Determining knowledge of antimicrobial therapy in senior medical students (results of the KANT-IV project)

Objective. To determine the level of basic knowledge of 5–6-year medical students in the issues of appropriate antimicrobial therapy. Materials and Methods. A multicenter questionnaire survey with analysis of results – stage of KANT project (full name of the project – «Physicians’ (Students’) knowledge in antimicrobials usage») conducted in 2020-2023. Results. A total of 277 students in 6 regions of Russia were surveyed. The average level of correct answers for the whole questionnaire amounted to 42.2%, taking into account the extended analysis of sub-items questions #8,9 – 42.6%. The respondents were best able to answer the questionnaire questions about the choice of time interval during which the effectiveness of antimicrobial therapy is assessed (average level of completeness of the answer – 90.6%); the choice of the most rational action when diagnosing acute tonsillitis or pharyngitis at the appointment (average level of completeness of the answer – 57.8%); indication of the regimen of different AMD (average level of completeness of the answer – 55.2%). The worst results were recorded when answering the following questions: justification of the situation of prolongation of antimicrobial therapy (AMT) for more than 5-7 days in a patient with positive clinical dynamics in the treatment of outpatient pneumonia (average level of completeness of the answer – 19.5%), indication of AMD of choice in the therapy of various infections (average level of completeness of the answer – 22.9%), prescription of auxiliary drugs to the justified prescription of AMD in the treatment of respiratory tract infections (average level of completeness of the answer – 21.3%). Conclusions. Having researched the results of this study, we can conclude that the level of knowledge of senior medical students in rational antibiotic therapy is quite low. In this regard, according to the authors, it is necessary to allocate an additional number of academic hours in the disciplines of "Pharmacology", "Clinical Pharmacology", specialized therapeutic disciplines, to optimize the educational program, as well as to provide students with modern sources of information that relate to the topic of rational antimicrobial therapy

The assessment of physicians' and senior medical students’ knowledge in the field of communityacquired pneumonia: preliminary results of the KNOCAP-II project (2017-2019)

Внебольничная пневмония (ВП) относится к одной из самых актуальных проблем современной медицины. На сегодняшний день ВП занимает 4 место в структуре смертности (после сердечно-сосудистых, цереброваскулярных заболеваний и злокачественных новообразований) и 1 место среди всех смертей от инфекционных заболеваний. Цель – оценка уровня знаний врачей терапевтического профиля и студентов старших курсов медицинских вузов в вопросах ведения пациентов с ВП. В рамках многоцентрового исследования KNOCAP (полное название проекта – «The assessment of physician and students’ knowledge of community-acquired pneumonia basics») представлены результаты анонимного проспективного опроса по оценке знаний и предпочтений врачей терапевтического профиля и студентов старших медицинских курсов в вопросах ведения пациентов с ВП. По итогам первого периода проекта (2017-2019 гг.) получены и проанализированы результаты анкетирования 588 врачей терапевтического профиля и 394 студентов-медиков из 17 центров России, Украины и Кыргызстана. За основу взят метод анонимного анкетирования, для чего была разработана оригинальная анкета на основании актуальных клинических рекомендаций. Наибольшие сложности вызвали следующие вопросы: сроки проведения повторного рентгенологического исследования при положительной динамике лечения, выбор основного диагностического признака при ведении пациента с ВП, указать типовые ошибки фармакотерапии ВП и выбор стартовой антимикробной терапии у пациентов с факторами риска и без них. В целом исследование показало значимое несоответствие знаний в вопросах ведения пациентов с ВП актуальным клиническим рекомендациям 2010 г. и проектом новых клинических рекомендаций 2018-2019 гг. В настоящее время существует необходимость в повышении уровня знаний и совершенствовании профессиональной деятельности врачей терапевтического профиля и студентов старших медицинских курсов, так как проведенный многоцентровой срез знаний и предпочтений специалистов во многих вопросах выявил их недостаточный уровень для корректного ведения пациентов с ВП. Community-acquired pneumonia (CAP) is one of the most relevant problems of modern medicine. Today, CAP takes 4th place in the structure of mortality (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and 1st place among all deaths from infectious diseases. The aim of the study is to assess the level of general physician’ and senior medical students’ basic knowledge in CAP treatment. The article represents the results of anonymous prospective surveys within the framework of the second stage of KNOCAP multi-centered research project (full name of the project «The assessment of physician’ and students’ knowledge of community-acquired pneumonia basics») aimed at accessing the knowledge and preferences of doctors and students on the fundamental issues in diagnosis and treatment of community-acquired pneumonia. The survey conducted in 2017-2019 involved 588 physicians and 394 students from seventeen Russian, Kyrgyzstan and Ukrainian centers. The method of anonymous questioning was used in this study, for which an original questionnaire was developed on the basis of current clinical recommendations. The following fundamental questions caused the greatest difficulties in the respondents: terms for a repeated X-ray examination in positive dynamics of CAP treatment, the choice of main diagnostic criteria of CAP, the choice of the typical mistakes of CAP treatment, the choice of the initial antimicrobial therapy. In general, the respondents’ knowledge in CAP patients’ management deviates significantly from the current clinical guidelines, as of 2010, and from the new clinical guidelines draft, 2018-2019. Currently, there is a need to increase the level of knowledge and improve the professional activities of therapists and senior medical students, as a multicenter section of the knowledge and preferences of specialists in many issues revealed their insufficient level for the correct management of patients with CAP

ANALGETICS-ANTIPYRETICS IN PEDIATRICIAN’S PRACTICE: THE POINT OF VIEW OF CLINICAL PHARMACOLOGIST

The article discusses on of the main problems of pediatrics — the problem of hyperthermia in children and administration of antipyretics. A pathogenesis of a fever and «point of attack» of antipyretics, data on effectiveness and adverse events of this group of medications are presented.Key words: children, fever, antipyretics, indications.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(6):135-138

Clinical-pharmacological priorities in the election of blockators of the renin-angiotenzine system and diuretics in patients with uncompleted hypertension

The article discusses the problem of using ACE inhibitors and diuretics in arterial hypertension. Analysis of the position of doctors when prescribing ACE inhibitors and diuretics showed its compliance with current national guidelines for the treatment of hypertension. Physicians use more adequate criteria for antihypertensive drugs usage. There were no non-rational use of diuretics in combination, regardless of indications and contraindications. If there are indications for the use of a diuretic and a preparation of ACE inhibitors, you have to make greater use of fixed combinations of drugs. The article discusses the results of clinical efficacy studies of perindopril and indapamide in clinical practice. Noliprel® forte is an effective antihypertensive medication, not only reducing BP, but also organoprotective aim and good tolerability in wide range of patients with arterial hypertension

Calcium antagonists in pharmacotherapy in patients with concomitant cardiac pathology: priorities of the recommendations in clinical practice

The article discusses the problem of using calcium antagonists in clinical practice. Physicians' judgments in prescribing calcium antagonists showed its compliance with current guidelines for the treatment of hypertension. Emphasizes the feasibility of dihydropyridine calcium antagonists as efficacy and safety tools in patients with combination of arterial hypertension, stable angina and chronic heart failure. The article discusses the results of clinical efficacy studies of felodipine in a combined cardiac pathology with cognitive impairment

CHILDREN'S ARTERIAL HYPERTENSION: DRUG CHOICE. THE RESULTS OF THE PHARMACOEPIDEMIOLOGICAL STUDY RIFAGD

The multicentered pharmacoepidemiological study «Rifagd» (prevalence and pharmacotherapy of arterial hypertension in children) in 13 cities of Russia was conducted with the purpose of analyzing of pediatricians' approach to the treatment of children's arterial hypertension, including drug choice. This allowed to estimate their experience, knowledge, as well as to direct the way to improvements of quality in medical treatment of patients with arterial hypertension. The majority of pediatricians (83,1%) encounter difficulties in hypertension treatment in connection with guidelines absence (37,3%), medical practice absence (30,4%) and «absence of indications for the application of antihypertensive drugs in pediatrics» (31,9%). for arterial hypertension treatment pediatricians use AgE-inhibitors, diuretics and beta blockers.Key words: rifagd, arterial hypertension, pharmacoepidemiology, questioning of pediatricians, ace inhibitors, diuretics, beta blockers

HYPERPIESIS OF CHILDREN AND TEENAGERS: REAL PROBLEM FOR A PEDIATRICIAN

The authors have conducted multicentric epidemiological research in 13 cities of russia to examine approaches of pediatricians to diagnostics and treatment hyperpiesis in childhood, which allowed the researchers to estimate their experience and knowledge. It has turned out that most pediatricians can not apply the knowledge in hyperpiesis diagnostics due to the absence of the agebdependent cuffs to measure hyperpiesis, as well as the skills to assess the hyperpiesis measurement findings along with centile tables use. Quality improvement of hyperpiesis diagnostics in childhood is possible by means of implementation of educational programs for the pediatricians on diagnostics and treatment of children, suffering from hyperpiesis.Key words: child's hyperpiesis, epidemiology, diagnostics, children

CHILDREN'S ARTERIAL HYPERTENSION: DRUG CHOICE. THE RESULTS OF THE PHARMACOEPIDEMIOLOGICAL STUDY RIFAGD

The multicentered pharmacoepidemiological study «Rifagd» (prevalence and pharmacotherapy of arterial hypertension in children) in 13 cities of Russia was conducted with the purpose of analyzing of pediatricians' approach to the treatment of children's arterial hypertension, including drug choice. This allowed to estimate their experience, knowledge, as well as to direct the way to improvements of quality in medical treatment of patients with arterial hypertension. The majority of pediatricians (83,1%) encounter difficulties in hypertension treatment in connection with guidelines absence (37,3%), medical practice absence (30,4%) and «absence of indications for the application of antihypertensive drugs in pediatrics» (31,9%). for arterial hypertension treatment pediatricians use AgE-inhibitors, diuretics and beta blockers.Key words: rifagd, arterial hypertension, pharmacoepidemiology, questioning of pediatricians, ace inhibitors, diuretics, beta blockers

АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ ДЕТСКОГО ВОЗРАСТА: ВЫБОР ЛЕКАРСТВЕННЫХ СРЕДСТВ. РЕЗУЛЬТАТЫ ФАРМАКОЭПИДЕМИОЛОГИЧЕСКОГО ИССЛЕДОВАНИЯ «РИФАГД»

The multicentered pharmacoepidemiological study «Rifagd» (prevalence and pharmacotherapy of arterial hypertension in children) in 13 cities of Russia was conducted with the purpose of analyzing of pediatricians' approach to the treatment of children's arterial hypertension, including drug choice. This allowed to estimate their experience, knowledge, as well as to direct the way to improvements of quality in medical treatment of patients with arterial hypertension. The majority of pediatricians (83,1%) encounter difficulties in hypertension treatment in connection with guidelines absence (37,3%), medical practice absence (30,4%) and «absence of indications for the application of antihypertensive drugs in pediatrics» (31,9%). for arterial hypertension treatment pediatricians use AgE-inhibitors, diuretics and beta blockers.Key words: rifagd, arterial hypertension, pharmacoepidemiology, questioning of pediatricians, ace inhibitors, diuretics, beta blockers.Проведено многоцентровое фармакоэпидемиологическое исследование РИФАГД в 13 городах России с целью изучения подходов врачей педиатров к терапии артериальной гипертензии в детском возрасте, в том числе выбору лекарственных средств, что позволило оценить их опыт, знания, а также наметить пути улучшения качества помощи пациентам с артериальной гипертензией. Большинство педиатров (83,1%) испытывают трудности при лечении артериальной гипертензии в связи с отсутствием методических рекомендаций (37,3%), практики лечения (30,4%) и показаний для применения антигипертензивных препаратов в педиатрии (31,9%). Для лечения артериальной гипертензии педиатры применяют ингибиторы ангиотензин-превращающего фермента, диуретики и β-адреноблокаторы. Ключевые слова: РИФАГД, артериальная гипертензия, фармакоэпидемиология, анкетирование врачей педиатров, ингибиторы ангиотензин-превращающего фермента, диуретики, β-адреноблокаторы.(Педиатрическая фармакология. – 2006; 3(3): 10-15