Rational antibiotic therapy of the first line for the treatment of patients with non-severe lower respiratory infections
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Abstract
In accordance with the European and National guidelines for the management of mild lower respiratory tract infections (LRTIs), macrolides have always played a leading role in the treatment of this pathology.
The objective: the purpose of this study was to evaluate the efficacy, safety and rationality of the prescribing of azithromycin (Chemomycin® from the manufacturer Hemofarm AD, Serbia) to patients with nonsevere LRTIs, as well as to determine the optimal dosing schedules for this nosology.
Materials and methods. The study was attended by 20 patients with non-severe LRTIs who needed outpatient treatment. After diagnosis, ABT was prescribed for patients. Depending on the treatment regimen, all patients were randomly divided into 2 groups: the main group was 10 patients with non-severe LRTIs who took the azithromycin (Chemomycin®) for the «three-day» schedule – 1, 2, 3 days to 500 mg 1 time per day, comparative group – 10 patients with non-severe LRTIs who took azithromycin for the «six days» schedule – 6 days for 500 mg once a day.
Results. All patients included in the study found recovery. At the same time, clinical benefit from the use of a six-day regimen with azithromycin was not observed. In the treatment of patients, there were no apparent clinical side effects of the drug. 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. The economic advantage of treating patients in the main group was evident. So, given the average price for Chemomycin® (100 UAH per 3 capsules), this saved a lot of money for patients.
Conclusion. The presence of concomitant pathology and bed habits in patients with chronic diseases in our region is a risk factor for the presence of respiratory pathogens that are resistant to beta-lactams (intracellular and those producing beta-lactamase); this determines the priority choice of macrolides (mainly azithromycin) as firstline ABT drugs (in accordance with the current recommendations), which not only acts on such strains, but also has additional positive effects (including the destruction of the biofilm of the Haemophilus influenzae). The three-day oral azithromycin (Chemomycin®) is not only safe and highly effective in the treatment of non-severe LRTI s, but also has a significant economic advantage over the six-day course. Chemomycin® drug is well tolerated, it may be recommended as a drug of choice for the first line of ABT in patients with CAP of the first and second clinical groups and infectious exacerbation of COPD.##plugins.themes.bootstrap3.article.details##
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