2023-12-01 17:57:06
“No to panic, yes to the appropriate use of antibiotics.” This, in a nutshell, is the warning of the Italian Society of Paediatrics (Sip) in response to concerns about the spread of pneumonia in children in China and, subsequently, in Vietnam and France. In fact, paediatricians state that in Italy “no increase in respiratory infections from Mycoplasma pneumoniae has been observed, which mainly affects children over 5 years of age and for whom macrolides are the antibiotics of choice”, while “in the population 0 -18 years old, a high prevalence of respiratory infections from influenza viruses and a concomitant circulation of Respiratory Syncytial Virus (Rsv) and Sars-CoV-2 are observed”.
“In a limited number of cases these viral infections can undergo bacterial superinfections, especially from Streptococcus pneumoniae, a bacterium for which amoxicillin is the antibiotic of first choice and which in approximately 25% of cases in Italy is resistant to macrolides “, explain the pediatricians of the Sip Infectious Diseases and Vaccinations Technical Table. The specialists therefore reiterate that “antibiotics should not be used to combat viral infections while, when used appropriately, they are a valuable tool in the fight against bacterial infections. However – they underline – the panic generated by the events reported in China, whose etiology based on what was declared by the Chinese authorities appears to be linked to known viruses and bacteria, and the indiscriminate use of antibiotics, in particular macrolides, can cause serious consequences on public health”.
And again, on the alarm in China, for the experts “it is not prudent to be guided by fear or unverified information. The health situation in China has shown an increase in respiratory infections from Mycoplasma pneumoniae since May, while since October they have respiratory infections caused by influenza viruses and Rsv have increased. This requires checks at an international level both through the surveillance of circulating viral and bacterial pathogens and by analyzing vaccination coverage (in China, for example, pneumococcal vaccination with conjugated preparations) without reaching hasty conclusions”.
Pediatricians are therefore keen to reiterate, in response to any concerns, that: antibiotics are not effective against viruses, including influenza viruses, Rsv and Sars-CoV-2; the use of antibiotics in children without the supervision of a pediatrician can aggravate the problem of antibiotic resistance in children; the inappropriate and indiscriminate use of macrolides can cause an increase in bacterial resistance, compromising the effectiveness of these drugs when they are truly necessary.
“Therefore – continue the Sip specialists – we strongly encourage pediatricians to base their decisions on the use of antibiotics following the guidelines and parents to be aware of the importance of the appropriate use of antibiotics to preserve their effectiveness over time. They remain vaccinations against respiratory pathogens, hand washing, the use of masks in crowded places, ventilation of closed environments and staying at home for adequate times in case of respiratory symptoms are fundamental. To support the work of paediatricians – they specify – it would be desirable to activate expanded surveillance to pathogens other than influenza viruses and Rsv in children with pneumonia, also including bacteria such as Mycoplasma pneumoniae and Streptococcus pneumoniae”.
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