Analysis of antibacterial therapy of community-acquired pneumonia in the therapeutic department

Background. Currently, the proportion of pneumonia of mycoplasma etiology (24 %) is increasing in the structure of all laboratory-confirmed cases of community-acquired pneumonia, which requires adjustment of empirical antibiotic therapy, taking into account the current flora, to accelerate recovery and reduce the risk of complications. Objective: to analyze the case histories of patients with pneumonia from January 2024 to November 2024. Analyze antibiotic therapy. Materials and methods. A retrospective analysis of the case histories of patients with pneumonia who are in the therapeutic department from 01.01.2024 to 30.11.2024 was carried out, and the Spearman’s rank correlation coefficient was calculated. Results. To conduct the study, data from 187 case histories of patients with community-acquired pneumonia were collected and retrospectively analyzed. Women (57 %), young patients aged 18–44 years (42 %) and middle-aged patients 45–59 years (25 %) were more likely to get sick, the course of the disease was predominantly severe (95.7 %). Correlations were revealed: severe course in young/middle-aged (coefficient 0.935), smokers (0.572) and HIV-infected (human immunodeficiency virus) (0.857). Every second patient had damage to the lower lobe of the lungs. One in four has multilobular lung damage. In most cases, in 152 patients (81.2 percent), a combination of levofloxacin and ceftriaxone was used to treat pneumonia. This combination was effective in 143 patients (94 %), the rest needed a change in antibiotic therapy. The average age of patients with no effect from combination therapy (levofloxacin + ceftriaxone) is 61 years, with a minimum age of 30 years and a maximum age of 88 years. Pneumonia with an atypical clinical presentation (young and medium age of patients, low-grade fever, headaches and muscle pains, absence of chest pain, catarrhal manifestations, non-productive cough) were detected, but laboratory confirmation of the presence of an atypical pathogen was not obtained. Antibiotic therapy (levofloxacin + ceftriaxone) was chosen due to the fact that the analyzed period coincided with the period of the epidemic of mycoplasma pneumonia, recorded by the medical company INVITRO. The analysis revealed the ratio of pneumonia to typical and atypical clinics: 72 % to 28 %. Conclusion. Analysis of case history data showed an increase in cases of pneumonia with an atypical clinic, for which the most effective combination of antibiotic therapy: levofloxacin and ceftriaxone. In addition, the combination of amoxicillin and clavulanic acid used at the outpatient stage did not affect the course and did not shorten the duration of hospitalization. Early detection of pneumonia with an atypical clinical presentation requires a comprehensive approach, including a thorough medical history, assessment of clinical symptoms, laboratory and instrumental tests, as well as a PCR (polymerase chain reaction) test for atypical flora. Timely diagnosis and the right choice of antibiotics will reduce the duration of hospitalization, reduce the number of complications and improve treatment outcomes, especially in young and middle-aged patients, where the course of the disease was more severe.

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