Методология

pulmo

Пульмонология

PULMONOLOGIYA

0869-01892541-9617

Scientific and Practical Journal “PULMONOLOGIYA” LLC

10.18093/0869-0189-2022-32-3-295-355

pulmo-4107

Research Article

КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ

CLINICAL GUIDELINES

Внебольничная пневмония: федеральные клинические рекомендации по диагностике и лечению

Federal guidelines on diagnosis and treatment of community-acquired pneumonia

https://orcid.org/0000-0002-5999-2150

Авдеев

С. Н

Avdeev

S. N.

д. м. н., профессор, академик Российской академии наук, заведующий кафедрой пульмонологии Института клинической медицины имени Н.В.Склифосовского, 119991, Москва, ул. Трубецкая, 8, стр. 2;

ведущий научный сотрудник, 115682, Москва, Ореховый бульвар, 28

Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of the Department of Pulmonology, N.V.Sklifosovsky Institute of Clinical Medicine, ul. Trubetskaya 8, build. 2, Moscow, 119991;

Leading Researcher, Orehovyy bul’var 28, Moscow, 115682

https://orcid.org/0000-0001-6897-5486

Дехнич

А. В.

Dekhnich

A. V.

к. м. н., заместитель директора Научно-исследовательского института антимикробной химиотерапии,

214019, Смоленск, ул. Крупской, 28

Candidate of Medicine, Deputy Director, Research Institute of Antimicrobial Chemotherapy,

ul. Krupskoy 28, Smolensk, 214019

Andrey.Dekhnich@antibiotic.ru

https://orcid.org/0000-0002-0934-7313

Зайцев

А. А.

Zaytsev

A. A.

д. м. н., профессор, главный пульмонолог,

105094, Москва, Госпитальная пл., 3

Doctor of Medicine, Professor, Chief Pulmonologist,

Gospital’naya pl. 3, Moscow, 105229

a-zaicev@yandex.ru

https://orcid.org/0000-0001-8728-1113

Козлов

Р. С.

Kozlov

R. S.

д. м. н., профессор, член-корр. Российской академии наук, ректор, 214019, Смоленск, ул. Крупской, 28;

директор, 214019, Смоленск, ул. Крупской, 28

главный внештатный специалист Министерства здравоохранения Российской Федерациипо направлению «Клиническая микробиология и антимикробная резистентность»

Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Rector, ul. Krupskoy 28, Smolensk, 214019;

Director, ul. Krupskoy 28, Smolensk, 214019;

Chief Freelance Specialist of the Healthcare Ministry of Russia in the field of “Clinical Microbiology and Antimicrobial Resistance”

Roman.Kozlov@antibiotic.ru

https://orcid.org/0000-0002-3329-7846

Рачина

С. А.

Rachina

S. A.

д. м. н., заведующая кафедрой госпитальной терапии № 2,

119991, Москва, ул. Трубецкая, 8, стр. 2

Doctor of Medicine, Head of Department оf Hospital Therapy No.2,

ul. Trubetskaya 8, build. 2, Moscow, 119991

svetlana.ratchina@antibiotic.ru

https://orcid.org/0000-0003-0830-786X

Руднов

В. А.

Rudnov

V. A.

д. м. н., профессор, заведующий кафедрой анестезиологии и реаниматологии, 620028 Екатеринбург, ул. Репина, 3;

руководитель службы анестезиологии и реанимации, 620036, Екатеринбург, ул. Соболева, 29

вице-президент Межрегиональной ассоциации общественных объединений «Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии»

Doctor of Medicine, Professor, Head of Department of Anesthesiology and Intensive Care, ul. Repina 3, Ekaterinburg, 620028;

Head of Anesthesiology and Intensive Care Service, ul. Soboleva, 29, Ekaterinburg, 620036;

Vice-president, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy

Vrudnov@mail.ru

https://orcid.org/0000-0002-1990-2042

Синопальников

А. И.

Sinopal’nikov

A. I.

д. м. н., профессор, заведующий кафедрой пульмонологии,

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Doctor of Medicine, Professor, Head of Department of Pulmonology,

ul. Barrikadnaya 2/1, build. 1, Moscow, 123995

aisyn@list.ru

https://orcid.org/0000-0003-3931-1431

Тюрин

И. Е.

Tyurin

I. E.

д. м. н., профессор, заведующий кафедрой рентгенологии и радиологии,

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Doctor of Medicine, Professor, Head of Department of Radiology,

ul. Barrikadnaya 2/1, build. 1, Moscow, 123995

igortyurin@gmail.com

Фесенко

О. В.

Fesenko

O. V.

д. м. н., профессор кафедры пульмонологии,

125993, Москва, ул. Баррикадная, 2 / 1, стр. 1

Doctor of Medicine, Professor, Pulmonology Department,

ul. Barrikadnaya 2/1, build. 1, Moscow, 123995

ofessenko@mail.ru

https://orcid.org/0000-0002-6808-5528

Чучалин

А. Г.

Chuchalin

A. G.

д. м. н., профессор, академик Российской академии наук, заведующий кафедрой госпитальной терапии педиатрического факультета, председатель правления Российского респираторного общества,

117997, Москва, ул. Островитянова, 1

Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of Department of Hospital Internal Medicine, Pediatric Faculty, ul. Ostrovityanova 1, Moscow, 117997;

Chairman of the Executive Board of Russian Respiratory Society

pulmomoskva@mail.ru

Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет); Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентстваРоссияFederal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Federal Pulmonology Research Institute, Federal Medical and Biological Agency of RussiaRussian Federation

Федеральное государственное бюджетное учреждение «Главный военный клинический госпиталь имени академика Н.Н.Бурденко» Министерства обороны Российской ФедерацииРоссияMain Military Clinical Hospital named after academician N.N.Burdenko, Ministry of Defense of the Russian FederationRussian Federation

Федеральное государственное бюджетное образовательное учреждение высшего образования «Смоленский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Межрегиональная ассоциация общественных объединений «Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии»РоссияSmolensk State Medical University, Healthcare Ministry of Russia; Interregional Association for Clinical Microbiology and Antimicrobial ChemotherapyRussian Federation

Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation

Федеральное государственное бюджетное образовательное учреждение высшего образования «Уральский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Государственное автономное учреждение здравоохранения Свердловской области «Свердловский областной онкологический диспансер»РоссияFederal State Budget Educational Institution of Higher Education “Ural State Medical University” of the Ministry of Health of the Russian Federation; State Autonomous Healthcare Institution of the Sverdlovsk Region “Sverdlovsk Regional Oncological Dispensary”Russian Federation

Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияRussian Medical Academy of Continuous Professional Education, Healthcare Ministry of Russian FederationRussian Federation

Федеральное государственное автономное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И.Пирогова» Министерства здравоохранения Российской ФедерацииРоссияPirogov Russian National Research Medical University (Pirogov Medical University), Ministry of Health of the Russian FederationRussian Federation

2022

14072022

323

Спецвыпуск

295355

2022

Авдеев С.Н., Дехнич А.В., Зайцев А.А., Козлов Р.С., Рачина С.А., Руднов В.А., Синопальников А.И., Тюрин И.Е., Фесенко О.В., Чучалин А.Г.

Avdeev S.N., Dekhnich A.V., Zaytsev A.A., Kozlov R.S., Rachina S.A., Rudnov V.A., Sinopal’nikov A.I., Tyurin I.E., Fesenko O.V., Chuchalin A.G.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.pulmonology.ru/pulm/article/view/4107

Внебольничная пневмония (ВП) является одним из наиболее распространенных острых инфекционных заболеваний и занимает существенную долю в структуре смертности от заболеваний органов дыхания. Крайне актуальным является подбор рациональной антибактериальной терапии, предполагающий оптимальную клиническую эффективность, улучшение прогноза, снижение скорости селекции антибиотикорезистентности и минимизацию побочных эффектов.

Методология

Методология. Целевой аудиторией данных клинических рекомендаций являются врачи-терапевты, врачи общей практики, врачи-пульмонологи, врачи-анестезиологи-реаниматологи, клинические фармакологи. Каждый тезис-рекомендация по проведению диагностических и лечебных мероприятий оценивается по шкалам уровней достоверности доказательств от 1 до 5 и шкале оценки уровней убедительности рекомендаций по категориям А, В, С. Клинические рекомендации содержат также комментарии и разъяснения к указанным тезисам-рекомендациям, алгоритмы по диагностике, тактике терапии, справочные материалы по использованию антибактериальных препаратов и проведению микробиологических (культуральных) исследований.

Заключение

Заключение. По данным представленных клинических рекомендаций освещаются современные сведения об этиологии, клинических проявлениях, диагностике и тактике терапии ВП. Одобрены решением Научно-практического совета Министерства здравоохранения Российской Федерации (2021).

Community-acquired pneumonia is one of the most common acute infectious diseases that has a significant share in the structure of mortality from respiratory diseases. It is extremely important to select rational antibiotic therapy which ensures optimal clinical efficacy, improved outcome, reduced rate of antibiotic resistance selection, and minimization of side effects.

Methods

Methods. The target audience of these clinical recommendations are therapists, general practitioners, pulmonologists, anesthesiologist-resuscitators, and clinical pharmacologists. Each thesis-recommendation about diagnostic and therapeutic procedures has been scored according to the scale of classes of recommendations from 1 to 5 and A, B, C scale of the levels of evidence. The clinical recommendations also contain comments and explanations to these theses, algorithms for the diagnosis and treatment, and reference materials on the use of antibacterial drugs and microbiological (culture) tests.

Conclusion

Conclusion. The presented clinical guidelines cover current information about the etiology, clinical manifestations, diagnosis and treatment tactics for community-acquired pneumonia. The presented clinical guidelines have been approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation in 2021.

внебольничная пневмониятяжелая пневмониядиагностикарекомендацииантибактериальная терапия

community-acquired pneumoniasevere pneumoniadiagnosticsrecommendationsantibiotic therapy

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The authors declare that there are no conflicts of interest present.