BACKGROUND. According to a 2019 epidemiological study, antibiotic resistance (AR) caused about 1.27 million deaths worldwide, with lower respiratory tract infections (particularly pneumonia) dominating the global disease burden caused by resistant microorganisms. OBJECTIVE. To determine the compliance of antibiotics (J01), which are recommended by the guidelines of the National Academy of Medical Sciences of Ukraine for the empiric therapy of community-acquired pneumonia (CAP) in adults, with World Health Organization (WHO) recommendations based on the prevention of the development of AR. MATERIALS AND METHODS. Objects – antibiotics (J01) recommended by the guideline and their belonging to the access, watch and reserve groups according to the WHO AWaRe classification of antibiotics. Methods: system overview, analytical, comparison and generalization. RESULTS AND DISCUSSION. In the guidelines for empiric therapy of CAP in adults, antibiotics of 7 groups are recommended, from which 36 international non-proprietary names (INNs) were selected and analyzed. Of these, 7 INNs belong to the access group, of which only 4 antibiotics (amoxicillin, amoxicillin / clavulanic acid, gentamicin, doxycycline) are recommended by WHO experts for empiric treatment of CAP in adults; 26 INNs belong to the watch group, but only 3 antibiotics (cefotaxime, ceftriaxone, clarithromycin) according to the WHO database are recommended as empiric therapy for the severe CAP in adults. Ceftaroline, according to the WHO AWaRe antibiotic classification, belongs to the reserve group and should be used to fight multiresistant microorganisms. No antibiotic of the reserve group is recommended by WHO for empiric therapy of CAP. CONCLUSIONS. The results of the analysis can be used in updating the recommendations for rational empiric antibiotic therapy of CAP, taking into account the mechanisms of resistance to the development and spread of AR.
Rational use of antimicrobials have been recognized as one of the strategies to fight AMR. In 2017 WHO proposed the classification of antibioticsAWaRe, dividing them into groups Access, Watch, Reserve, which takes into account the potential of AMR and emphasizes the importance of rational antibiotic therapy. In Ukraine, the State Formulary of Medicines (State Formulary of Ukraine) is the manual on the rational use of medicines. The aim of the work was to analyse the assortment of systemic antibiotics (J01) of the State Formulary of Ukraine, their compliance with the classification of antibiotics AWaRe according to the WHO database, which will contribute to rational antibiotic therapy. The objects of the study were antibiotics (J01), of the 13th version of the State Formulary of Ukraine, data on the belonging of antibiotics to the group Access, Observations, Reserve on WHO AWaRe antibiotic classification database.The following research methods were used in the work: system-review, analytical, method of comparison and generalization. According to the analysis, the group Access includes 23 INN antibiotics (J01) of the State Formulary of Ukraine. For 16 INNs of these antibioticsWHO provides recommendations for rational antibiotic therapy as the first choice for 31 infectious diseases and the second choice for 13 infectious diseases. The Observations group includes 31 INN antibiotics (J01) of the State Formulary of Ukraine. For 18 INNs of these antibiotics WHO provides recommendations for rational antibiotic therapy as the first choice for 21 infectious diseases and the second choice for 17 infectious diseases. The Reserve group includes 3 INN antibiotics (J01) of the State Formulary of Ukraine. The State Formulary of Ukraine includes 64 INN antibiotics of systemic action (J01), 23 INNs according to the WHO AWaRe antibiotic classification are assigned to the group Access, 31 ‒ Observations and 3 ‒ Reserve group. The analysis provides WHO recommendations for rational antibiotic therapy for the treatment of common infectious diseases, taking into account the degree of counteraction to the development of AMR. The results of the work can be used in the development of guidelines for the rational choice of antibiotics for the treatment of infectious diseases.
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