Assessment of the value of antiviral therapy in the complex treatment of ARVI in children aged 3–7 years in outpatient practice for the prevention of bacterial complications, the development of antibiotic resistance, and polypharmacy in the Russian F

The objective of this study was to evaluate the effectiveness of antiviral therapy in acute respiratory viral infections (ARVI) / acute respiratory infection in children aged 3–7 years in outpatient practice, to identify the frequency of complications, and to assess the appropriateness of prescribing antibiotic therapy to prevent the development of antibiotic resistance and polypharmacy in the Russian Federation (RF). Patients and methods. Large-scale program “AlgORITM” conducted from January to April 2024 covered 115 cities and 38 regions of the Russian Federation. It involved 379 doctors and 4,319 patients (54.9% boys and 45.1% girls). Depending on the drugs prescribed by doctors, the children were divided into three groups: group 1 (n = 481) received Groprinosin®, group 2 (n = 419) received other antiviral and interferon-containing drugs, and group 3 (n = 3,419) received only symptomatic therapy. The main clinical symptoms during the peak period of ARVI in children are highlighted. The highest number of cases is observed in children aged 4–5 years, with 7 times more cases among those who were not prescribed antiviral drugs (p < 0.05). Results. The results of the study showed that antiviral drugs were prescribed by only 20.8% of pediatricians. In the first group, in which patients received Groprinosin®, significantly fewer clinical symptoms (rhinitis, nasal congestion, cough, presence of sputum) were observed, as well as a faster and smoother regression of clinical symptoms (2 days earlier than in the third group), with all symptoms peaking on the third day of the illness. In the other groups, the peak of clinical symptoms was shifted to the fifth day of treatment, and the duration of ARVI often reached 10 days. A total of 792 complications were identified. The most common were bronchitis (30%), otitis, and rhinosinusitis (60.5%). Overall, in all three groups, 533 (9.5%) children were prescribed antibacterial drugs, mainly from the group of protected aminopenicillins (66.8%), less often – macrolides (16.1%) and cephalosporins (15.2%). It should be noted that among those patients who required antibiotic therapy (533 people), antibiotics were less frequently prescribed in the first (11.8%) and second (17.0%) groups, while in the third group, 71.2% of patients received them. Conclusion. Timely prescription of antiviral drugs can significantly reduce the duration of respiratory disease, decrease the number of bacterial complications and, in turn, the frequency of prescribing antibacterial drugs, as well as prevent the development of antibiotic resistance and polypharmacy in the Russian Federation. Key words: acute respiratory viral infections, preschool children, antiviral therapy, inosine pranobex, complications, antibiotics