42 research outputs found
"difficult" pneumonia
No full textThe article considers the issues of therapeutic management of patients with so-called "difficult" pneumonia, particularly, patients with diagnosed syndrome slowly resolving / nonresolving pneumonia, who do not respond to the treatment. The reasons and significant risk factors potentially affecting the effectiveness of therapy are analyzed, the therapeutic tactics of managing patients with no "response to treatment" are considered, the list of necessary diagnostic methods and directions of antibiotic therapy is updated. The article analyses the tactics of managing patients with pneumonia during a pandemic caused by SARS-CoV-2 coronavirus. It also provides directions of diagnostics with priority discussion of biological markers of the inflammatory response as well as antimicrobial therapy strategy
PLACE OF RESPIRATORY FLUOROQUINOLONES IN THERAPY OF COMMUNITY ACQUIRED PNEUMONIA: FOCUS ON HIGH-DOSE LEVOFLOXACINE THERAPEUTIC REGIME
No full textCommunity-acquired pneumonia is one of the most prevalent infectious diseases and there are numerous diagnostic and therapeutic mistakes in relation to it. Prescription of the antibiotics to CAP patients remains a classic example of “educated guess”. Today one can find antibiotics active against a large range of intra- and extracellular causative agents able to prolong widely spread mechanism of resistance of major respiratory pathogens. The modern practice of clinical application of levofloxacin simultaneously demonstrates possibilities of modification of dosing regimes, safe reduction of the time of administration of the drug, minimization of the risk of selection of drug resistance of the disease causative agents, reduction of frequency and intensity of drug reactions
Fixed-dose combinations of bronchodilators in the treatment of patients with COPD: problem of choice
No full textChronic Obstructive Pulmonary Disease (COPD) is a disease characterized by air flow limitation that progresses over time and is not fully reversible, which, along with the severity of clinical symptoms and the frequency of relapses, is one of its key characteristics [1, 2]. The main “tool” in achieving therapeutic goals in accordance with current guidelines GOLD [1], GesEPOC [3], NICE [4], PPO [5], etc. - are bronchodilators. Fixed-dose combinations of long acting beta-2 agonists/long acting anticholinergic agents provide optimal bronchodilation and play a primary role in preventing exacerbations of COPD
Moxifloxacin: safety profile
No full textThe latest, so-called respiratory, fluoroquinolones are a group of antimicrobial agents (AMA), most commonly prescribed for community-acquired lower respiratory tract infection (caLRTI), which is a relevant issue in routine clinical practice
Moxifloxacin in the treatment of community-acquired pneumonia in adults: what's new?
No full textThe article is devoted to the role of respiratory fluoroquinolones in the treatment of community-acquired pneumonia. Respiratory fluoroquinolones are key in the treatment of the disease as they affect virtually all pathogens of community-acquired pneumonia, and have attractive pharmacokinetic and pharmacodynamic profiles. The article tells about the results of several multicenter clinical trials of moxifloxacin and its use as a second-line therapy in tuberculosis of the respiratory tract
The problem of patient compliance with treatment for respiratory infections
No full textPatient compliance describes the degree, to which a patient follows treatment regimen. At present, non-compliance with medical recommendations is one of the key problems for outpatient practice. Even in case of respiratory infections, patients often violate the prescribed treatment regimen, which leads to growth of ineffective treatment cases, complications, and is also accompanied by a high risk of selection of drug-resistant infectious organisms and rise in expenditures for managing patients. The most common mistakes made by patients include the change by patients of the prescribed antibiotic dosing regimen and premature termination of antimicrobial therapy. Factors affecting patient compliance are extremely diverse. Among them are factors associated with treatment and a disease, patient-associated factors of «doctor - patient» contact, and demographic predictors of low compliance, drug dosage frequency. The most important factors affecting adherence to treatment are duration of therapy; drug tolerance/safety; dosage forms (tablets, syrup, sachet); patient confidence in medical recommendations (presence of «doctor - patient» relationship); severity of the disease; patient age and sex; social activity/employment of the patient; social status of the patient, level of education; marital status; presence of a concomitant pathology in the patient; presence of bad habits (smoking, alcohol) in the patient. The main factor affecting the compliance with therapy is the drug dosage frequency. It is known that compliance is highest, if a patient is required to take a single dose of the drug per day. Duration of therapy is another important factor affecting the patient compliance. For instance, pharmacotherapy for 7 days is characterized by better compliance compared to longer antibiotic treatment regimens. Methods of improving compliance with antimicrobial therapy: reduction in the drug dosage frequency; short courses of antibiotic therapy; favourable safety profile; the cost of the drug; a patient-friendly form of antibiotic dosage form; patient education, clear information of the patient; monitoring the treatment process (repeat visits, phone contacts, etc.). The most effective way to increase compliance is to use an antibiotic drug 1-2 times per day. The use of short antibiotics courses (less than 7 days) is also a good way to increase adherence to treatment. The use of antibiotics with a good safety profile is another important approach to improving the compliance. The article also discusses other ways to enhance the patient compliance with the treatment for respiratory infections
ANTIBACTERIAL THERAPY OF EXACERBATIONS OF CHRONIC BRONCHITIS/CHRONIC OBSTRUCTIVE PULMONARY DISEASE: KEY PROVISIONS
No full textThe article considers key issues of the antibacterial therapy of exacerbations of chronic bronchitis and chronic obstructive pulmonary diseases. Etiology of exacerbations of the disease, indications for prescription of antibiotics, regimes of antimicrobial therapy are provided
