Abstract
Summary: The problem of rational antibiotic therapy of pneumonia is among the most relevant in modern medicine. The aim of the study was to evaluate the clinical efficacy and therapeutic tolerance of parenteral application of clarithromycin in the treatment of patients with non-hospital pneumonia (NHP). Materials and methods. We observed 20 patients: 12 men - (60%), 8 women - (40%), the average age of patients was 46.1 ± 17.6 years. All patients showed clinical symptoms of severe infection of the lower respiratory tract. In 75.0% (15 patients) bilateral lung damage was noted, in 27% (5 patients) - unilateral lung tissue damage. Hemoptysis was observed in 4 (20%) patients. Clarithromycin-MB was included in complex therapy (detoxification, mucolytic drugs, multivitamins, and metabolices) for 6 patients with NHP after 3 days of ineffective starting therapy, 14 patients with emergency received clarithromycin-MB immediately after admission to the hospital. The drug was administered by intravenous drip for 60 minutes at a dose of 500 mg 2 times a day for 7-10 days. Result. The analysis of the obtained results of clarithromycin-MB therapy showed that clinical success was achieved in all patients. The positive dynamics of clinical indicators was noted already on the 3rd day from the beginning of antibiotic therapy with clarithromycin-MB, which was expressed in a decrease in body temperature until the 7th day of treatment, and in almost all patients the temperature returned to normal and only in 1 (5%) patient remained subfebrile. Also, during this period, patients noted a decrease in pain syndrome as well as signs of intoxication. According to the data of X-ray studies on the 10th day of therapy, 6 (30%) patients showed complete disappearance of infiltrative changes in the lungs, in 14 (70%) patients - a significant decrease in their severity. On the 15-24th (average 15.3 ± 1.2) days after the start of therapy signs of inflammatory infiltration in the lungs leveled off on the 15-24th in all patients. Conclusion. Clarithromycin-MB has good therapeutic tolerance, allows maintaining the required concentration in the focus of inflammation because of dosage regimen also affects the clinical and bacteriological effectiveness of therapy.
Highlights
The antiinflammatory effect is due to a decrease in the activity of cyclooxygenase and lipoxygenase cells. It has become recently known about the inhibition of the mediator chain of proinflammatory cytokines, such as interleukin-6, tumor necrosis factor-α [11], which significantly increased the efficiency of treatment in severe forms of ventilator-associated pneumonia [12]
All this became the basis for the use of clarithromycin as an etiotropic drug for the treatment of patients with non-hospital pneumonia (NHP)
Serological test was performed before treatment to detect Cl. pneumoniae, Cl. psittaci, Mycoplasma pneumoniae, Legionella pneumophila, Coxiella burnetii
Summary
3 groups, which are formed depending on the number of carbon atoms in the lactone ring: I. 14-. Macrolides stimulate mechanisms of nonspecific defense of the organism [6, 7, 8] The action of this group of antibiotics is usually bacteriostatic, but in high concentrations, they may have bactericidal properties. The antiinflammatory effect is due to a decrease in the activity of cyclooxygenase and lipoxygenase cells It has become recently known about the inhibition of the mediator chain of proinflammatory cytokines, such as interleukin-6, tumor necrosis factor-α [11], which significantly increased the efficiency of treatment in severe forms of ventilator-associated pneumonia [12]. In patients with respiratory infections, clarithromycin inhibits the formation of sputum and improves its rheological properties [13] All this became the basis for the use of clarithromycin as an etiotropic drug for the treatment of patients with non-hospital pneumonia (NHP). The aim of the study was to evaluate clinical efficiency and therapeutic tolerability of clarithromycin in a parenteral use form for the treatment of patients with non-hospital pneumonia
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