4^th Congress of the European Association for Clinical Pharamacology and Therapeutics

Florence, Italy, July 15-20, 2000

Abstract # 351

Antimicrobials prescription pattern in outpatient adults with community-acquired pneumonia

S. RATCHINA, S. KOZLOV, L. STRATCHOUNSKI

Institute of Antimicrobial Chemotherapy, Smolensk State Medical Academy, Smolensk, Russia

INTRODUCTION

Although a lot of local and international guidelines for antibiotic therapy of community-acquired pneumonia (CAP) have been published during the last decade information on actual CAP management is very scarce.

OBJECTIVE

To evaluate the pattern of antimicrobials prescribing to adults with CAP in outpatient departments in Russia.

METHODS

Case histories of outpatients with CAP who had not required hospitalization were randomly selected in seven regions of Russia for retrospective analysis. Diagnoses were classified according to the ICD-10; antimicrobials - to the ATC classification.

RESULTS

Altogether 778 case histories of patients aged from 16 to 88 (383 males, 395 females, average age 47.1+15.2) were included in the study. A total of 36 antimicrobials of 9 groups were prescribed. The most common "first choice" drug for initial monotherapy was gentamicin (15.6%), followed by ampicillin (12.1%), ciplofloxacin (10.5%), co-trimoxazole (8.0%). About 16% of patients received a combination of 2-3 antibiotics as initial therapy. The top three most frequently prescribed combinations were ampicillin+co-trimoxazole (26.1%), gentamicin+co-trimoxazole (9.2%), ampicillin+gentamicin (6.7%). Average duration of treatment was 9.9+4.7 days. In 71.6% of cases antimicrobials were administered orally, in 28% - intramuscularly.

CONCLUSION

Unacceptably large number of various antibiotics was used for treatment of CAP. Most of the "popular" antibiotics are not recommended for empirical therapy by the current guidelines. Further studies are advisable to clarify the reasons for such prescription habits.