Currently, much attention is paid to pathogenetic methods of treatment of community-acquired pneumonia. As a rule, pneumonia is accompanied by a violation of the balance of formation and discharge of bronchial secretions. In order to normalize the drainage function of the bronchi, both pharmacological and mechanical methods of influencing the muciliary clearance are successfully used. The comprehensive use of the entire arsenal of therapeutic capabilities allows you to minimize the duration of the patient's stay in a hospital bed, as well as speed up the process of restoring impaired lung functions after pneumonia. The study was conducted in the pulmonology Department of the district hospital of the Eastern military district. The effectiveness of using the device of vibroacoustic influence on the chest using the BARK VibroLUNG device in the treatment of community-acquired pneumonia was studied. In addition to the traditional therapy regimens, 5 to 7 sessions of hardware vibration massage were performed. In patients who received a course of vibroacoustic massage, there was a decrease in the duration of General intoxication, productive cough, and physical signs of lung tissue consolidation. Regression of the main clinical manifestations of pneumonia was accompanied by an increase in sputum discharge, simultaneously with a decrease in the time of its production. The main group of patients was characterized by the best time for normalization of acute-phase indicators, restoration of lung ventilation function, and resolution of pneumonic infiltration according to X-ray data. The use of a course of vibration exposure to the chest allowed to reduce the duration of stationary treatment by an average of 3 days.
Objectives: To analyze ambulatory prescribing practice and to assess the costeffectiveness of asthma pharmacotherapy in country settings. MethOds: It is a prospective prescribing practice and cost-effectiveness analysis. During 2008-2011 were observed 238 patients in Plovdiv region and collected information about their ambulatory asthma pharmacotherapy. Prescribed medicines were systematized in INN groups of mono and fixed dose combination products. The FEO1 and percentage of patients without exacerbation were used as measure of the therapeutic results. Incremental cost-effectiveness ratio was calculated and with Tornado diagram was explored the sensitivity of the results. Results: Pharmacotherapy with fixed dose combination was performed mainly with Beclomethazone/formoterol; Budesonide/ formoterol; and Salmeterol/fluticasone. The monthly cost of pharmacotherapy is varying among 35 and 50 Euro. Incremental cost effectiveness ratio is favoring the combination Beclomethazone/ formoterol 100/6 mcg with ICER of 324 Euro for additional increase in FEO1, and 50 Euro ICER for additional patient without exacerbation, although all alternatives are cost-effective because all ICERs fall below the GDP per capita. The monotherapy was performed with Beclomethazone, Fluticasone, Budesonide, Ciclesonide, and Montelukast. Its monthly cost was among 19 and 40 Euro. Incremental cost effectiveness ratio is favoring ciclesonide that is a dominant alternative as monotherapy for both studies outcomes. Results are sensitive to the changes in therapeutic outcomes. cOnclusiOns: The real life therapy follows the international guidelines but less fixed dose combinations were prescribed in comparison with international recommendations. Beclomethazone/ formoterol fixed dose combination and ciclesonide as monotherapy are cost-effective alternatives for the observed health care settings.
До настоящего времени дискуссия, касающаяся длительности антибактериальной терапии при внебольничной пневмонии (ВП), продолжается. В ряде клинических рекомендаций схемы длительности приема антибиотика разнятся. Между тем появляется все больше данных, свидетельствующих, что краткосрочные режимы антибиотикотерапии при нетяжелых респираторных инфекциях нижних дыхательных путей являются привлекательными и перспективными.Ключевые слова: внебольничная пневмония, антимикробная терапия, длительность курса.
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