编号 10 (2017)

Несмотря на очевидные прорывы и успехи в лечении внебольничных пневмоний (ВП), проблема растущей резистентности антибиотиков требует своевременного пересмотра позиций и руководящих принципов. Повышению эффективности антибактериальной терапии пациентов с острой и затяжной ВП был посвящен научный симпозиум в рамках XXIV Российского национального конгресса «Человек и лекарство» (10-13 апреля 2017 г., Москва). Открывая симпозиум, академик РАН, директор ФГБУ НИИ пульмонологии ФМБА России, заведующий кафедрой госпитальной терапии педиатрического факультета ФГБОУ ВО РНИМУ им. Н.И. Пирогова МЗ России Александр Григорьевич Чучалин отметил, что на проблему антибактериальной терапии в лечении ВП необходимо смотреть сквозь призму знаний с учетом позиций разных сторон.

The ubiquitous appearance and rapid spread of nosocomial gram-negative pathogens with multiple resistance to antimicrobial agents is an extremely alarming trend throughout the world. In this regard, health care systems of all countries face an issue of most efficient use of available antibacterial drugs in hospitals, and first of all it concerns carbapenems. The article presents information on the comparative antimicrobial activity of imipenem, meropenem and doripenem in relation to problem Gram-negative pathogens, and discusses the most relevant options for increasing the effectiveness of doripenem in clinical practice, namely, the use of higher doses of antibiotic, the extensive introduction of extended infusion and the use of combination therapy with simultaneous administration of several antimicrobial agents (including two carbapenems).

The article presents a clinical example of the use of modern wound dressings HydroClean plus and Hydro Tac (Paul Hartman, Germany) for the local treatment of venous ulcers. This clinical observation showed high clinical effectiveness of wound dressings HydroClean plus and HydroTac in the treatment of venous trophic ulcers. The innovative structure of these dressings corresponds to modern views on the etiopathogenesis of chronic wounds against the background of decompensation of venous circulation, allows evacuating the exudate and toxic components from the wound, while maintaining high humidity and ensuring proper gas exchange.

Epidemiological studies of recent decades have convincingly confirmed that cardiovascular diseases are one of the leading causes of early disability and mortality of the population. Based on the statistical data of the Healthcare Department of the Tyumen Region over period of 2007-2016, an epidemiological assessment of indicators of circulatory diseases (CD) and cerebrovascular disease (CVD) in the Tyumen Region was performed. It was revealed that the mortality rates for CD and CVD in the region were less than the average rates in Russia, with significantly higher rates for the rural population compared to the urban population. The mortality rates for these diseases among men were also significantly higher than among women, while in 2016 the mortality rates for CVD have significantly decreased in both men and women, demonstrating the effectiveness of the healthcare system in organization of rehabilitation and preventive activities in the region. Further implementation of strategies aimed at improving epidemiological indicators will reduce the CVD burden.

The article discusses the problem of the use of fluoroquinolones in otorhinolaryngology. It has been established that the number of prescriptions of levofloxacin continues to grow in the world. The reason for the increase in the use of levofloxacin includes its more favorable benefit/risk ratio compared to many other fluoroquinolones as evidenced by the results of not only clinical but also ongoing pharmacoepidemiological studies.