Aim To analyze the actual clinical management of children with ARI in various regions of the Russian Federation.

Material and Method 9272 children’s medical records from all 8 federal districts of the Russian Federation were analyzed. 250 cases with ICD codes J00-J06, J09-J18, J20-J22 (according to acute respiratory infections) were randomly selected from each of the regions.

Results The distribution of diagnoses showed that the majority of patients were diagnosed with J06, corresponding to acute upper respiratory tract infections (75.33% or 6985 people). The second prevalent diagnosis was acute pharyngitis (J02) (7.64% or 708 patients). Pneumonia without specifying the causative agent (J18) was diagnosed in 0.87% (81 children). The analysis showed high adherence to clinical recommendations for J00–06 nosologies. Thus, no referral for hospitalization among such patients (99.97% of children were not sent to the hospital) was. In 90% of cases, J00–06 patients group did not receive antibiotic therapy, as did all patients with influenza (J09). This is strikingly different from the situation in the early 2000s, when antibiotics were prescribed to children with ARVI symptoms in 90% of cases in the Russian Federation, and more than 2/3 of patients were sent to hospital. Also the difference is the fact that chest X-rays were performed in most cases with suspected pneumonia, 86.42% of patients with pneumonia were prescribed antibiotics. However, the analysis revealed persisting errors: the analysis of saturation’s fixation (SpO2) showed that less than half of the patients had documented SpO2 levels; the C-reactive protein was determined unreasonably rarely; a high percentage of antibiotic prescribing was observed in patients with acute bronchitis (J20) – 40.6%, which doesn’t compliance with clinical guidelines.

Conclusions The data obtained indicate significant progress in the actual clinical children’s management with ARVI in the Russian Federation. However, clinical guidelines are followed in different ways in different regions, which requires further study.