scholarly journals Historical and Regulatory Perspectives on the Treatment Effect of Antibacterial Drugs for Community‐Acquired Pneumonia

2008 ◽  
Vol 47 (S3) ◽  
pp. S216-S224 ◽  
Author(s):  
M. Singer ◽  
S. Nambiar ◽  
T. Valappil ◽  
K. Higgins ◽  
S. Gitterman
Keyword(s):  
Treatment Effect ◽  
Community Acquired Pneumonia ◽  
Antibacterial Drugs

scholarly journals Predictors for individual patient antibiotic treatment effect in hospitalized community-acquired pneumonia patients

2017 ◽  
Vol 23 (10) ◽  
pp. 774.e1-774.e7 ◽  
Author(s):  
A.F. Simonetti ◽  
C.H. van Werkhoven ◽  
V.A. Schweitzer ◽  
D. Viasus ◽  
J. Carratalà ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Treatment Effect ◽  
Community Acquired Pneumonia

scholarly journals Community-Acquired Pneumonia of Bacterial Etiology and the Spectrum of Pathogen Sensitivity to Antibiotics in Corona-Positive and Corona-Negative Patients in Rostov-on-Don

2021 ◽  
Vol 66 (1-2) ◽  
pp. 26-32
Author(s):  
N. V. Pavlovich ◽  
М. V. Tsymbalistova ◽  
N. V. Aronova ◽  
A. S. Anisimova ◽  
S. О. Vodopyanov ◽  
...  
Keyword(s):  
Multiple Drug Resistance ◽  
Healthcare Facility ◽  
Community Acquired Pneumonia ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Disk Diffusion Method ◽  
Antibacterial Drugs ◽  
Treatment Regimens ◽  
Causative Agents ◽  
High Degree

Relevance. In the context of the ongoing pandemic of coronavirus infection, the course of viral pneumonia is often complicated by the addition of bacterial microflora due to a decrease in the body's immune status. The causative agents of such a co-infection can exhibit multiple drug resistance, which significantly reduces the effectiveness of etiotropic therapy. In this regard, it seems expedient to provide microbiological support to patients in order to select the most optimal treatment regimens. Aim. To study the composition of bacterial pathogens’ species, that cause community-acquired pneumonia (CAP) in corona-positive (COVID-19+) and corona-negative (COVID-19–) patients and to determine the spectrum of their sensitivity/resistance to antibacterial drugs. Material and methods. The species composition of microorganisms in sputum samples from 723 patients with CAP, who were admitted from the healthcare facility in Rostov-on-Don in August and December 2020 were studied. The isolated cultures were identified using bacteriological and mass spectrometric methods. The sensitivity of bacteria to antibiotics was determined by the disk diffusion method. Results. It was shown that in August pneumococci and  staphylococci prevailed in the spectrum of CAP pathogens, while in December the percentage of excretions of Acinetobacter spp. and S. haemolyticus increased. Various types of p. Candida yeast were found with a high degree of isolation, COVID-19 + patients showed a tendency towards greater contamination (I104 mcl/ml). Some pathogens (A.baumannii, S.haemolyticus, P.aeruginosa, S.maltophilia) are characterized by polydrug resistance, and some strains of these species are pan-resistant to all groups of antibiotics. Conclusion. The data obtained demonstrate that severe forms of community-acquired pneumonia can be caused by viral-bacterial and viral-bacterial-yeast combinations of pathogens, including bacteria with a narrow spectrum of sensitivity to antibacterial drugs. 

Pharmacological drug interactions in the treatment of community-acquired pneumonia in hospital settings (based on electronic databases of reported drug interactions)

2021 ◽  
Vol 31 (1) ◽  
pp. 38-45
Author(s):  
O. V. Zhukova ◽  
E. S. Khoroshavina ◽  
O. V. Ruina ◽  
M. V. Khazov
Keyword(s):  
Clinical Practice ◽  
Drug Interactions ◽  
Antimicrobial Therapy ◽  
Community Acquired Pneumonia ◽  
Treatment Standards ◽  
Antibacterial Drugs ◽  
Treatment Standard ◽  
Clinically Significant ◽  
Potential Interactions ◽  
Real Clinical Practice

The article presents the results of a study of potential drug interactions in the treatment of moderate and severe community-acquired pneumonia (CAP) in hospital settings. The study was conducted by analysis of treatment standards and data from real clinical practice regarding antimicrobial therapy. Methods. The study used the lists of drug products for medical use for the treatment of CAP (according to the standards of specialized medical care for moderate and severe CAP with complications). Also, the medical records of patients (n = 165) with CAP, hospitalized in hospitals of medical organizations (Nizhny Novgorod) were used. The study period was 2 years (2015 - 2016). The study included all patients admitted to the hospital during the analyzed period. CAP was treated in accordance with treatment standards. Results. The analysis of potential interactions of drugs used for moderate and severe CAP according to the treatment standards, showed that 27 and 72 drugs can be used, respectively. 325 potential interactions are possible in hospital settings for moderate CAP and 2,485 for severe CAP. According to the treatment standard, the number of minimally clinically significant potential interactions during the pharmacotherapy of moderate CAP in hospital settings is 8, the number moderately clinically significant interactions - 19; undesirable interactions - 7. In case of severe CAP, the number of potential interactions increases and amounts to 27 minimally clinically significant, 105 moderately clinically significant, and 41 undesirable. The analysis of the results of antimicrobial therapy in real clinical practice showed 4 therapeutic duplications (prescribing 2 β-lactam antibacterial drugs simultaneously) and 2 moderately clinically significant interactions during antimicrobial therapy in hospital 1. Only 1 therapeutic duplication was noted during antimicrobial therapy in hospital 2. Therapeutic overlap has been found between β-lactam antibacterial drugs (ceftaroline fosamil and meropenem). It is advisable to prescribe no more than one в-lactam antibacterial drug and it is inappropriate to include > 3 antimicrobial drugs in an antimicrobial regimen. Conclusion. Electronic databases simplify the selection of medicines and thus ensure the safe and effective use of registered drug interactions.

scholarly journals Community-acquired pneumonia. Diagnosis, treatment approaches

The Clinician ◽  
2019 ◽  
Vol 13 (1-2) ◽  
pp. 55-64
Author(s):  
A. A. Anderzhanova ◽  
Yu. A. Meleshkina
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Community Acquired Pneumonia ◽  
Current Data ◽  
World Health ◽  
Duration Of Treatment ◽  
Antibacterial Drugs ◽  
American Society ◽  
Severe Community Acquired Pneumonia ◽  
Health Organization

The article presents current data on the prevalence and etiology of community-acquired pneumonia, shows the contribution of each of the possible pathogens to the structure of the disease. The diagnostic criteria for pneumonia are given. The main algorithms for assessing the severity of pneumonia and the prognosis of the disease using different scales: CURB-65 / CRB-65, PORT (PSI), are described. The purpose of the test is to determine the place of treatment: outpatient or in the in-patient department, in the general department or in the intensive care unit. The criteria for IDSA / ATS (American Thoracic Society / American Society of Infectious Diseases), as well as the SMART-COP / SMRCO scale to determine the need for hospitalized patients in the intensive care unit, are reviewed. The Aliberti and PES scales are given, assessing the risk of the presence of resistant pathogens in community-acquired pneumonia. Modern recommendations on the empirical choice of antibacterial drugs depending on individual patient factors are presented: anamnestic indications for treatment with antimicrobials during the preceding three months, hospitalization within six months before the onset of pneumonia, the presence of comorbidities, the severity of the disease, the risk of resistant pathogens. The average therapeutic doses of antibacterial drugs for the treatment of community-acquired pneumonia in patients with normal renal function are indicated. The questions of the optimal duration of treatment of pneumonia depending on the etiology are considered, the criteria of sufficiency of antibacterial therapy are presented. The reasons for the possible ineffectiveness of the empirical antibiotic therapy of community-acquired pneumonia are described. The importance of identifying a particular form of community-acquired pneumonia – severe community-acquired pneumonia is emphasized. Described drugs for the treatment of severe community-acquired pneumonia. The issues of prevention of pneumonia were discussed, its importance in the strategy of reducing mortality according to the World Health Organization was emphasized.

The Effect of Partly Missing Covariates on Statistical Power in Randomized Controlled Trials With Discrete-Time Survival Endpoints

Methodology ◽  
2017 ◽  
Vol 13 (2) ◽  
pp. 41-60
Author(s):  
Shahab Jolani ◽  
Maryam Safarkhani
Keyword(s):  
Randomized Controlled Trials ◽  
Discrete Time ◽  
Treatment Effect ◽  
Survival Data ◽  
Controlled Trials ◽  
Missing Covariates ◽  
Indicator Method ◽  
Imputation Methods ◽  
Randomized Controlled ◽  
Baseline Covariates

Abstract. In randomized controlled trials (RCTs), a common strategy to increase power to detect a treatment effect is adjustment for baseline covariates. However, adjustment with partly missing covariates, where complete cases are only used, is inefficient. We consider different alternatives in trials with discrete-time survival data, where subjects are measured in discrete-time intervals while they may experience an event at any point in time. The results of a Monte Carlo simulation study, as well as a case study of randomized trials in smokers with attention deficit hyperactivity disorder (ADHD), indicated that single and multiple imputation methods outperform the other methods and increase precision in estimating the treatment effect. Missing indicator method, which uses a dummy variable in the statistical model to indicate whether the value for that variable is missing and sets the same value to all missing values, is comparable to imputation methods. Nevertheless, the power level to detect the treatment effect based on missing indicator method is marginally lower than the imputation methods, particularly when the missingness depends on the outcome. In conclusion, it appears that imputation of partly missing (baseline) covariates should be preferred in the analysis of discrete-time survival data.

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