医生对呼吸道感染孕妇药物治疗的了解和偏好:PIKAP 研究

R. A. Bontsevich, A. A. Ryabchikova, T. I. Balamutova, O. Tsygankova, O. Kompaniets, G. Ketova, V. O. Bogdanova, G. A. Batisheva, V. A. Nevzorova, I. Martynenko, N. Chukhareva, S. P. Pakhomov, M. L. Maximov
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摘要

导言。妊娠期最常见的生殖器外病变包括上呼吸道感染和下呼吸道感染(URTI 和 LRTI),如果不及时治疗,会导致产科和围产期病变。开展药物流行病学研究,评估专家对孕妇治疗的偏好以及在实际临床实践中对疫苗接种的态度,具有重要意义。分析孕妇 URTI 和 LRTI 的药物治疗方法,评估处方药物与当前临床建议和治疗标准的符合性。研究于 2018 年至 2022 年在俄罗斯七个地区采用匿名问卷调查法进行。共有来自俄罗斯7个地区的227名医生接受了调查,其中66.8%为内科医生,33.2%为妇产科医生。这项研究表明,医生对孕妇合理使用抗菌药物(AMD)的认识不足。受访者在使用抗菌药物治疗肺炎方面取得了较好的结果,78.7%的受访者表示策略正确。在回答 "AMD 用于治疗尿路感染、气管炎和支气管炎是否合适 "的问题时,结果最差(40.3% 至 67.7% 的受访者选择错误)。总体而言,57.7%的受访者了解孕妇接种疫苗的重要性。研究结果表明,在某些情况下,孕妇门诊治疗 URTI 和 LRTI(尤其是 AMD)的药物选择并不完全符合我国目前的临床建议。此外,尤其令人担忧的是,一些医生开出的药物对孕妇不安全,或缺乏必要的证据基础或使用指征。
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Physicians’ knowledge and preferences regarding pharmacotherapy of pregnant women with respiratory tract infections: research PIKAP
Introduction. The most common extragenital pathology during pregnancy includes upper and lower respiratory tract infections (URTI and LRTI), which, if left untreated, leading to obstetric and perinatal pathology. It is relevant to conduct pharmacoepidemiological studies assessing the preferences of specialists regarding the treatment of pregnant women and attitudes towards vaccination in real clinical practice.Aim. To analyze approaches to pharmacotherapy of URTI and LRTI in pregnant women, evaluate the compliance of prescribed drugs with current clinical recommendations and treatment standards.Materials and methods. The study was conducted from 2018 to 2022 using an anonymous questionnaire method in seven regions of Russia.Results and discussion. A total of 227 physicians from seven regions of Russia were surveyed, with 66.8% being internal medicine doctors and 33.2% obstetrician-gynecologists. This study revealed that physicians’ knowledge regarding the rational use of antimicrobial drugs (AMD) in pregnant women is insufficient. Respondents showed better results in the use of AMD in the treatment of pneumonia, with 78.7% of surveys indicating correct tactics. The worst results were observed in answering the question about the appropriateness of prescribing AMD for URTI, tracheitis, and bronchitis (40.3% to 67.7% of respondents made incorrect choices). Overall, 57.7% of respondents understand the importance of vaccination among pregnant women.Conclusion. The results of the conducted study indicate that the choice of drugs for the therapy of URTI and LRTI, especially AMD, for outpatient treatment of pregnant women in some situations does not fully correspond to the current clinical recommendations in our country. Moreover, it is particularly concerning that some physicians prescribe drugs that are unsafe for pregnant women or lack the necessary evidence base or indications for use.
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