ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Sustainable Antibacterial Management of Respiratory Infections in Actual Practice

DOI:10.31550/1727-2378-2020-19-5-67-73
Bibliography link: Fesenko O.V., Sinopalnikov A.I., Yanina А.А., Tokmulina G.M. Sustainable Antibacterial Management of Respiratory Infections in Actual Practice. Doctor.Ru. 2020; 19(5): 67–73. (in Russian) DOI: 10.31550/1727-2378-2020-19-5-67-73
22 July 19:45

Objective of the Review: to describe the principles of sustainable antibacterial therapy of respiratory infections in actual practice.

Key Points. Continuous increase in infectious agents’ resistance and dramatic reduction in the number of novel antibiotics make sustainable antibiotics therapy one of the burning issues of the contemporary medicine. Analysis of the current federal recommendations on management of respiratory infections and case studies are used in the article to discuss the principles of antibacterial therapy of respiratory infections.

Conclusion. The key principles of a successful antimicrobial therapy are accurate diagnosis, selection of a starting antibiotic agent depending on the causative agent, the rate of resistivity in the country and region, and individual risk factors for infection with resistant agents; accurate drug dosing; adequate efficiency and antimicrobial therapy duration assessment.

Contributions: Fesenko, O.V. — manuscript preparation; Sinopalnikov, A.I. — selection of sources; Yanina, A.A. — patient examination; Tokmulina, G.M. — patient examination and management.

Conflict of interest: The authors declare that they do not have any conflict of interests

O.V. Fesenko (Corresponding author) — Russian Medical Academy of Continuous Professional Education at the Ministry of Health of the Russian Federation; Bld. 1, 2/1 Barrikadnaya Str., Moscow, Russian Federation 125993. Е-mail: ofessenko@mail.ru

A.I. Sinopalnikov — Russian Medical Academy of Continuous Professional Education at the Ministry of Health of the Russian Federation; Bld. 1, 2/1 Barrikadnaya Str., Moscow, Russian Federation 125993. Е-mail: aisyn@list.ru

А.А. Yanina — S.P. Botkin Municipal Clinical Hospital of Moscow Department of Public Health; 5 2-Y Botkinskiy Proyezd, Moscow, Russian Federation 125284. Е-mail: darkcherry-a55mail.ru

G.M. Tokmulina — N.V. Sklifosovskiy Clinical Medicine Institute, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation; 8/2 Trubetskaya Str., Moscow, Russian Federation 119435. Е-mail: tokmulinagalia@mail.ru

Доктор.ру

Table 1 Amoxicillin/ clavulanate (Amoxiclav) is highly potent against major causative agents of respiratory infections [28]

t11_1.jpg

Note: +++ — high potency, ++ — moderate potency, 0 — no clinical potency, PRP — penicillin-resistant pneumococci, PSP — penicillin-susceptible pneumococci, MSSA — methicillin-susceptible Staphylococcus aureus.

 Fig. 1. Patient Т. X-ray image at first visit: frontal and lateral view. Illustrations by A. A. Yanina

r11_1.jpg

Table 2
Antibacterial therapy of community-acquired pneumonia in adults [22]

t11_2.jpg

1 Chronic obstructive pulmonary disease, diabetes mellitus, chronic cardiac failure, chronic renal disease, hepatic cirrhosis, alcoholism, drug addiction, exhaustion.
2 Administration: ≥ 2 days.
3 Not feasible for regions with resistivity of over 25% (Moscow, St. Petersburg).

Fig. 2. Patient Т. X-ray image at first visit (frontal and lateral view) after therapy. Illustrations by A. A. Yanina

r11_2.jpg

Table 3
Antibacterial therapy of infectious complications of chronic obstructive pulmonary disease (COPD) [23]

t11_3.jpg

Received: 15.06.2020
Accepted: 06.07.2020

22 July 19:45
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