War and Peace: the difficult treatment of urinary tract infections and fosfomycin trometamol

The title of this review “War and peace” is not accidental and the analogies with a well-known literary masterpiece have absolutely justified ground. As in the case of Lev Tolstoy’s novel this title has a profound philosophical meaning, although at first glance it may seem quite obvious. The word «war» may well correspond to those hostile changes of microorganisms leading to the current problem of antimicrobial resistance recognized worldwide. This is the “war” we have to wage against the antibiotic-resistant bacteria today. And the «peace» in this context is considered as the world, the entire universe, all people, the whole society and its reaction to what is happening. On the other hand, the word «peace» means something opposite in meaning to the word «war». Thus, the essence of the title bears a sharp contrast between military actions and peacetime, between something that carries a threat to life and peace, or illness and recovery. Preserving original novel’s structure the authors of this review consistently consider justification of fosfomycin trometamol as a first-line drug in the treatment of acute uncomplicated cystitis in women taking into account the latest research, publications and global trends

EFFECTIVENESS AND SAFETY OF FAVIPIRAVIR INFUSION IN PATIENTS HOSPITALIZED WITH COVID-19 [ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ ИНФУЗИОННОГО ВВЕДЕНИЯ ФАВИПИРАВИРА У ПАЦИЕНТОВ, ГОСПИТАЛИЗИРОВАННЫХ С COVID-19]

Research in the development of new therapeutic agents with a wide spectrum of the antiviral activity and a low ability to develop resistance remains the main dimension in combating the global threat to public health. The need for a parenteral form of favipiravir was dictated by the necessity to increase the efficacy of therapy in COVID-19 inpatients. This dosage form has expanded the possibilities of drug therapy in the inpatients, for whom a therapeutic effect acceleration and a high safety profile of the drugs used are especially important. The aim of the article is the evaluation of the efficacy and safety of a medicinal product containing favipiravir for the parenteral administration against the background of pathogenetic and symptomatic therapy, in comparison with standard therapy in hospitalized COVID-19 patients. Materials and methods. An open, randomized, multicenter comparative study was conducted in 6 research centers in the Russian Federation to evaluate the efficacy and safety of favipiravir, a lyophilisate for the preparation of a concentrate for the infusion solution administrated to the patients hospitalized with COVID-19. Screening procedures and randomization were completed in 217 patients, 209 of which had completed the study in accordance with the protocol. Results. Between the study groups, statistically significant differences have been found out, making it possible to consider the hypothesis of the drug Areplivir (favipiravir) superiority for the parenteral administration over the standard therapy, which included favipiravir (p. o.) and remdesivir. A comparative analysis has shown that a course of therapy with the parenteral favipiravir drug leads to a significant improvement in the condition of patients with COVID-19, significant benefits in terms of the speed and frequency of improvement in the clinical status of patients, as well as a reduction in the hospital stay length. It has been proven that therapy with a drug containing favipiravir for the parenteral administration does not adversely affect the parameters of clinical and biochemical blood tests, urinalysis, coagulograms, vital signs and ECG, which indicates the therapy safety. The study drug is characterized by a high safety profile and tolerability. Conclusion. The versatility and resistance to mutations of RNA-dependent RNA polymerase make it possible to consider it as the main target for combating the most common RNA viruses that cause ARVI, that determines the need further studies of favipiravir to expand the range of its indications. © 2022 Volgograd State Medical University, Pyatigorsk Medical and Pharmaceutical Institute. All rights reserved