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Outpatient antimicrobial therapy prescribing patterns for respiratory tract infections in different regions of the Russian Federation

https://doi.org/10.18093/0869-0189-2026-36-4-620-633

Abstract

The outpatient sector is a key area for antimicrobials’ (AMs) consumption and, therefore, a critical point of impact on patients’ safety, antibiotic resistance selection, and costs. Respiratory tract infections are considered to be the primary indication for antimicrobial therapy in outpatients, and this therapy can be inappropriate. The aim. To evaluate the patterns of antimicrobials’ prescription in outpatients with respiratory tract infections in different regions of the Russian Federation and to assess the compliance of prescription with quality indicators. Methods. This cross-sectional study was conducted in 14 outpatient clinics of 11 Russian cities in accordance with the outpatient protocol of international Global-PPS project during the period from January to April 2024. Results. The survey included 5,084 outpatients from 149 units, of whom 311 (6.1%) received at least one systemic antimicrobial agent to treat upper and/or lower respiratory tract infection. The main indications included acute respiratory viral infections (49.8%) and acute/exacerbation of chronic bronchitis (24.1%). Antibacterials and antivirals accounted for 53.4% and 46.3% prescriptions on average, respectively. Penicillins (26.1%) including combinations of penicillin and beta-lactamase inhibitor (19.5%) were the leaders among the prescribed antibiotics, umifenovir (35.6%) – among the prescribed antivirals. Only 79.2% of prescribed AMs complied with the national guidelines. “Watch” antibiotics according to the WHO AWaRe classification represented 51.1% of prescriptions. Conclusion. The proportion of patients with respiratory tract infections in Russian outpatient clinics is substantial, while the choice of AMs for their treatment does not always comply with clinical guidelines. High rate of “watch” antibacterials among the prescribed ones attests to increased risk of resistance selection in the participating institutions.

About the Authors

Yu. A. Belkova
Federal State Budgetary Educational Institution of Higher Education “Smolensk State Medical University” Ministry of Health of the Russian Federation
Russian Federation

Yuliya A. Belkova, Candidate of Medicine, Associate Professor, Associate Professor, Department of Clinical Pharmacology; tel.: (4812) 55-02-75

ul. Krupskoy 28, Smolensk, 214019
Competing Interests:

The authors declare no conflicts of interest.



S. A. Rachina
Federal 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

Svetlana A. Rachina, Doctor of Medicine, Professor, Professor of the Russian Academy of Sciences, Head of the Department of Hospital Therapy No.2; tel.: (499) 248-88-92

ul. Trubetskaya 8, build. 2, Moscow, 119991
Competing Interests:

The authors declare no conflicts of interest.



R. S. Kozlov
Federal State Budgetary Educational Institution of Higher Education “Smolensk State Medical University” Ministry of Health of the Russian Federation
Russian Federation

Roman S. Kozlov, Doctor of Medicine, Professor, Corresponding Member of the Russian Academy of Sciences, Rectorn; tel.: (481) 255-02-75

ul. Krupskoy 28, Smolensk, 214019
Competing Interests:

The authors declare no conflicts of interest.



A. A. Kurkova
Federal State Budgetary Educational Institution of Higher Education “Smolensk State Medical University” Ministry of Health of the Russian Federation
Russian Federation

Anastasia A. Kurkova, Candidate of Medicine, Researcher, Research Institute of Antimicrobial Chemotherapy; tel.: (4812) 55-02-75

ul. Krupskoy 28, Smolensk, 214019
Competing Interests:

The authors declare no conflicts of interest.



A. N. Stafeev
Federal 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

Aleksandr N. Stafeev, Candidate of Medicine, Assistant Professor, Department of Hospital Therapy No.2; tel.: (499) 248-88-92

ul. Trubetskaya 8, build. 2, Moscow, 119991
Competing Interests:

The authors declare no conflicts of interest.



R. V. Guchakov
Federal State Autonomous Educational Institution of Higher Education “National Research University Higher School of Economics”, Government of the Russian Federation
Russian Federation

Ratmir V. Guchakov, Candidate of Medicine, Leading Expert and Lecturer, Institute of Communication Management; tel.: (495) 628-90-00

ul. Myasnitskaya 20, Moscow, 101000
Competing Interests:

The authors declare no conflicts of interest.



V. G. Kukava
Federal 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

Veriko G. Kukava, Student, N.V.Sklifosovsky Institute of Clinical Medicine; tel.: (495) 609-14-00

ul. Trubetskaya 8, build. 2, Moscow, 119991
Competing Interests:

The authors declare no conflicts of interest.



E. M. Kurc
Regional State Budgetary Healthcare Institution “Regional Clinical Hospital”
Russian Federation

Evgeniya M. Kurc, Head of the Department of Clinical Pharmacology;tel.: (391) 226-99-97

ul. Partizana Zheleznyaka 3А, Krasnoyarsk, 660022
Competing Interests:

The authors declare no conflicts of interest.



E. V. Eliseeva
Federal State Budgetary Educational Institution of Higher Education “Pacific State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation

Ekaterina V. Eliseeva, Doctor of Medicine, Professor, Head of the Department of General and Clinical Pharmacology; tel.: (423) 245-16-50

Prospekt Ostryakova 2, Vladivostok, 690002, Primorskiy kray
Competing Interests:

The authors declare no conflicts of interest.



S. K. Zyryanov
Medical Institute, Federal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia named after Patrice Lumumba”, Ministry of Science and Higher Education of the Russian Federation
Russian Federation

Sergey K. Zyryanov, Doctor of Medicine, Professor, Head of Department of General and Clinical Pharmacology, Medical Institute; tel.: (495) 434-70-27

Scopus Author ID: 35796816700; WoS Researcher ID: D-8826-2012

ul. Miklukho-Maklaya 8, Moscow, 117198
Competing Interests:

The authors declare no conflicts of interest.



G. G. Ketova
Federal State Budgetary Educational Institution of Higher Education “South-Ural State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation

Galina G. Ketova, Doctor of Medicine, Professor, Head of the Department of Outpatient Therapy and Clinical Pharmacology; tel.: (351) 268-41-39

ul. Vorovskogo 64, Chelyabinsk, 454092
Competing Interests:

The authors declare no conflicts of interest.



E. V. Luchsheva
State Budgetary Institution of Healthcare “Kuzbass Children’s Clinical Hospital named after Professor Yu.E.Malakhovsky”
Russian Federation

Elena V. Luchsheva, Candidate of Medicine, Deputy Chief Physician for Outpatient Care for Children of the Central District; tel.: (3843) 32-49-87

ul. Dimitrova 33, Novokuznetsk, 654063
Competing Interests:

The authors declare no conflicts of interest.



Sh. Kh. Palyutin
Federal State Budgetary Educational Institution of Higher Education “Yaroslavl State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation

Shamil K. Palyutin, Candidate of Medicine, Associate Professor, Associate Professor, Department of Pharmacology and Clinical Pharmacology; tel.: (4852) 46-09-35

ul. Revolyutsionnaya 5, Yaroslavl’, 150000
Competing Interests:

The authors declare no conflicts of interest.



I. S. Panshina
State Autonomous Institution of Healthcare of the Sverdlovsk Region “Children’s City Clinical Hospital No.11, Yekaterinburg”
Russian Federation

Irina S. Panshina, Candidate of Medicine, Deputy Chief Physician for Clinical Expertise Work; tel.: (343) 381-54-31

ul. Nagornaya 48, Yekaterinburg, 620028
Competing Interests:

The authors declare no conflicts of interest.



U. S. Portnyagina
Federal State Autonomous Educational Institution of Higher Education “M.K.Ammosov North-Eastern Federal University”, Ministry of Science and Higher Education of the Russian Federation
Russian Federation

Ulyana S. Portnyagina, Candidate of Medicine, Associate Professor, Department of Internal Medicine and General Practice (Family Medicine); tel.: (914) 224-03-99

ul. Belinskogo 58, Yakutsk, 677000
Competing Interests:

The authors declare no conflicts of interest.



O. V. Reshetko
Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I.Razumovsky”, Healthcare Ministry of the Russian Federation
Russian Federation

Olga V. Reshetko, Doctor of Medicine, Professor, Head of the Clinical Pharmacology Departmentn; tel.: (8452) 39-48-72

ul. Bol’shaya Kazach’ya 112, Saratov, 410012
Competing Interests:

The authors declare no conflicts of interest.



V. D. Shegimova
State Autonomous Healthcare Institution “Republican Clinical Hospital named after N.A.Semashko” of the Ministry of Health of the Republic of Buryatia
Russian Federation

Vera D. Shegimova, Clinical Pharmacologist, Department of Clinical Pharmacology; tel.: (3012) 37-11-26

ul. Pavlova 12, Ulan-Ude, 670031, Republic of Buryatia
Competing Interests:

The authors declare no conflicts of interest.



M. V. Shutov
State Budgetary Healthcare Institution of the City of Moscow “City Polyclinic No.64 of the Moscow Department of Healthcare”
Russian Federation

Mikhail V. Shutov, Candidate of Medicine, Head”; tel.: (499) 673-41-43

ul. Malaya Semenovskaya 13, Moscow, 107023
Competing Interests:

The authors declare no conflicts of interest.



N. E. Titova
Federal 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

Natalya E. Titova, Candidate of Medicine, Associate Professor, Associate Professor, Department of General Medical Practice, Outpatient Therapy with a Course in Geriatrics, Faculty of Continuing Professional Education

ul. Trubetskaya 8, build. 2, Moscow, 119991
Competing Interests:

The authors declare no conflicts of interest.



S. B. Yakushin
Federal 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

Sergey B. Yakushin, Assistant, Department of Outpatient Paediatrics; tel.: (4812) 55-02-75

ul. Trubetskaya 8, build. 2, Moscow, 119991
Competing Interests:

The authors declare no conflicts of interest.



I. A. Baynov
Russian Global-PPS Project Study Group;State Autonomous Institution of Healthcare of the Sverdlovsk Region “Children’s City Clinical Hospital No.11, Yekaterinburg”
Russian Federation

Yekaterinburg
Competing Interests:

The authors declare no conflicts of interest.



T. V. Karavanova
Russian Global-PPS Project Study Group;Regional State Budgetary Healthcare Institution “Regional Clinical Hospital”
Russian Federation

Krasnoyarsk
Competing Interests:

The authors declare no conflicts of interest.



N. A. Kolesnikova
Russian Global-PPS Project Study Group;Regional State Budgetary Healthcare Institution “Regional Clinical Hospital”
Russian Federation

Krasnoyarsk
Competing Interests:

The authors declare no conflicts of interest.



S. O. Korol’kov
Russian Global-PPS Project Study Group;Federal 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

Moscow
Competing Interests:

The authors declare no conflicts of interest.



A. L. Levitan
Russian Global-PPS Project Study Group;Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I.Razumovsky”, Healthcare Ministry of the Russian Federation
Russian Federation

Saratov
Competing Interests:

The authors declare no conflicts of interest.



I. G. Ryzhenkova
Russian Global-PPS Project Study Group;Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I.Razumovsky”, Healthcare Ministry of the Russian Federation
Russian Federation

Saratov
Competing Interests:

The authors declare no conflicts of interest.



O. M. Shamina
Russian Global-PPS Project Study Group;Federal State Budgetary Educational Institution of Higher Education “South-Ural State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation

Chelyabinsk
Competing Interests:

The authors declare no conflicts of interest.



Yu. V. Feoktistova
Russian Global-PPS Project Study Group;Federal State Budgetary Educational Institution of Higher Education “Pacific State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation

Vladivostok
Competing Interests:

The authors declare no conflicts of interest.



E. A. Poddubnyy
Russian Global-PPS Project Study Group; Federal State Budgetary Educational Institution of Higher Education “Pacific State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation

Vladivostok
Competing Interests:

The authors declare no conflicts of interest.



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Review

For citations:

Belkova Yu.A., Rachina S.A., Kozlov R.S., Kurkova A.A., Stafeev A.N., Guchakov R.V., Kukava V.G., Kurc E.M., Eliseeva E.V., Zyryanov S.K., Ketova G.G., Luchsheva E.V., Palyutin Sh.Kh., Panshina I.S., Portnyagina U.S., Reshetko O.V., Shegimova V.D., Shutov M.V., Titova N.E., Yakushin S.B., Baynov I.A., Karavanova T.V., Kolesnikova N.A., Korol’kov S.O., Levitan A.L., Ryzhenkova I.G., Shamina O.M., Feoktistova Yu.V., Poddubnyy E.A. Outpatient antimicrobial therapy prescribing patterns for respiratory tract infections in different regions of the Russian Federation. PULMONOLOGIYA. 2026;36(4):620-633. (In Russ.) https://doi.org/10.18093/0869-0189-2026-36-4-620-633

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