Background In Moldova, acute respiratory infections (ARI) constitute 2/3 of infant morbidity and are in the top causes of mortality in last 20 years.

The aim of the study was to analyse the practical aspects of ARI treatment in young children in the light of national and international guidelines.

Materials and methods It was performed a retrospective study of 100 medical records of inpatients with IRA hospitalised in 2012. Mean age of patients was 12.58 ± 1.09 months, including 66% of infants. Analysis included: clinical signs of disease onset, clinical outcome and cause of hospitalisation, laboratory tests, home and in hospital treatment, treatment compliance with guidelines.

Results The most common syndrome at admission was fever (36% patients), but antipyretics were administered at lower levels than considered febrile, contrary to international guidelines.

In 93% cases were given anti-viral drugs, mucolytics, topical treatment, in 45% cases – antibacterial treatment. The antibiotics used at home were not according to local protocols in 31% cases. The average length of home treatment was 4.6 ± 0.3 days.

Serum levels of leukocytes (8.9 ± 0.35 × 10⁹/l) at admission were not suggestive of bacterial aetiology.

Antibacterial treatment was applied in all patients. Antibiotic was changed within the first 24 h in 35.3% of children, after 48 h of hospitalisation – in 14.7% children, and after 72 h or more – in 50% children. Unjustified polypharmacy was found in 51% cases.

Conclusion Antibacterial treatment of ARI is not always according national and international protocols, but there are divergences between national and international guidelines.