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More than half a century ago, clinicians first encountered real difficulties in the treatment of infectious diseases due to the development and subsequent spread of pathogens with antimicrobial resistance (AMP). Since then, medical science has been constantly searching for a solution to the problem of ineffective antibacterial therapy (ABT) against a background of rapidly changing sensitivity of microorganisms to antibiotics. One of the medications which could compromise the most common mechanisms of pathogenic resistance is amoxicillin in combination with clavulanic acid. Despite its long-term use, the drug is becoming increasingly relevant for ABT of respiratory bacterial infections today, justifying the trust of doctors and patients with its long history of effective and safe use. The review tells about indications for amoxicillin/clavulanic acid with regard to the most widespread pediatric infections of the upper and lower respiratory tract and the ENT organs in outpatient settings.

Advancements in fluoroquinolones (FQ) resulted in the development of the so-called respiratory quinolones which are different from their predecessors in having a stronger clinically significant effect against gram-positive pathogens of relevant human infections. Broad antibacterial spectrum, resistance to certain factors of pathogen resistance and absence of cross-resistance formation, along with their unique pharmacokinetic characteristics, made respiratory FQ the drug of choice for quite a wide range of diseases, including in outpatient clinical practice. The review presents the results of epidemiological observations and qualitative clinical trials demonstrating the efficacy of levofloxacin in the treatment of respiratory tract infections (RTI), urinary tract infection (UTI), infections of skin and soft tissues (ISST).

Community-acquired pneumonia is one of the most common infectious diseases in developed countries. Chronic heart failure is an independent risk factor for unfavorable course and prognosis of community-acquired pneumonia. Objective challenges of clinical, radiological, laboratory and microbiological diagnosis of community-acquired pneumonia in elderly patients with chronic heart failure dictate the need for a greater number of physicians to routinely examine for serum biomarkers of inflammation. Systemic antibiotic therapy for the category of patients is carried out in accordance with the standard guidelines and should be based on certain peculiarities of the etiology, impact of concomitant functional impairment of the organ systems and additional medication therapy on the pharmacokinetics of antimicrobial agents, and take into account the risk of potentiation of adverse reactions as a result of administration of drugs.

The review continues the publication series devoted to well-known "classical" antimicrobial drugs the application of which in clinical practice takes on a new meaning in light of the striving to limit the globally increasing resistance of infectious diseases to antibiotics. For example, doxycycline is indicated for still relevant sexually transmitted infections, pelvic inflammatory diseases, lower respiratory tract infections, some skin infections and periodontitis. Antibiotic drug remains crucial in addressing the complex issues of prevention and treatment of a number of zoonotic diseases (including special danger infections) and vector-borne diseases, making it a strategic product for healthcare.

Infections of the lower respiratory tract are a serious challenge for modern healthcare. Macrolides occupy a special place in the list of antibiotics recommended for the treatment of such conditions, which is not only due to their high safety and efficiency associated with their potent activity against major pathogens; macrolides are also characterized by unique non-antibiotic properties. The review highlights specific use of macrolides today for pneumonia and infectious exacerbation of chronic obstructive pulmonary disease/chronic bronchitis in view of the immunomodulatory and anti-inflammatory properties of the drugs.