Короткие курсы антибактериальной терапии внебольничных инфекций дыхательных путей: эффективность и безопасность


DOI: https://dx.doi.org/10.18565/pharmateca.2018.8.8-15

А.И. Синопальников

Российская медицинская академия непрерывного профессионального образования, Москва, Россия
Обсуждается проблема длительности антибактериальной терапии (АБТ) внебольничных инфекций дыхательных путей. Накопленные к настоящему времени свидетельства сопоставимой терапевтической эффективности коротких и длительных («традиционных») курсов АБТ бактериальных инфекций позволяют утверждать, что сокращение сроков приема антибиотика сопровождается уменьшением риска нежелательных лекарственных реакций, снижением вероятности селекции лекарственноустойчивых штаммов возбудителей, повышением приверженности больного врачебным рекомендациям и оказывается более экономичным.
Ключевые слова: инфекции дыхательных путей, длительность антибактериальной терапии

Литература


1. Fleming-Dutra K.E., Hersh A.L., Shapiro D.J., et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315:1864–73. Doi: 10.1001/jama.2016.4151.

2. Ball P., Baquero F., Cars O., et al. Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence. J. Antimicrob. Chemother. 2002;49:31–40.

3. File TM Jr. Duration and cessation of antimicrobial treatment. J Hosp Med 2012; 7 (Suppl 1): S22–33.

4. Tansarli G.S., Mylonakis E.E. Efficacy of short-course antibiotic treatments for community-acquired pneumonia in adults: A systematic review and meta-analysis. Antimicrob. Agents Chemother. 2018;62(9).e00635–18. Doi: 10.1128/ AAC.00635-18.

5. Bronzawear S., Cars O., Udo Buchholz S.M., et al. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg. Infect. Dis. 2002;8:278–82.

6. Goossens H., Ferech M., Vander Stichele R., Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365:579–87.

7. Esposito S., Esposito I., Leone S. Considerations of antibiotic therapy duration in community- and hospital-acquired bacterial infections. J. Antimicrob. Chemother. 2012;67:2570–75. Doi: 10.1093/jac/dks277.

8. Bartlett J.G., Breiman R.F., Mandell L.A., et al. Community-acquired pneumonia in adults: guidelines for management. Clin. Infect. Dis. 1998;26:811–38.

9. Sobel J.D., Kaye D. Urinary tract infections. In: Principles and Practice of Infectious Diseases, Vol. 1, 4th edn (Mandell GI, Bennett JE, Dolin R, eds). New York: Churchill Livingstone. 1995;662–90.

10. Boerema J.B., Willems F.T. Fosfomycin trometanol in single dose versus norfloxacin for seven days in the treatment of uncomplicated urinary infection in general practice. Infection. 1990;18(2):80–8.

11. Haizlip J., Isbey S.F., Hamilton H.A., et al. Time required for elimination of Neisseria gonorrhoeae from the urogenital tract in men with symptomatic urethritis: comparison of oral and intramuscular single-dose therapy. Sex. Transm. Dis. 1995;22:145–48.

12. De Montalembert M. Bacterial meningitis in children: how many lumbar punctures? Pediatrie. 1993;48:17–9.

13. Carlin S.A., Marchant C.D, Shurin P.A., et al. Host factors and early therapeutic response in acute otitis media. J. Pediatr. 1991;118;178–83.

14. Pechère J.-C. Modelling and predicting clinical outcomes of antibiotic therapy. Infect. Med. 1998;15(E):46–54.

15. Taylor Z., Nolan C.M., Blumberg H.M. Controlling tuberculosis in the United States. MMWR. Recomm. Rep. 2005;54(RR–12):1–81.

16. Yousefi-Nooraie R., Mortaz-Hejri S., Mehrani M., Sadeghipour P. Antibiotics for treating human brucellosis. Cochrane Database Syst. Rev. 2012;10:CD007179. Doi: 10.1002/14651858.

17. Wilson W.R., Karchmer A.W., Dajani A.J., et al. Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci and HACEK microorganisms. JAMA. 1995;274:1706–13.

18. Chow A.W., Benninger M.S., Brook I., et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin. Infect. Dis. 2012;54:72–112. Doi: 10.1093/cid/cir1043.

19. 2011-infections-respir-hautes-recommandations.pdf. Available from: http://www.infectiologie.com/UserFiles/File/mediasRecios/2001-infections-respir-hautes-recommandations.pdf

20. Piltcher O.B., Kosugi E.M., Sakano E., et al. How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from expert panel. Braz J Otorhonolaryngol2018; 84: 265–79.

21. Sharma P., Finley R., Weese S., et al. Antibiotic prescriptions for outpatient acute rhinosinusitis in Canada, 2007-2013. PLoS One 2017;12: e00181957.

22. Cohen R., Levy C., Doit C., et al. Six-day amoxicillin vs. ten-day penicillin V therapy for group A streptococcal tonsillopharyngitis. Pediatr. Infect. Dis. J. 1996;15:678–82.

23. Cohen R., Levy C., Boucherat M., et al. Five vs. ten days of antibiotic therapy for acute otitis media in young children. Pediatr. Infect. Dis. J. 2000;19:458–63.

24. Cohen R., Levy C., Boucherat M., et al. A multicenter, randomized, double-blind trial of 5 versus 10 days of antibiotic therapy for acute otitis media in young children. J. Pediatr. 1998;133:634–39.

25. Pichichero M.E., Marsocci S.M., Murphy M.L., et al. A prospective observational study of 5-, 7-, and 10-day antibiotic treatment for acute otitis media. Otolaryngol. Head Neck Surg. 2001;124:381–87.

26. Hoberman A., Paradise J.L., Cohen R. Duration of therapy for acute otitis media. Pediatr. Infect. Dis. 2000;19:471–73.

27. Kozyrskyj A., Klassen T.P., Moffatt M., et al. Short-course antibiotics for acute otitis media. Cochrane Database Syst. Rev. 2010;9:CD001095.

28. Kozyrskyj A., Hildes-Ripstein G.E., Longstaffe S.E., et al. Treatment of acute otitis media with a shortened course of antibiotics: a meta-analysis. JAMA. 1998;279:1736–42.

29. Venekamp R.P., Sanders S.L., Glasziou P.P., et al. Antibiotics for acute otitis media in children. Cochrane Database Syst. Rev. 2015;6:CD000219.

30. Lemiengre M.B., van Driel M.L., Merenstein D., et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst. Rev. 2012;10:CD006089.

31. Peyramond D., Portier H., Geslin P., et al. 6-day amoxicillin versus 10-day penicillin V for group A beta-hemolytic streptococcal acute tonsillitis in adults: a French multicenter, open-label, randomized study. Scand. J. Infect. Dis. 1996;28:497–501.

32. Pichichero M.E., Casey J.R. Bacterial eradication rates with shortened courses of 2nd- and 3rd-generation cephalosporins versus 10 days of penicillin for treatment of group A streptococcal tonsillopharyngitis in adults. Diagn. Microbiol. Infect. Dis. 2007;59:127–30.

33. Société de pathologie infectieuse de langue franҫaise. Agence franҫaise de sécurité sanitaire des produits de santé. Antibiothérapie par voie Générale dans les infections respiratoires basses de l’adulte; 2010. Available from: http://www.infectiologie.com/site/ medias/documents/consensus/2010-infVRB-spilf-afssaps.pdf

34. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of COPD, 2018. Available from: http://goldcopd.org/gold-2018-global-strategy-diagnosis-management-prevention-copd/

35. Masterton R.G., Burley C.J. Randomized, double-blind study comparing 5- and 7-day regimens of oral levofloxacin in patients with acute exacerbation of chronic bronchitis. Int. J. Antimicrob. Agents. 2001;18:503–12.

36. Mandell L.A., Wunderink R.G., Anzueto A., et al. Infectious Diseases Society of America/American thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin. Infect. Dis. 2007;44 (2):27–72.

37. Woodhead M., Blasi F., Ewig S., et al. Guidelines for the management of adult lower respiratory tract infections. Clin. Microbiol. Infect. 2011;17:1–24. Doi: 10.1111/j.1469-0691.2011.03602.x.

38. Lim W.S., Baudouin S.V., George R.C., et al. BTS guidelines for the management of community-acquired pneumonia in adults: update 2009. Thorax. 2009;64:1–55. Doi: 10.1136/thx.2009.121434.

39. Wunderink R.G. A CAP on antibiotic duration. Am. J. Respi.r Crit. Care Med. 2006;174:3–5.

40. Schrag S.J., Pena C., Fernandez J., et al. Effect of short-course, high-dose amoxicillin therapy on resistant pneumococcal carriage: a randomized trial. JAMA. 2001;286:49–56.

41. Guillemot D., Carbon C., Balkau B., et al. Low dosage and long treatment duration of beta-lactam: risk factors for carriage of penicillin-resistant Streptococcus pneumoniae. JAMA. 1998;279:365–70.

42. Falagas M.E., Avgeri S.G., Matthaiou D.K., et al. Short- versus long-duration antimicrobial treatment for exacerbations of chronic bronchitis: a meta-analysis. J. Antimicrob. Chemorther. 2008;62:442–50. Doi: 10.1093/jac/dkn201.

43. Navarta A.C., Peyrani P., Wiemken T.L., et al. Short duration of antibiotic therapy in hospitalized patients with community-acquired pneumonia: results from the CAPO international cohort study. ULJRI. 2017;1:21–6.

44. Uranga A., Espana P.P., Bilbao A., et al. Duration of antibiotic treatment in community-acquired pneumonia: a multicenter randomized clinical trial. JAMA. Intern. Med. 2016;176:1257–65. Doi: 10.1001/jamainternmed.2016.3633.

45. Royer S., DeMerle K.M., Dickson R.P., Prescott H.C. Shorter Versus Longer Courses of Antibiotics for Infection in Hospitalized Patients: A Systematic Review and Meta-Analysis. J. Hosp. Med. 2018;13:336–42. Doi: 10.12788/jhm.2905.

46. O’Doherty B., Muller O. Randomized, multicenter study of the efficacy and tolerance of azithromycin versus clarithromycin in the treatment of adults with mild to moderate community-acquired pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 1998;17:828–33.

47. Siegel R.E., Alicea M., Lee A., Blaiklock R. Comparison of 7 versus 10 days of antibiotic therapy for hospitalized patients with uncomplicated community-acquired pneumonia: a prospective, randomized, double-blind study. Am. J. Ther. 1999;6:217–22.

48. Leophonte P., Choutet P., Gaillat J., et al. Efficacy of a ten day course of ceftriaxone compared to a shortened five day course in the treatment of community-acquired pneumonia in hospitalized adults with risk factors. Med. Mal. Infect. 2002;32:369–81.

49. Dunbar L.M., Wunderink R.G., Habib M.P., et al. High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm. Clin. Infect. Dis. 2003;37:752–60.

50. Dunbar L.M., Khashab M.M., Kahn J.B., et al. Efficacy of 750-mg, 5-day levofloxacin in the treatment of community-acquired pneumonia caused by atypical pathogens. Curr. Med. Res. Opin. 2004;20:555–63.

51. Tellier G., Chang J.R., Asche C.V., et al. Comparison of hospitalization rates in patients with community-acquired pneumonia treated with telithromycin for 5 or 7 days or clarithromycin for 10 days. Curr. Med. Res. Opin. 2004;20:739–47.

52. Drehobl M.A., De Salvo M.C., Lewi D.E., Breen J.D. Single-dose azithromycin microspheres vs. clarithromycin extended release for the treatment of mild to moderate community-acquired pneumonia in adults. Chest. 2005;128:2230–37.

53. El Moussaoui R., de Borgie C.A., van Den Broek P., et al. Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate -severe community-acquired pneumonia: randomized, double blind study. BMJ. 2006;332:1355.

54. File T.M., Mandell L.A., Tillotson G., et al. Gemifloxacin once daily for 5 days versus 7 days for the treatment of community-acquired pneumonia: a randomized, multicenter, double-blind study. J. Antimicrob. Chemother. 2007;60:112–20.

55. Kaziani K., Sotiriou A., Dimopoulos G. Duration of pneumonia therapy and the role of biomarkers. Curr. Opin. Infect. Dis. 2017;30:221–25. Doi: 10.1097/QCO.0000000000000351.

56. Albrich W.S., Dusemund F., Bucher B., et al. Effectiveness and safety of procalcitonin-guided antibiotic therapy in lower respiratory tract infections in “real life”. An international, multicenter poststudy survey (proreal). Arch. Intern. Med. 2012;172:715–22. Doi: 10.1001/archinternmed.2012.770.

57. Fine V.J., Smith M.A., Carson C.A., et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA. 1996;275:134–41.

58. Schuetz P., Christ-Crain M., Thomann R., et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled study. JAMA. 2009;302:1059–66. Doi: 10.1001/jama.2009.1297.

59. Christ-Crain M., Stolz D., Bingisser R., et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am. J. Respir. Crit. Care Med. 2006;174:84–93.

60. Shuetz P., Wirz I., Sager R., et al. Effect of procalcitonin-guided antibiotic treatment on mortality in acute respiratory infections: a patient level meta-analysis. Lancet Infect Dis 2018; 18: 95-107.

61. Christ-Crain M., Jaccard-Stolz D., Bingisser R., et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004;363:600–7.

62. De Jong E., van Oers J.A., Beishuizen A., et al. Efficacy and safety of procalcitonin in guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomized, controlled, open-label trial. Lancet. Infect. Dis. 2016;16:819–27. Doi: 10.1016/S1473-3099(16)00053-0.

63. Muller F., Christ-Crain M., Bregenzer T., et al. Procalcitonin levels predict bacteremia in patients with community-acquired pneumonia: A prospective cohort trial. Chest. 2010;138:121–29. Doi: 10.1378/chest.09-2920.

64. Kruger S., Ewig S., Papassotiriou J., et al. Inflammatory parameters predict etiologic patterns but do not allow for individual prediction of etiology in patients with CAP: Results from the German competence network CAPNETZ. Respir. Res. 2009;10:65. Doi: 10.1186/1465-9921-10-65.

65. Kruger S., Ewig S., Kunde J., et al. Assessment of inflammatory markers in patients with community-acquired pneumonia-Influence of antimicrobial pre-treatment results from the German competence network CAPNETZ. Clin. Chim. Acta. 2010;411:1929–34. Doi: 10.1016/j.cca.2010.08.004.

66. Uzzan B., Cohen R., Nicolas P., et al. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: A systematic review and meta-analysis. Crit. Care Med. 2006;34:1996–2003.

67. Hunziker S., Hugle T., Schuchardt K., et al. The value of serum procalcitonin level for differentiation of infectious from noninfectious causes of fever after orthopedic surgery. J. Bone Joint. Surg. Am. 2010;92:138–48. Doi: 10.2106/JBJS.H.01600.

68. Sponholz C., Sakr Y., Reinhart K., Brunkhorst F. Diagnostic value and prognostic implications of serum procalcitonin after cardiac surgery: A systematic review of the literature. Crit. Care. 2006;10:R145.

69. Wester C.W., Durairaj L., Evans A.T., et al. Antibiotic resistance: a survey of physician perceptions. Arch. Intern. Med. 2002;162:2210–16.

70. Brookes-Howell L., Elwyn G., Hood K., et al. ‘The body gets used to them’: patients’ interpretations of antibiotic resistance and the implications for containment strategies. J. Gen. Intern. Med. 2012;27:766–72. Doi: 10.1007/s11606-011-1916-1.

71. Zhou J.J., Patel S.J., Jia H., et al. Clinicians’ knowledge, attitudes, and practices regarding infections with multidrug-resistant gram-negative bacilli in intensive care units. Infect. Control. Hosp. Epidemiol. 2013;34:274–83. Doi: 10.1086/669524.

72. Srinivasan A., Song X., Richards A., et al. A survey of knowledge, attitudes, and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance. Arch. Intern. Med. 2004;164:1451–56.

73. Centers for Disease Control and Prevention. Antibiotic resistance questions and answers. Available from https://www.cdc.gov/getsmart/community/ about/antibioticresistance-faqs.html. Accessed August 15, 2017.

74. Antimicrobial resistance 2016

75. Hanretty A.M., Gallagher J.C. Shortened courses of antibiotics for bacterial infections: A systematic review of randomized controlled trials. Pharmacother. 2018;38:674–87.

76. Sanchez G.V., Fleming-Dutra K.E., Roberts R.M., Hicks L.A. Core elements of outpatient antibiotic stewardship. MMWR. Recomm. Rep. 2016; 65: 1–12. Doi: 10.15585/ mmwr.rr6506a1.


Об авторах / Для корреспонденции


Автор для связи: А.И. Синопальников – д.м.н., проф., зав кафедрой пульмонологии, Российская медицинская академия непрерывного профессионального образования, Москва, Россия; e-mail: aisyn@list.ru, ORCID: https://orcid.org/0000-0002-1990-2042


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