ADJUNCTIVE THERAPY OF COMMUNITY-ACKUIRED PNEUMONIA: NECESSITY AND SUFFICIENCY

Abstract

Objective: analysis of pathogenetic and symptomatic therapy of community-acquired pneumonia in the prehospital and at the stage of hospital treatment of disease in hospitals of city Khujand of the Republic of Tajikistan. Materials and methods: A retrospective analysis of 393 case histories of patients treated for community-acquired pneumonia in the hospital Khujand from 2011 to 2015 is conducted. The estimation of the scope and efficiency of the additional medical support for the treatment of communityacquired pneumonia was conducted, take into account the drugs that given to patients in an outpatient setting and in a hospital. Analyzed purpose rationale, adequacy of dose, duration of treatment and compliance of the activities with existing international and national guidelines for the treatment of community-acquired pneumonia. Results: the study found that in clinical practice, 57% of patients with community-acquired pneumonia received funds pathogenetic and symptomatic therapy. It is found that quite often prescribed drugs with unproven efficiency. Thus, 75% of patients received expectorants and mucolytic drugs, 42.2% of patients received anti-allergic medicals. Non-steroidal anti-inflammatory medicals received 37.9% of patients with community-acquired pneumonia, almost 30% of patients receiving infusion therapy. Quite often (15.7%) patients with community-acquired pneumonia prescribed antifungal drugs and antiprotozoal drug – metronidazole (59% of cases). Furthermore, in complex treatment of community-acquired pneumonia include vitamin C (23.1%) and vitamin B (65.9%). Conclusion: the analysis of pharmacotherapy community-acquired pneumonia showed that in the treatment of this disease occurs unjustified polypharmacy. Quite often prescribe drugs with unproven efficacy and, as a consequence of a significant frequency of clinical failures at both the outpatient and inpatient, which significantly increases the cost of treatment. From the standpoint of evidence-based medicine is justified by the inclusion in the treatment of communityacquired pneumonia, only a mucolytic drugs and indications NSAIDs as an antipyretic and analgesic short course. The use of most drugs of pathogenic therapy do not have the evidence base and the efficiency of their purpose can not be considered reasonable. In this case, the analysis can serve as a basis for planning a set of measures for improvement of pharmacotherapy community-acquired pneumonia based on the principle of minimal sufficiency.