Rational combined antibacterial therapy of the first line for treatment of patients with in-patient community-acquired pneumonia

Abstract

Given that community-acquired pneumonia (CAP) is a frequent disease, in which antibiotics are always prescribed, in foreign literature there are papers devoted to rationalizing of the choice of one-component or combination antibiotic therapy (ABT) in this pathology, as well as to optimize its terms appointment.The objective: to evaluate the efficacy, safety and rationality of the appointment of beta-lactam in combination with azithromycin (Chemomycin® from the manufacturer Hemofarm AD, Serbia) in patients with CAP of the third clinical group.Materials and methods. The study was attended by 25 patients the third clinical group of CAP, who were treated in the therapeutic and pulmonary departments of the city. After diagnosis, the patient was given a combined ABT: beta-lactam, namely, amoxicillin / clavulanate (at a dose of 1,2 g three times a day intravenously) or ceftriaxone (at a dose of 2 g once a day intravenously), and the macrolide, namely the preparation of azithromycin Chemomycin® from the manufacturer Hemofarm AD, Serbia (at a dose of 500 mg once daily orally).Results. As a result, all patients included in the study, found recovery. In the treatment of patients, there were no apparent clinical side effects of the drug. In addition, in patients with the presence of concomitant cardiology, the deterioration of the condition, the appearance of new changes and/or prolongation of the QT interval (clinically and according to the electrocardiogram) was not observed in any case.Conclusion. 1. The presence of a frequent concomitant pathology and false habits in hospitalized patients with CAP of our region is a risk factor for the presence of intracellular pathogens, as well as typical strains of respiratory pathogens producing beta-lactamase; this is an indication for the addition of macrolides (mainly azithromycin) to the first line ABT that acts on intracellular pathogens and destroys the Haemophilus influenzae biofilms.2. Integrated step-by-step antibiotics inpatients with CAP in the three-day oral azithromycin treatment program (Chemomycin®) significantly reduces the serum level of the systemic inflammation marker of CRP, is safe and highly effective.3. The drug Chemomycin® is well tolerated, it can be recommended as a drug of choice for conducting a complex first-line ABT for the patients with third clinical group of CAP.