medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-8-89-97medsovet-6873Research ArticleИНФЕКЦИИ В ОТОРИНОЛАРИНГОЛОГИИINFECTIONS IN OTORHINOLARYNGOLOGYАнтибиотикорезистентность и современная стратегия антибактериальной терапииAntibiotic resistance and modern strategy of antibacterial therapyhttps://orcid.org/0000-0002-4293-3285ОрловаН. В.OrlovaN. V.

Орлова Наталья Васильевна, д.м.н., профессор, профессор кафедры факультетской терапии педиатрического факультета; старший аналитик аналитического отдела

117997, Москва, ул. Островитянова, д. 1

117246, Москва, Научный проезд, д. 18

Natalia V. Orlova, Dr. Sci. (Med.), Professor, Professor of the Faculty Therapy Department of the Pediatric Faculty; Senior Analyst, Analytical Department

1, Ostrovi tyanov St., Moscow, 117997

18, Nauchnyi Proezd, Moscow, 117997

vrach315@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; Научно-исследовательский институт системной биологии и медициныРоссияPirogov Russian National Research Medical University; Research Institute for Systems Biology and MedicineRussian Federation202217052022088997Copyright © Орлова Н.В., 20222022Орлова Н.В.Orlova N.V.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/6873

Антибиотикорезистентность является серьезной проблемой здравоохранения. Применение новых лекарственных форм антибиотиков должно соответствовать стратегии рационального использования противомикробных препаратов, которая включает комплекс мер для стационаров и амбулаторной сети, направленных на сохранение эффективности существующих антибиотиков. Принципы стратегии по применению антимикробных/антибактериальных препаратов следующие: исключение необоснованного назначения антибиотиков, приоритет назначения препаратов на основе идентификации бактериального агента и его чувствительности к антибиотику в сравнении с эмпирическим назначением, учет данных по региональной антибиотикорезистентности, применение принципа минимальной достаточности в отношении выбора препарата (доза, выбор пути введения, безопасность и продолжительность курса лечения). В статье на примере систем здравоохранения разных стран приводится оценка эффективности применения стратегии рационального использования противомикробных препаратов. Обсуждается проблема необоснованного применения антибиотиков при лечении COVID-19. Новыми инновационными формами антибиотиков являются диспергируемые таблетки. Амоксициллин ЭКСПРЕСС и Амоксициллин + Клавулановая кислота ЭКСПРЕСС являются антибиотиками с улучшенными фармакокинетическими свой ствами в форме диспергируемых таблеток, которые зарекомендовали свою безопасность и эффективность против многих грамположительных и грамотрицательных микроорганизмов. Проведен анализ эффективности терапии заболеваний, обусловленных бета-гемолитическим стрептококком группы А, с применением 2 форм препарата (Амоксициллин и Амоксициллин + Клавулановая кислота). Приведен клинический случай применения второй формы препарата в виде диспергируемых таблеток, который подтверждает эффективность лекарственного средства в терапии острого стрептококкового тонзиллита.

Antibiotic resistance is a serious health problem. The use of new dosage forms of antibiotics should comply with the strategy of rational use of antimicrobials, which includes a set of measures for hospitals and outpatient network aimed at preserving the effectiveness of existing antibiotics. The principles of the strategy for the use of antimicrobial/antibacterial drugs: the exclusion of unjustified prescribing of antibiotics, the priority of prescribing drugs based on the identification of the bacterial agent and its sensitivity to the antibiotic in comparison with empirical prescribing, taking into account data on regional antibiotic resistance, the application of the principle of minimum sufficiency in relation to the choice of the drug – its dose, the choice of route of administration, safety and duration of treatment. The article uses the example of healthcare systems in different countries to assess the effectiveness of the strategy of rational use of antimicrobials. The problem of unjustified use of antibiotics in the treatment of COVID-19 is discussed. New innovative forms of antibiotics are dispersible tablets. Amoxicillin EXPRESS and Amoxicillin + Clavulanic Acid EXPRESS are antibiotics with improved pharmacokinetic properties in the form of dispersible tablets that have proven their safety and effectiveness against many gram-positive and gram-negative microorganisms. The analysis of the effectiveness of therapy of diseases caused by beta-hemolytic streptococcus group A, with the use of two forms: Amoxicillin and Amoxicillin + Clavulanic acid. A clinical case of the use of Amoxicillin + Clavulanic acid EXPRESS in the form of dispersible tablets is presented, which confirms the effectiveness of this drug in the treatment of acute streptococcal tonsillitis.

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