Zaytsev AA, Guchev IA. Community-acquired pneumonia: antibiotic therapy approach after the COVID-19 pandemic. A review. Consilium Medicum. 2023;25(9):581–588. DOI: 10.26442/20751753.2023.9.202408
Внебольничная пневмония – тактика антибактериальной терапии после пандемии COVID-19
Зайцев А.А., Гучев И.А. Внебольничная пневмония – тактика антибактериальной терапии после пандемии COVID-19. Consilium Medicum. 2023;25(9):581–588. DOI: 10.26442/20751753.2023.9.202408
Zaytsev AA, Guchev IA. Community-acquired pneumonia: antibiotic therapy approach after the COVID-19 pandemic. A review. Consilium Medicum. 2023;25(9):581–588. DOI: 10.26442/20751753.2023.9.202408
Пневмонии четким образом обособлены от других очаговых воспалительных заболеваний легких неинфекционного происхождения. После установления диагноза внебольничной пневмонии (ВП) пациенту необходимо назначить антибактериальные препараты в срок не позднее 4 ч с момента установления диагноза. Стартовую антибактериальную терапию при ВП следует назначать с учетом факторов, влияющих на круг потенциальных возбудителей заболевания и риск «проблемных» микроорганизмов. Рациональное по показателю доза-кратность применение амоксициллина при ВП у лиц без тяжелой сопутствующей патологии и факторов риска PES-возбудителей, применение в группах риска данных возбудителей комбинированной терапии β-лактамами в сочетании с макролидом или монотерапии моксифлоксацином является наиболее эффективной тактикой эмпирической антибактериальной терапии.
Pneumonia is clearly differentiated from other focal inflammatory lung diseases of non-infectious origin. A patient with community-acquired pneumonia (CAP) should receive antibacterial drugs no later than 4 hours after the diagnosis. Initial antibacterial therapy in CAP should be based on factors affecting the potential causative agents and the risk of drug-resistant microorganisms. Rational use of amoxicillin in terms of dose and frequency in CAP patients without severe comorbidities and risk factors for PES pathogens, the use of β-lactam in combination with a macrolide or moxifloxacin monotherapy in high-risk groups of patients is the most effective strategy of empirical antibacterial therapy.
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Авторы
А.А. Зайцев*1, И.А. Гучев2
1ФГБУ «Главный военный клинический госпиталь им. акад. Н.Н. Бурденко» Минобороны России, Москва, Россия; 2ООО «Никита и КО», Москва, Россия
*a-zaicev-a@yandex.ru
________________________________________________
Andrey A. Zaytsev*1, Igor A. Guchev2
1Burdenko Main Military Clinical Hospital, Moscow, Russia; 2Nikita and Co LLC, Moscow, Russia
*a-zaicev-a@yandex.ru