[Frequent severe exacerbations of chronic obstructive pulmonary disease: markers of bacterial infection and features of antibiotic therapy].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-04-15 DOI:10.26442/00403660.2025.03.203130

A R Zinnatullina, R F Khamitov

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引用次数: 0

Abstract

Aim: To evaluate markers of bacterial infection and features of antibiotic therapy in patients hospitalized with exacerbation of chronic obstructive pulmonary disease (COPD) once and again during the year.

Materials and methods: Analysis of 423 medical records of inpatients hospitalized in the therapeutic department of a city hospital with exacerbation of COPD over 4 years. 276 cases were hospitalized once during the year (control group), 147 - hospitalized repeatedly (main group).

Results: In the control group 36.9% of patients complained of cough with purulent sputum, while in the main group - 25.2% (p<0.05). 31.5% of patients in the control group and 17% of the main group reported fever during hospitalization (p<0.05). A high level of CRP during hospitalization was observed in 62.8% of patients in the control group and 49.1% in the main group (p<0.05); 47.1% of patients in the control group and 28.6% of patients in the main group had an increased level of leukocytes in sputum. According to the results of bacteriological analysis of sputum, there were no differences in the inoculation of infectious agents in the groups. At the same time, in almost 90% of cases, patients in both groups were prescribed antibiotic therapy, and in some cases, the same antibiotic for 2 and 3 hospitalizations in a row. Patients of the main group had extremely severe obstructive disorders twice as often. The degree of respiratory failure in patients with repeated exacerbations increased by 2 times from the first to the third hospitalization. Arterial hypertension and chronic heart failure of the 2nd stage were more common in the main group.

Conclusion: The severity of obstructive disorders, the severity of the comorbidity, and the general condition of patients may have a more significant effect on the recurrence of severe exacerbations requiring repeated hospitalizations than bacterial infection. In this regard, in this group of patients, special attention should be paid to assessing the indications for prescribing antibiotic therapy, as well as optimizing its regimens.

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慢性阻塞性肺疾病的频繁严重恶化：细菌感染的标志和抗生素治疗的特点。

目的：探讨慢性阻塞性肺疾病（COPD）急性加重住院患者一年内细菌感染指标及抗生素治疗特点。材料与方法：对某市医院治疗科423例COPD加重期住院患者4年以上的病历资料进行分析。全年住院一次276例（对照组），多次住院147例（主要组）。结果：对照组有36.9%的患者主诉咳嗽并脓痰，而主诉组为25.2% （ppp）。结论：阻塞性疾病的严重程度、合并症的严重程度以及患者的一般情况可能比细菌感染对严重加重的复发有更显著的影响，需要反复住院。在这方面，在这组患者中，应特别注意评估抗生素治疗的适应症，并优化其方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.