Сравнительная фармакоэпидемиологическая характеристика назначений антибактериальных препаратов, применяемых у больных с инфекцией нижних дыхательных путей в условиях типичной практики г. Курска и г. Кишинева

Abstract

Objective: to study the structure of medical prescriptions for antibacterial drugs used in patients with various types of infection of the bronchopulmonary system in the conditions of typical practice in Kursk (Russian Federation) and Chisinau (Republic of Moldova). Materials and methods. In order to assess the structure of prescribing various classes of antibacterial agents used to treat patients with infections of the respiratory system, a survey of doctors from medical organizations in Kursk and Chisinau was conducted in the period from October 2019. to January 2020 as a one-time descriptive study. As model diseases are taken: acute bronchitis with purulent sputum, exacerbation of chronic obstructive pulmonary disease with purulent sputum, non-severe community-acquired pneumonia. Results. The leaders in prescription for acute bronchitis with purulent sputum were cephalosporins: in Kursk, their share was 24% (cefixime was most often prescribed), and in Chisinau, 26.8% (leaders were cefixime and ceftriaxone). In patients with exacerbation of chronic obstructive pulmonary disease and purulent sputum, doctors from both cohorts also more often recommended cephalosporins: 29.4% and 36.1% for Kursk and Chisinau, respectively; among them, cefixime, ceftriaxone and cefotaxime were leaders in Kursk, while ceftriaxone, cefotaxime and cefuroxime axetil were the priorities in Chisinau. For non-severe community-acquired pneumonia, doctors in Kursk preferred macrolides (more often - azithromycin and clarithromycin), inhibitor-protected penicillins (more often - amoxicillin/clavulanate) and cephalosporins (mainly of the 3rd generation), in Chisinau, cephalosporins (mainly of the 3rd generation) and penicillins (including inhibitor-protected) were more often prescribed, the proportion of macrolides was significantly less. Conclusion. Doctors from Chisinau and Kursk implement pharmacotherapy for this group of patients in accordance with modern clinical guidelines; at the same time, cases of irrational use of certain medicines are recorded.