Diagnostics of an acute bronchitis and community-acquired pneumonia and tactics of antibacterial therapy using amoxicillin

The most frequent forms of lower respiratory tract infections in practice of the doctor are the acute bronchitis and communityacquired pneumonia. The doctor should make the decision on tactics of maintaining such patients taking into account a clinical picture and results of inspection. Community-acquired pneumonia is a common and potentially life-threatening respiratory disease. The severity of the problem is that during periods of influenza epidemics or other respiratory viral infections, when Streptococcus pneumoniae is activated, there is an increase in the incidence of community-acquired pneumonia. However, recent years have shown that the etiology of pneumonia has expanded significantly, and among the causes of community-acquired pneumonia, in addition to bacteria, pneumotropic viruses began to occupy an important place (new coronavirus SARS-CoV-2, MERS, influenza A viruses, including pandemic H1N1, avian influenza, bocaviruses, metapneumoviruses, etc.). The association of bacteria and viruses makes the disease worse. In the world, 5-8 people per 1,000 adults suffer from pneumonia annually, in Europe – 2-15. In Russia, cases of community-acquired pneumonia in adults exceed 1,5 million per year. In 2020, Russia registered a significant increase in the incidence of community-acquired pneumonia – 3,6 times (1856,18 per 100 thousand population), including viral pneumonia – 109 times (783,08 per 100 thousand population) due to the spread of the new coronavirus SARS-CoV-2. Approaches to diagnostics and medicamentous therapy of bronchitis and communityacquired pneumonia are considered. Clinical performance of the treatment including intake of amoxicillin is estimated, results allow to recommend amoxicillin for use in out-patient practice.

1. Raherison С., Peray Р., Poirier R. et al. Management of lower respiratory tract infections by French general practitioners: the AIR II study // Eur. Respir. J. 2002; 19: 314-319.

2. Dvoreckij L. I. The patient with a lower respiratory tract infection. Medical consultation // Pul'monologiya. 2014; (2): 122-126. (In Russ.)

3. Krasnova E. I., Provorova V. V., Gajnc O. V. et al. Cough at children with an acute respiratory infection: when to appoint Mucolyticums? // Lechashchi Vrach. 2015; (9): 42. (In Russ.)

4. Krasnova E. I., Chemodanov V. V. Diagnostics and the principles of treatment of acute bronchitis against the background of a dysplasia of connecting fabric at children of early age // Lechashchi Vrach. 2018; (10): 32. (In Russ.)

5. Chuchalin A. G., Sinopal'nikov A. I., Strachunskij L. S. et al. Communityacquired pneumonia at adults: recommendations about diagnostics, treatment and prevention. M.: OOO Izd. Dom ŠM.Vesti‹, 2006: 462. (In Russ.)

6. About a condition of sanitary and epidemiologic wellbeing of the population in the Russian Federation in 2020: State report. M.: Federal'naya sluzhba po nadzoru v sfere zashchity prav potrebitelej i blagopoluchiya cheloveka, 2021. 256 р. (In Russ.)

7. Mustafin T. I., Kudoyarov R. R. Topical issues of community-acquired pneumonia // Medicinskij vestnik Bashkortostana. 2014; (5): 39-41. (In Russ.)

8. Community-acquired pneumonia at children. Clinical recommendations. M., 2015. 64 с. (In Russ.)

9. Geppe N. A., Rozinova N. N., Volkov I. K. i dr. Working classification of the main clinical forms of bronchopulmonary diseases at children. // Rossijskoe respiratornoe obshchestvo, 2009. 18 р. (In Russ.)

10. Gerasimova A. S., Mitroshina S. Yu., Kupryushina N. V. et al. Clinic morphological features of a current of community-acquired pneumonia in flu epidemic A/H1N1 // Pul'monologiya. 2012; (4): 50-55. (In Russ.)

11. Bobylev A. A., Rachina S. A., Avdeev S. N. et al. Community-acquired pneumonia at patients of advanced and senile age // Pul'monologiya. 2015; 25 (3): 261-276. (In Russ.)

12. Chuchalin A. G. Clinical recommendations. Pulmonology. M.: GEOTAR Media, 2005. 240 р. (In Russ.)

13. Chuchalin A. G., Sinopal'nikov A. I., Kozlov R. S. et al. Clinical recommendations about diagnostics, treatment and prevention of heavy community-acquired pneumonia at adults. M.: RRO, MAKMAH; 2014; (4): 13-48. (In Russ.)

14. Romanenko V. V., Somova A. V. Epidemiological features of communityacquired pneumonia in Sverdlovsk region // Epidemiologiya i vakcinoprofilaktika. 2014; 2 (75): 59-65. (In Russ.)

15. Hamitov R. F. Community-acquired pneumonia: non-drug risk factors of a lethal outcome // Pul'monologiya. 2014; (1): 23-26. (In Russ.)

16. Kanwar M., Brar N., Khatib R. et al. Misdiagnosis of community acquired pneumonia and inappropriate utilization of antibiotics: side effects of the 4 h antibiotic administration rule // Chest. 2007; 131 (6): 1865-1869.

17. Clinical recommendations Community-acquired pneumonia at adults. Ministry of Health of the Russian Federation, 2019. 97 р. (In Russ.)

18. Titova E. A., Reuckaya E. M., Ejrih A. R. Presepsin – a marker of sepsis and heavy pneumonia // Pul'monologiya. 2017; 27 (3): 366-370. (In Russ.)

19. Kelly E., MacRedmond R. E., Cullen G. et al Community acquired pneumonia in older patients: does age influence systemic cytokine levels in community acquired pneumonia? // Respirology. 2009; 14: 210-216.

20. Coelho L. M., Salluh J. I., Soares M. et al. Patterns of С reactive protein RATIO response in severe communityacquired pneumonia: a cohort study // Crit. Care. 2012; 16 (2): R53.

21. Lacoma A., Rodríguez N., Prat C. et al. Usefulness of consecutive biomarkers measurement in the management of community acquired pneumonia // Eur. J. Clin. Microbiol. Infect. Dis. 2012; 31 (5): 825-833.

22. Menéndez R., Sahuquillo Arce J. M., Reyes S. et al. Cytokine activation patterns and biomarkers are influenced by microorganisms in community acquired pneumonia // Chest. 2012; 141 (6): 1537-1545.

23. Berg P., Lindhardt B. O. The role of procalcitonin in adult patients with community acquired pneumonia – a systematic review // Dan. Med. J. 2012; 59 (3): A4357.

24. Zyryanov S. K., Baybulatova Ye. A. Use of new dosage forms of antibiotics as a way to increase the effectiveness and safety of antibiotic therapy. DOI: 10.24411/0235-2990-2019-10020.

25. Yakovlev S. V., Dovgan' Ye. V. Aspects of the effectiveness of antibiotics // Spravochnik poliklinicheskogo vracha. 2014; 6.

26. Dimopoulos G., Matthaiou D. K., Karageorgopoulos D. E., et al. Short-versus long-course antibacterial therapy for community-acquired pneumonia: a metaanalysis // Drugs. 2008; 68 (13): 1841-1854.