Pharmacotherapy of exacerbation of chronic obstructive pulmonary disease in rural hospitals of the Stavropol territory
N.E. AFANASIEV1, O.YU. POZDNYAKOVA2
¹City Clinical Polyclinic No. 5, Stavropol
²Stavropol State Medical University, Stavropol
Contact details:
Afanasiev N.E. — PhD (medicine), therapist
Address: 15 Zarechniy proyezd, Stavropol, Russian Federation, 355026, tel.: +7-928-813-70-88, e-mail: dvamedika03@yandex.ru
A retrospective analysis of medical documents of 735 patients with exacerbation of chronic obstructive pulmonary disease in round-the-clock hospitals in the Shpakovsky district of the Stavropol Territory was carried out. The sensitivity of the main bacterial pathogens of the disease such as Streptococcus pneumonia, Staphylococcus aureus, Haemophilus influenza and Enterobacteriacea was determined in a third of patients. The search for epidemiologically significant pathogens of the respiratory tract infectious pathology, such as Mycoplasma pneumoniae, Сhlamydia pneumoniae, was not carried out during the analyzed period. The wrong choice of starting antibiotic therapy was made in 45% of cases. Estimation of the effectiveness of antibiotic therapy was revised in less than 33.5% of hospitalized patients. Broncholytic and anti-inflammatory therapy did not correspond to the severity of the disease in 39.2% of patients. The identified problems of therapy in patients with chronic obstructive pulmonary disease led to long periods of hospitalization and increase in health care costs.
Key words: chronic obstructive pulmonary disease, antibacterial therapy, resistance, exacerbation.
REFERENCES
- Rennard S.I., Drummond M.B. Early chronic obstructive pulmonary disease: definition, assessment, and prevention. Lancet, 2015, vol. 385 (9979), pp. 1778–1788. DOI: 10.1016/S0140-6736(15)60647-X
- Agusti A., Celli B. Natural history of COPD: gaps and opportunities. ERJ Open Res., 2017, vol. 3 (4), pp. 00117–2017. DOI: 10.1183/23120541.00117-2017
- Yip K.P., Stockley R.A., Sapey E. Satching «Early» COPD — The diagnostic conundrum. J Chron Obstruct Pulmon Dis, 2021, vol. 16, pp. 957–968. DOI: 10.2147/COPD.S296842
- Aysanov Z.R., Avdeev S.N., Arkhipov V.V. et al. National clinical guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease: algorithms for making clinical decisions. Pul’monologiya, 2017, no. 27 (1), pp. 13–20 (in Russ.).
- Pozdnyakova O.Yu., Baturin V.A. Features of clinical manifestations of chronic obstructive pulmonary disease depending on age. Meditsinskiy vestnik Severnogo Kavkaza, 2011, no. 1, pp. 7–9 (in Russ.).
- Bystritskaya E.V., Bilichenko T.N. Morbidity, disability and mortality from respiratory diseases in the Russian Federation (2015–2019). Pul’monologiya, 2021, no. 31 (5), pp. 551–561 (in Russ.).
- Chuchalin A.G., Avdeev S.N., Aysanov Z.R. et al. Federal Clinical Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease. Pul’monologiya, 2014, no. 3, pp. 15–54 (in Russ.).
- Global strategy for the diagnosis, management and prevention of COPD, available at: https://goldcopd.org/gold-reports, 2018.
- Josef Yayan. The comparative development of elevated resistance to macrolides in community-acquired pneumonia caused by Streptococcus pneumonia. Drug Des Devel Ther., 2016, vol. 3 (8), pp. 1733–1743. DOI: 10.2147//DDDT.S71349
- Kozlov S.N., Rachina S.A., Domnikova N.P. et al. Pharmacotherapy of exacerbation of chronic bronchitis in outpatient practice: results of a pharmacoepidemiological study. Klin. mikrobiol. antimikrob. khimioter., 2001, no. 2, pp. 148–155 (in Russ.).
- Zaytsev A.A. et al. Pharmacoepidemiological aspects of antibacterial therapy of infectious exacerbation of chronic obstructive pulmonary disease in a military hospital. Voenno-meditsinskiy zhurnal, 2007, no. 328 (10), pp. 63–64 (in Russ.).
- Zubkov M.N. Mikrobiologicheskaya diagnostika pri legochnykh zabolevaniyakh [Microbiological diagnostics in pulmonary diseases]. Respiratornaya meditsina, 2007, no.1, pp. 238–252 (in Russ.).
- Prikaz Ministerstva zdravookhraneniya Rossiyskoy Federatsii ot 10.03.2022 no.151n «Ob utverzhdenii standarta meditsinskoy pomoshchi vzroslym pri khronicheskoy obstruktivnoy bolezni legkikh (diagnostika, lechenie i dispansernoe nablyudenie)» (zaregistrirovan 14.04.2022 no. 68207) [Order of the Ministry of Health of the Russian Federation dated March 10, 2022 No. 151n “On approval of the standard of medical care for adults with chronic obstructive pulmonary disease (diagnosis, treatment and dispensary observation)”, (registered on April 14, 2022 No. 68207)], accessed on: 15.04.2022.
- Determination of the sensitivity of microorganisms to antibacterial drugs (Guidelines MUK 4.2.1890-04). Klin. mikrobiol. antimikrob. khimioter, 2004, no. 6 (4), pp. 306–357 (in Russ.).