medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-1-84-92medsovet-6032Research ArticleБРОНХОПУЛЬМОНОЛОГИЯ. ЛОРBRONCHOPULMONOLOGY. ENTИнгаляционное введение антибиотиков как способ повышения эффективности и безопасности терапии воспалительных заболеваний верхних дыхательных путей и легкихInhaled antibiotics to improve efficacy and safety in the treatment of upper airway and lung inflammatory diseaseshttps://orcid.org/0000-0002-0535-2916ДроздовВ. Н.DrozdovVladimir N.

 Дроздов Владимир Николаевич,д.м.н., профессор, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Vladimir N. Drozdov,Dr. of Sci. (Med.), Professor of the Department of Clinical Pharmacology and Propaedeutics

 6, Bldg. 1, B. Pirogovskaya St., Moscow, 119991

https://orcid.org/0000-0003-1436-6671АрефьевК. И.ArefevKonstantin I.

Арефьев Константин Игоревич,клинический ординатор кафедры клинической фармакологии и пропедевтики внутренних болезней119991,  Москва, ул. Трубецкая, д. 8, стр. 2

Konstantin I. Arefev,Clinical Resident of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

 8, Bldg. 2, Trubetskaya St., Moscow, 119991

https://orcid.org/0000-0002-7163-7119СереброваС. Ю.SerebrovaSvetlana Y.

 Сереброва Светлана Юрьевна, д.м.н., главный научный сотрудник, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней

119991,  Москва, ул. Трубецкая, д. 8, стр. 2

 127051, Москва, Петровский бульвар, д. 8, стр. 2

Svetlana Y. Serebrova,Dr. of Sci. (Med.), Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

8, Bldg. 2, Petrovsky Boulevard, Moscow, 127051

https://orcid.org/0000-0001-5621-2721КомиссаренкоИ. А.KomissarenkoIrina A.

Комиссаренко Ирина Арсеньевна,д.м.н., профессор кафедры поликлинической терапии

127473, Москва, ул. Делегатская, д. 20, стр. 1

 Irina A. Komissarenko, Dr. of Sci. (Med.), Professor of the Department of Polyclinic Therapy

20, Bldg. 1, Delegatskaya St., Moscow, 127473

https://orcid.org/0000-0001-6589-7654ШихЕ. В.ShikhEvgenia V.

Ших Евгения Валерьевна, д.м.н., профессор, заведующая кафедрой клинической фармакологии и пропедевтики внутренних болезней

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Evgenia V. Shikh, Dr. of Sci. (Med.), Chair of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

https://orcid.org/0000-0001-9842-4503СтародубцевА. К.StarodubtsevAlexey K.

Стародубцев Алексей Константинович,д.м.н., профессор, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней

119991,  Москва, ул. Трубецкая, д. 8, стр. 2

Alexey K. Starodubtsev, Dr. of Sci. (Med.), Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

https://orcid.org/0000-0002-8974-4457МаринТ. В.MarinTatiana V.

 Марин Татьяна Висентевна,к.м.н., доцент, доцент кафедры клинической фармакологии и пропедевтики внутренних болезней

119991,  Москва, ул. Трубецкая, д. 8, стр. 2

Tatiana V. Marin,Cand. of Sci. (Med.), Assistant Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Bldg. 2, Trubetskaya St., Moscow, 119991

https://orcid.org/0000-0002-9215-9339ШароноваС. С.SharonovaSvetlana S.

 Шаронова Светлана Сергеевна,студент

119991,  Москва, ул. Трубецкая, д. 8, стр. 2

Svetlana S. Sharonova, Student

8, Bldg. 2, Trubetskaya St., Moscow, 119991

Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет); Научный центр экспертизы средств медицинского примененияРоссияSechenov First Moscow State Medical University (Sechenov University); Scientific Centre for Expert Evaluation of Medicinal ProductsRussian FederationМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияYevdokimov Moscow State University of Medicine and DentistryRussian Federation202118032021018492Copyright © Дроздов В.Н., Арефьев К.И., Сереброва С.Ю., Комиссаренко И.А., Ших Е.В., Стародубцев А.К., Марин Т.В., Шаронова С.С., 20212021Дроздов В.Н., Арефьев К.И., Сереброва С.Ю., Комиссаренко И.А., Ших Е.В., Стародубцев А.К., Марин Т.В., Шаронова С.С.Drozdov V.N., Arefev K.I., Serebrova S.Y., Komissarenko I.A., Shikh E.V., Starodubtsev A.K., Marin T.V., Sharonova S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6032

Ингаляционные антибактериальные препараты с большей или меньшей эффективностью используются с 1940-х гг., что обусловлено возможностью таргетной доставки препаратов непосредственно в очаг инфекции в концентрациях, во много раз превосходящих МИК. Используемый принцип значительного повышения локальных концентраций антибактериальных средств расширяет возможности лечения инфекций, вызванных полирезистентными штаммами, и снижает антибио-тикорезистентность в популяции. Ингаляционный способ доставки характеризуется высоким уровнем безопасности по причине отсутствия системного токсического действия, что позволяет снизить риск псевдомембранозного колита и других характерных осложнений антибактериальной терапии.

Тиамфеникола глицинат ацетилцистеинат – комбинированный препарат, включающий тиамфеникол и N-ацетилцистеин, что обуславливает его антибактериальную и муколитическую активность. Результаты клинических исследований продемонстрировали эффективность тиамфеникола глицинат ацетилцистеината в терапии острых и хронических бронхитов, хронической обструктивной болезни легких, внебольничных пневмоний, ларинготрахеита, риносинусита и других инфекций верхних и нижних дыхательных путей. В педиатрии препарат применяется для лечения бронхитов и пневмоний, особенно не поддающихся лечению другими антибактериальными препаратами, бронхиолитов, коклюша, муковисцидоза. В статье приведены данные по эффективности и безопасности препарата, содержащего тиамфеникола глицинат ацетил-цистеинат. Отмечены широкий спектр антибактериального действия, способность формировать высокие локальные концентрации антибактериального и муколитического компонентов в очаге инфекции, низкий риск развития серьезных побочных эффектов как у взрослых, так и у детей.

Топическое применение комбинированного препарата позволяет не только добиться выраженного клинического улучшения, но и снизить частоту использования системной антибактериальной терапии. По эффективности тиамфеникола глицинат ацетилцистеинат не уступает макролидным антибиотикам.

Inhaled antibacterial drugs have been used since the 1940s with greater or lesser effectiveness, due to the possibility of targeted delivery of drugs directly to the infection site at concentrations higher than MICs. High local concentrations of antibacterial agents expand the possibilities of treating infections caused by multiresistant strains and reduces antibiotic resistance in the population. The inhaled delivery method is characterized by a high level of safety due to the absence of systemic toxic effects, which reduces the risk of pseudomembranous colitis and other complications of antibiotic therapy. Thiamphenicol glycinate acetylcysteinate is a combined drug that includes thiamphenicol and N-acetylcysteine, which causes its antibacterial and mucolytic activity. The results of clinical studies have demonstrated the effectiveness of TGA in the treatment of acute and chronic bronchitis, chronic obstructive pulmonary disease, community-acquired pneumonia, laryngotracheitis, rhinosinusitis and other infections of the upper and lower respiratory tract. In pediatrics, the drug is used to treat bronchitis and pneumonia, especially those that cannot be treated with other antibacterial drugs, bronchiolitis, whooping cough, and cystic fibrosis. The article presents data on the effectiveness and safety of containing TGA. A wide spectrum of antibacterial actions, the ability to form high local concentrations of antibacterial and mucolytic components in the focus of infection, a low risk of serious side effects in both adults and children are noted. The topical use of the combination drug has proven to be effective not only in bringing about a pronounced clinical improvement, but also in reducing the frequency of use of systemic antibiotic therapy. The efficacy of thiamphenicol glycinate acetylcysteinate is not inferior to macrolide antibiotics.

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The authors declare that there are no conflicts of interest present.