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[Rational use of antibiotics--basis for prevention of their side effects]
Abstract:
Three hundred and sixty eight case histories of pulmonological patients and 127 case histories of other patients were examined retrospectively. Morphohistochemical investigation of the internal ear structure was performed on rabbits treated with different aminoglycoside antibiotics in various doses. Within 15 years (from 1978 to 1992) the incidence of adverse reactions to the antibiotic therapy in the pulmonological patients decreased from 33 to 5 per cent as a result first of all of the observation of the principles of antibiotic therapy by the physicians. Within 1992-1994 there were recorded no classical complications of the antibiotic therapy in the pulmonological patients. The only adverse reaction was the body temperature elevation. In 1994 there was stated the drug fever in 37 patients, 35 of them being treated without observation of the principles of rational antibiotic therapy. The aminoglycosides were used for the treatment of the main and concomitant diseases in 51 and 22 per cent of the patients respectively. Prophylactically the aminoglycosides were used in 12 per cent of the patients. In 15 per cent of the cases the use of the antibiotics was not indicated. The application of the routine methods for the control of the safe use of the aminoglycosides was stated to be unsatisfactory which made it impossible to detect nephrological complications. Nevertheless, changes for the worse were recorded twice as often as those for the better. The development of iatrogenic neuritis of the acoustic nerve to some extent associated with the incorrect regimens of the aminoglycoside therapy was stated in 3.9 per cent of the patients.
Insights
Adherence to rational antibiotic therapy significantly reduced adverse drug reactions in pulmonology patients. However, inadequate monitoring of aminoglycoside use still led to complications like drug fever and acoustic nerve neuritis.
Area of Science:
- Pharmacology
- Ototoxicology
- Clinical Medicine
Context:
- Retrospective analysis of 368 pulmonology patients and 127 other cases.
- Morphohistochemical study of internal ear structures in rabbits treated with aminoglycosides.
- Examined antibiotic therapy practices from 1978 to 1994.
Purpose:
- To evaluate the incidence and causes of adverse reactions to antibiotic therapy, particularly aminoglycosides.
- To assess the effectiveness of adhering to rational antibiotic therapy principles.
- To investigate the safety and monitoring of aminoglycoside use in clinical practice.
Summary:
- Adverse reaction incidence in pulmonology patients decreased from 33% to 5% due to improved adherence to antibiotic therapy principles.
- Drug fever occurred in 37 patients, primarily those treated without rational therapy principles.
- Aminoglycosides were inappropriately used in 15% of cases, and monitoring for nephrological complications was unsatisfactory.
- Iatrogenic acoustic nerve neuritis was observed in 3.9% of patients, linked to incorrect aminoglycoside therapy regimens.
Impact:
- Highlights the critical importance of rational antibiotic prescribing for patient safety.
- Underscores the need for improved monitoring systems to detect and prevent aminoglycoside-induced complications.
- Provides evidence for refining antibiotic stewardship programs to minimize iatrogenic harm.