ADJUNCTIVE THERAPY OF COMMUNITY-ACKUIRED PNEUMONIA: NECESSITY AND SUFFICIENCY

• Published in: Zhurnal infektologii Vol. 8; no. 4; pp. 58 - 65
• Main Authors: Savchenkova, L. V., Saidova, M. N., Sanginova, N. S.
• Format: Journal Article
• Language: English; Russian
• Published: Journal Infectology 01.12.2016
• Subjects: community-acquired pneumonia; pharmacotherapy; polypharmacy
• ISSN: 2072-6732; 2499-9865
• DOI: 10.22625/2072-6732-2016-8-4-58-65

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.