Анализ реальной практики антибактериальной терапии инфекций нижних дыхательных путей в амбулаторных условиях

Статья в Elpub

Рецепт. 2018; : 220-225

Анализ реальной практики антибактериальной терапии инфекций нижних дыхательных путей в амбулаторных условиях

Аннотация

С целью изучения реальной практики антибактериальной терапии при инфекциях нижних дыхательных путей в амбулаторных условиях проведен выборочный ретроспективный анализ медицинской документации 168 пациентов. Оценка проводилась по следующим параметрам: наличие показаний для назначения антибактериальных препаратов, нозологический диагноз, адекватность выбора и дозы антибиотика конкретной клинической ситуации, наличие нежелательных лекарственных реакций в ходе лечения. Установлено, что наиболее часто были назначены цефалоспорины II-III поколений, макролиды, защищенные формы аминопенициллинов и фторхинолоны. Амбулаторно отдавалось преимущество пероральным формам лекарственных средств. Качественный анализ назначенных препаратов продемонстрировал избыточное использование антибиотиков широкого спектра действия из групп цефалоспоринов и респираторных фторхинолонов.

Список литературы

1. Prikaz MZRBot 05.07.2012 № 768 «Klinicheskie protokoli diagnostiki i lecheniya zabolevanii organov dihaniya» [The Order Of the Ministry of Health of the Republic of Belarus from 5th of July. 2012

2. № 768 "Diseases of the respiratory system diagnosis and management clinical pathways"].

3. Prikaz MZ RB № 1301 ot 29.12.2015 g. «O merah po snizheniyu antibiotikorezistentnosti mikroorganizmov» [The Order Of the Ministry of Health of the Republic of Belarus № 1301 from 29th of December, 2015 "On measures for microorganisms antibiotic resistance reduction"].

4. U.S. Food & Drug Administration. (2016) FDA Drug Safety Communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects. Updated 9 August 2016. Retrieved from http://www.fda.gov/Drugs/DrugSafety/ucm511530. htm. Accessed 29 November 2016.

5. (2008) Respiratory tract infections - antibiotic prescribing. Prescribing of antibiotic for self- limiting respiratory tract infections in adults and children in primary care. National Institute for Health and Clinical Excellence. NICE clinical guideline, vol. 69, 122 p. Available at: www.nice.org.uk

6. Örtqvist A. (2002) Treatment of community-acquired lower respiratory tract infections in adults.

7. European Respiratory Journal, vol. 20, рр. 40s-53s.

8. Winchester CC, Macfarlane TV, Thomas M, Price D. (2009) Antibiotic prescribing and outcomes of lower respiratory tract infection in UK primary care. Chest., May; vol. 135(5), рр. 1163-1172.

9. Woodhead М. (2011) Guidelines for the management of adult lower respiratory tract infections - Summary. Clinical Microbiology and Infection, vol. 17, suppl. 6, рр. 1-24.

10. Rachel McKay, Allison Mah, Michael R. Law, Kimberlyn McGrail and David M. Patricka. (2016) Systematic Review of Factors Associated with Antibiotic Prescribing for Respiratory Tract Infections. Antimicrobial Agents and Chemotherapy, July, vol. 60, Number 7, рр. 4106-4118.

11. Bell B.G., Schellevis F., Stobberingh E., Goossens H., Pringle M. (2014) A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis, vol. 14:13. Available at: http://dx.doi.org/10. Doi: 1186/1471-2334-14-13.

12. Calbo E., Alvarez-Rocha L., Gudiol F., Pasquau J. (2013) A review of the factors influencing antimicrobial prescribing. Enferm. Infecc. Microbiol. Clin., 31 (suppl. 4), рр. S12-S15. 8.

13. Lopez-Vazquez P., Vazquez-Lago J.M., Figueiras A. (2011) Misprescription of antibiotics in primary care: a critical systematic review of its determinants. J. Eval. Clin. Pract., vol. 18, рр. 473-484.

Recipe. 2018; : 220-225

The analysis of the real practice of antibacterial therapyof lower respiratory tract infections under outpatient treatment

Davidovskaya E. ., Ruzanov D. .

Abstract

In order to study the actual practice of antibacterial therapy in lower respiratory tract infections under outpatient treatment, a selective retrospective analysis of medical records of 168 patients was conducted. The evaluation was carried out on the following parameters: the presence of indications for the appointment of antibacterial drugs, nosological diagnosis, the adequacy of the choice and dose of the antibiotic in a particular clinical situation, the presence of adverse drug reactions during treatment. It was found that cephalosporins of II-III generations, macrolides, protected forms of aminopenicillins and fluoroquinolones were most often prescribed. Out-patient advantage was given to oral forms of medicines. Qualitative analysis of medications have demonstrated excessive use of broad-spectrum antibiotics from the groups of cephalosporins and respiratory fluoroquinolones.

References

2. № 768 "Diseases of the respiratory system diagnosis and management clinical pathways"].

6. Örtqvist A. (2002) Treatment of community-acquired lower respiratory tract infections in adults.

7. European Respiratory Journal, vol. 20, rr. 40s-53s.

8. Winchester CC, Macfarlane TV, Thomas M, Price D. (2009) Antibiotic prescribing and outcomes of lower respiratory tract infection in UK primary care. Chest., May; vol. 135(5), rr. 1163-1172.

9. Woodhead M. (2011) Guidelines for the management of adult lower respiratory tract infections - Summary. Clinical Microbiology and Infection, vol. 17, suppl. 6, rr. 1-24.

12. Calbo E., Alvarez-Rocha L., Gudiol F., Pasquau J. (2013) A review of the factors influencing antimicrobial prescribing. Enferm. Infecc. Microbiol. Clin., 31 (suppl. 4), rr. S12-S15. 8.