ACUTE RESPIRATORY INFECTIONS

Acute respiratory infections

are diseases of the respiratory
tract, usually bacterial or viral
etiology.
ARIs are classified as upper
respiratory tract infections or
lower respiratory tract
infections.
ARIs are the most common
cause of morbidity and
mortality in children under five
years who presented average
3-6 episodes per year, being
pneumonia the leading cause
of infant mortality worldwide.

Factors associated with the incidence of ARIs

The outcome of infection results from a set of diverse

factors including pathogen virulence factors, the
environment, and the genetic make-up of the host.

Environmental conditions

environmental changes such as cold fronts,

promotes patterns of behavior and the use of
firewood and charcoal intradomicilliary, causing
changes in the respiratory epithelium that
promote colonization of microorganisms

Availability and effectiveness of medical care.

as infection prevention measures such as
vaccines, access to health centers, insulation
capacity, etc

HOST FACTORS
Age
Smoking
Host ability to transmit infection
Nutritional status
Previous or concurrent infection with
other pathogens
Underlying clinical conditions
The presence of atopy

Genetic factors
patients with asthma, cystic fibrosis,
bronchopulmonary dysplasia and children with
selective immunodeficiencies, congenital heart
disease are more susceptible to get the
infections.

5 STEPS TO FULL
CONSULTATION

1.-IDENTIFY BAD PROGNOSTIC

FACTORS
Under 5 years

Under two months

Moderate or severe malnutrition

High risk pregnancy

Persistent Infections

Birth defects

Hearth disease

Neonatal hypoxia

Mother Illiterate or less 17 years

Infectious process in under 28

days of age

2.- CLINICAL EVALUATION AND

CLASSIFICATION

Questioning and physical examination should be

oriented to identify or exclude pneumonia data,
including heart frecuency, respiratory frecuency,
temperature and complete otoscopy.

3.- TREATMENT

Plan A: IRAs without

pneuomnia
Plan B: IRAs with
pneumonia but without
respiratory distress
Plan C: IRAs with
pneumonia and respiratory
distress.

4.- MOTHER TRAINING

Training mothers to recognize warning signs:
fast breathing
Intercostal retractions
Cyanosis
Pus or discharge from the ear

5.- MONITORING OF THE CASES

Without Pneumonia
evaluating at 72 hours.
Whitout pneumonia but with
poor prognosis data evaluate
in 24-48 hours
With pneumonia evaluate in
12 hours

TREATMENT
PLAN A
General Treatment:

Increace

the intake of liquids

Keep normal diet.
Otorrea: Auditory canal. Dont use otic drops.
Pain, fever: Paracetamol : 10 15 mg/kg 4-6 H
Ibuprofen: 10 mg/kg 6-8 H
Warning signs.

PLAN A
Specific treatment:

Most

of them are VIRAL.

If it is bacterial, need a specific treatment.

Plan B
General treatment
Specific Treatment:
Child with Polypnea with out breathing difficulty.
Can have an ambulatory antibiotic therapy.

Start

with an antibiotic acording to the clinical signs.

First election: Amoxicilin: 80-90mg/kg/day divided 2 doses

for 7 10 days.

Fever

and pain.
wheezing: Salbutamol (Inhaled) 2 shots, 0.02
mcg/dose. Every 20 min 3 doses.

PLAN C
Child with signs of breathing difficulty. Refer to
hospital.
Start with:

Oxigen

(if avaible)

Newborn: 0.5L/min
Infant: 2-3L/min

Fever

and pain control

Wheezing
Star antibiotic therapy:

Ampicilin: 200 mg/kg/day divided in 4 doses IM

Amoxicilin/ clavulanic Acid: 100mg/Kg/day 2 dosis IM