Журнал "Гастроэнтерология" Том 55, №2, 2021
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Adherence of Physicians to Preventive Prescription of Probiotics in Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease
Авторы: V.A. Moroz, Yu.V. Timchenko, E.F. Grintsov
National University of Pharmacy, Kharkiv, Ukraine
Рубрики: Гастроэнтерология
Разделы: Медицинские форумы
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Background. In recent decades, the problem of chronic obstructive pulmonary disease (COPD) is gaining more and more medical and social importance. Statistics record this pathology in 4–8 % of the population of developed countries. According to experts, COPD ranks fifth among the causes of persistent disability and mortality. At the same time, the widespread use of antibiotics in exacerbations of COPD, often in combination with glucocorticosteroids, contributes to the occurrence of intestinal dysbiosis, which is recorded in 35–75.8 % of such patients. According to the international recommendations of the WHO expert committee, in most cases, the need for the simultaneous use of probiotics to prevent and correct the existing intestinal dysbiosis is recognized.
The purpose of the work was to study the frequency of joint prescriptions of probiotics by attending physicians together with antibiotics in patients with COPD according to the data of the pharmacy dispensing of preparations.
Materials and methods. The assortment of dispensing of one of the pharmacies in Kharkiv for patients with COPD has been analyzed. 244 cases of dispensing antibiotics and probiotics were taken into account, both according to the prescription and taking into account the over-the-counter dispensing. In general, the range of prescribed antibiotics was following the existing international recommendations. Beta-lactams were most often prescribed (58.1 %). And protected aminopenicillins made up a fourth of this group. At the same time, beta-lactams had the lowest frequency of accompanying probiotics (from 6 % to 9.4 % in different subgroups). And this is even though it was this group of preparations that had the greatest potential for the development of intestinal dysbiosis. Macrolides and fluoroquinolones were combined with more balanced probiotic delivery in 16 % and 18 % of cases, respectively. Among the former, azithromycin (18 %) and clarithromycin (17 %) had the highest frequency of co-administration. Among the individual fluoroquinolones, probiotic accompaniment ranged from 7 % to 26 %. The overall incidence of co-administration of probiotics for antibiotic treatment of exacerbations of COPD was 11.5 %.
Conclusions. A low frequency of prescribing probiotics to patients with exacerbations of COPD was revealed, which is incompatible with modern recommendations for the prevention and treatment of intestinal dysbiosis. Beta-lactams most often prescribed by physicians had the lowest frequency of accompaniment (average 8.2 %). The results obtained demonstrated low adherence of the attending physicians to the prevention of intestinal dysbiosis according to modern international recommendations.