Pharmacoepidemiology of out-patient pneumonia

Abstract

Pharmacoepidemiological analysis of mild community-acquired pneumonia management was performed in 800 patients who were divided into two groups: 418 patients younger 60 without concomitant pathologies (groupl) and 382 patients older 60 and/or having concomitant diseases (group 2). Monotherapy took place in 73% of all the patients. Twenty two antibiotics of 9 pharmacological classes were applied. Aminopenicillins, macrolides and quinolones were prescribed more often. Aminopenicillins, spiramycin and erythromycin were more effective in the 1st group (their effectiveness were 91.3%, 82.4% and 78.6% accordingly) compared with the 2nd group (80%, 74.1% and 41.2% respectively). Quinolones and co-amoxiclav were more effective in the 2nd group (81.4% and 84.6% versus 67.1% and 100% in the 1st group). The identical efficiency in the both groups was shown for azithromycin and midecamycin (100% and 84.6% correspondingly). The extremely low efficacy was found for gentamycin and co-trimoxazole (40.6% and 33% respectively); these drugs should not be used in community-acquired pneumonia management. The most reasonable antibiotics’ combinations were: ampicillin + co-trimoxazole (the effectiveness is 76%, which was lower than that of monotherapy with ampicillin) and ciprofloxacin + co-trimoxazole (75% of the efficacy). The best cost-effectiveness was revealed for ampicillin, amoxicillin, azithromycin and midecamycin. So, this analysis demonstrates the necessity of different approach to antibiotics administration taking into account various parameters including economic ones.