Clinical efficiency of clarithromycin-MB in complex therapy of patients with non-hospital pneumonia
Abstract
Summary: The problem of rational antibiotic therapy of pneumonia is among the most relevant in modern medicine. The aim of the study was to evaluate the clinical efficacy and therapeutic tolerance of parenteral application of clarithromycin in the treatment of patients with non-hospital pneumonia (NHP). Materials and methods. We observed 20 patients: 12 men - (60%), 8 women - (40%), the average age of patients was 46.1 ± 17.6 years. All patients showed clinical symptoms of severe infection of the lower respiratory tract. In 75.0% (15 patients) bilateral lung damage was noted, in 27% (5 patients) - unilateral lung tissue damage. Hemoptysis was observed in 4 (20%) patients. Clarithromycin-MB was included in complex therapy (detoxification, mucolytic drugs, multivitamins, and metabolices) for 6 patients with NHP after 3 days of ineffective starting therapy, 14 patients with emergency received clarithromycin-MB immediately after admission to the hospital. The drug was administered by intravenous drip for 60 minutes at a dose of 500 mg 2 times a day for 7-10 days. Result. The analysis of the obtained results of clarithromycin-MB therapy showed that clinical success was achieved in all patients. The positive dynamics of clinical indicators was noted already on the 3rd day from the beginning of antibiotic therapy with clarithromycin-MB, which was expressed in a decrease in body temperature until the 7th day of treatment, and in almost all patients the temperature returned to normal and only in 1 (5%) patient remained subfebrile. Also, during this period, patients noted a decrease in pain syndrome as well as signs of intoxication. According to the data of X-ray studies on the 10th day of therapy, 6 (30%) patients showed complete disappearance of infiltrative changes in the lungs, in 14 (70%) patients - a significant decrease in their severity. On the 15-24th (average 15.3 ± 1.2) days after the start of therapy signs of inflammatory infiltration in the lungs leveled off on the 15-24th in all patients. Conclusion. Clarithromycin-MB has good therapeutic tolerance, allows maintaining the required concentration in the focus of inflammation because of dosage regimen also affects the clinical and bacteriological effectiveness of therapy.
Downloads
References
Shikhnebiev DA, Modern approaches to antimicrobial therapy of community-acquired pneumonia (literature review). International Journal of Applied and Basic Research. 2014; 4: 101-104.
Protocol of good medical assistance We have a problem with non-hospital and nosocomial (hospital) pneumonia in older adults: etiology, pathogenesis, classification, diagnostics, antibacterial therapy. Order of the Ministry of Health of Ukraine No. 128 dated 19.03. 2007 p.
Feshchenko YuI, Golubovska OA, Goncharov KA, Dziublyk OYa, Dziublyk YaO, Dmitrichenko VV, Kapitan GB, Kliagin VYa, Mostovyi YuM, Mukhin OO, Nedlinska NM, Obertynska OV, Pertseva TO, Pylypenko MM, Simonov SS, Sukhin RYe, Shlapak IP, Yudina LV. Community-acquired pneumonia in adults: etiology, pathogenesis, classification, diagnosis, antibiotic therapy (draft clinical guidelines) Part II. Ukrainian pulmonological journal. 2013;1:5-21.
Antimicrobial Resistance, Еlectronic source: http://www.who.int/drugresistance/en/
Sahm DF, Antimicrobial resistance trends among sinus isolates of Streptococcus pneumoniae in the United States (2001-2005). Otolaryngol. Head Neck Surg. 2007;- 136 (3):385-389.
Strachunsky HP, Kozlov SN, Macrolides in modern clinical practice. Clinical medicine. 2012;3:23–30.
Greenwood D, Antimicrobial Chemotherapy, Oxford.1995;4:43–49.
Labro MT, Antibiotics as anti-inflammatory drugs. Current Opinion in Investigational Drugs. 2002.
Kohno SA, New macrolide, TE-031 (A-56268), in treatment of experimental Legionnais’ disease. J. Antimicrob. Chemother.1989;24:397–405.
Takeda H, Long-term administration study on TE-031 (A-56268) in treatment of diffuse panbronchiolitis.1989;63:71–78.
Gogos CA, Drosou E, Bassaris HP, Skoutelis A, Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: a marker for prognosis and future therapeutic options. J. Infect. Dis.2002;181:176–180.
Giamarellos-Bourboulis EJ, Pechère JC, Routsi C, Effect of clarithromycin in patients with sepsis and ventilator-associated pneumonia. Clin. Infect. Dis.2008;46(8):1157–1164. https://doi.org/10.1086/529439.
Averyanov AV, Zykov KA, Clarithromycin in the treatment of exacerbations of chronic obstructive pulmonary disease. Ukr. pulmonol. magazine. 2009; 2: 48–52.
Norimichi A, Naoki I, Kazutaka M, Yutaro N, Hiroshi H. Effect of rifampicin and clarithromycin on the CYP3A activity in patients with Mycobacterium avium complex. J Thorac Dis.2019;11(9):3814–3821. https://doi.org/10.21037/jtd.2019.09.06.
