Ofloxacin, levofloxacin, moxifloxacin, and gatifloxacin have been tested in RCTs of standard first-line regimens based on rifampicin and pyrazinamide for treating drug-sensitive TB. There is insufficient evidence to be clear whether addition or substitution of fluoroquinolones for ethambutol or isoniazid in the first-line regimen reduces death or relapse, or increases culture conversion at eight weeks. Much larger trials with fluoroquinolones in short course regimens of four months are currently in progress.

Introduction of evidence-based principles through educational interventions at a multidisciplinary health facility resulted in a number of changes towards more rational medicine use. Regular educational interventions for practicing physicians and heads of clinical departments of health facilities that promote rational prescribing are needed.

The effects of studied agents on the intensity of inflammation and lipid peroxidation were inconsistent. The results of the study did not show a clear link between anti-inflammatory and anti-oxidant activity. Further research in potential anti-inflammatory activity of new drugs exhibiting antioxidant properties needs to be done before recommending their use in clinical practice.

Aim. To develop a program for monitoring the use of antibacterial agents and training in their rational use using the information on consumption and expenses in a multidisciplinary healthcare institution. Methods. From 2011 to 2014, a group of clinical pharmacologists developed and implemented a monitoring program for the use of antibacterial agents using the ATC/DDD and ABC/VEN methodology in SBIH Penza Regional Clinical Hospital named after N.N. Burdenko. Hospital doctors were trained in the principles of rational use of drugs and antibiotics as part of continuing education in clinical pharmacology using monitoring results analysis of the costs and consumption of antibacterial agents. Results. Over the four years of monitoring and three years of educational activities, the most pronounced changes have occurred in the use of fluoroquinolones, aminoglycosides, macrolides and carbapenems. Fluoroquinolones consumption reduced 2 times, and it cost of purchase reduced 6 times (of total). Aminoglycosides consumption increased 3 times, primarily due to amikacin 5 times consumption increase. Macrolides consumption reduced 3 times, primarily due to clarithromycin decrease in consumption. At the same time, the antibacterial agents of the cephalosporin group leading in consumption, with their cost had decreased 2-fold. However, carbapenems consumption increased 3 times, with their costs increase 7 times. Conclusion. Over the three years of the program, expenses and consumption of antibacterial agents of the fluoroquinolone and macrolide group were reduced, with an increase in the consumption of aminoglycosides and carbapenems without changes in the consumption of cephalosporins; costs of cephalosporins and carbapenems led to an increase in overall antibiotic costs; further efforts and studies are needed to study the use of antibacterial agents.