidelines, prioritization of narrow-spectrum agents, individualized dosing and treatment duration, restriction of uncontrolled antibiotic sales, and implementation of antimicrobial stewardship programs in pediatric healthcare. In addition, the article identifies major socio-organizational factors that contribute to the increasing resistance, such as parents’ misconceptions about antibiotics, physicians’ excessive precautionary prescribing, limited access to rapid diagnostic tools, and insufficient pharmaceutical regulation. As a result, the article concludes that reducing antibiotic resistance among children requires not only pharmacological interventions but also comprehensive strategies involving healthcare system reforms, education and prevention measures, improved laboratory diagnostics, and effective public awareness initiatives.