Terapevt Arkh
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To study the adverse reactions that develop as a result of complex antibiotic therapy in patients with non-tuberculous lung mycobacterial (NTML) and to determine methods for their elimination without compromising the effectiveness of NTML treatment. ⋯ The incidence of ADR development remains high when complex AMT is administered to patients with NTML. The patient's comorbid background is the main risk factor for the development of ADR when prescribing multicomponent AMT. A multivariate analysis of the effectiveness of treatment in NTML patients showed comparable data among patients taking complex AMT and receiving only alternative therapies. The success of NTML treatment depends on a comprehensive personalized approach.
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To evaluate the efficacy of the antiviral drug riamilovir (trade name - «Triazavirin®») for the prevention of SARS-CoV-2 infection (COVID-19) and other acute respiratory viral infections in young people from organized groups. ⋯ Riamilovir (trade name - «Triazavirin®») showed statistically significant prophylactic efficacy during its administration in an organized group. Its use decreased the frequency of detection of viral pathogens and resulted in milder acute respiratory disease, likely due to reduced viral load in individuals.
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The most severe complications of antibiotic use are clostridial infection (CDI) and pseudomembranous colitis (PMC). There is a need for further study of these conditions and identification of their triggers. ⋯ PMC was characterized by a combination of diarrhea, intoxication and abdominal pain. The formation of PMC was preceded by courses of antibacterial drugs of the fluoroquinolone and cephalosporin groups, eradication therapy for Helicobacter infection, the use of high doses of glucocorticosteroids, as well as intestinal superinfection in patients with previous episodes of CDI.
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Atrial fibrillation (AF) and heart failure (HF) often accompany each other, as they share similar risk factors and pathophysiological mechanisms. AF in patients with HF is known to increase hospitalizations and worsen prognosis. A combination of AF and HF translates into high risks of thromboembolic complications, which renders anticoagulants an important aspect of therapy for these patients. ⋯ At the same time, patients with HF often require a personalized approach when choosing an anticoagulant due to increased risks of thromboembolic complications and bleeding, as well as multiple comorbidities. The article presents the results of sub-analyses of key studies on the efficacy and safety of DOACs vs vitamin K antagonists in patients with HF and AF. It also explores DOACs use in patients with chronic kidney disease.
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Since the era of the widespread introduction of antibiotics into the human sphere of activity, the problem of antimicrobial resistance has become an urgent and very important topic around the world. Recently, coagulasonegative staphylococci (CoNS), which are representatives of opportunistic microorganisms of the microbiome of the skin and mucous membranes of healthy people, have made a certain contribution to its progression. For a long time, they did not pose a threat to patients, but in recent decades among microorganisms they have been seeded in more than two-thirds of patients with postoperative mediastinitis, catheter-associated infections, as well as from wounds of the neck vessels and the inguinal region separated by pacemaker beds. ⋯ During the examination of patients, it was shown that skin defects are foci of persistent bacteremia of representatives of the CoNS group, which can cause the development of a systemic inflammatory infectious response with the formation of resistant strains of the opportunistic flora of the microbiome of the skin and mucous membranes. It has been shown that to determine the tactics of antibacterial therapy, a bacteriological study of all detected foci of infection in patients, screening of pathogens and their sensitivity to antibiotics, and especially in persons at risk, is necessary. This will increase the effectiveness of antibacterial therapy and reduce the possibility of forming resistant strains of pathogens.