Actual therapeutic practice for sexually-transmitted bacterial diseases in Russia: the results of a multicenter pharmacoepidemiological trial

Abstract

To investigate the actual practice of antibacterial therapy of sexually-transmitted bacterial diseases (STD) in adult patients at the various regions of the Russian Federation as well as to evaluate the concordance of the antibacterial therapy with national standards, a multicenter retrospective analytical trial was carried out. Investigational data of 1250 subjects (61% males, 39% females, the mean age of 28.8 ± 9.2) with early types of Lues (n = 341), uncomplicated urogenital gonococcal infection (n = 309), candidiasis (n = 310), mycoplasmosis (n = 137) and ureaplasma infection (n = 153), being treated at prevention and treatment facilities of 10 cities of Russia from January to December 2007 were analysed.
1567 prescriptions for the treatment of the underlying disease were registered, among which 1352 (86.2%) prescriptions regarded antibacterial agents. The therapy of early forms of Lues most frequently included benzathine benzylpenicillin (38.4%), procaine penicillin (28.3%), ceftriaxone (26.9%), and benzylpenicillin (5.5%); therapy of uncomplicated urogenital gonococcal infection included: ceftriaxone (57.5%), spectinomycin (9.3%), doxycycline (7.2%), and azithromycin (5.1%); urogenital chlamydial infections: azithromycin (28.2%), doxycycline (22.2%), clarithromycin (14.9%), josamycin (11.1%), and ofloxacin (7.9%); urogenital mycoplasmal and ureaplasmal infections: doxycycline (32.4 and 31.3%), josamycin (21.4 and 21.3%), azithromycin (15.2 and 11.3%), clarithromycin (14.5 and 11.3%), levofloxacin (4.1 and 6.9%). Frequency of administration of ther drugs was less then 5% for each one.
The study has demonstrated a high variability of choice of antibacterial agents by physicians along with an evident tendency to exceeding the total doses during the course therapy. The prescribed therapy was conforming with national recommendations in 71.8% of the subjects, while the total treatment doses were consistent with recommended doses in 24% of patients only, that indicates a necessity to change the established practice of bacterial STD therapy in Russia.

References

  1. Глобальная стратегия профилактики инфекций, передаваемых половым путем, и борьбы с ними. 2006-2015 гг. ВОЗ; 2007.
  2. Федеральное государственное учреждение здравоохранения «Федеральный центр гигиены и эпидемиологии Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека». URL: http://www.fcgsen.ru/D0C/270110/ infdec09..xls
  3. Simms I., Stephenson J. M. Pelvic inflammatory disease epidemiology: what do we know and what do we need to know? Sexually Transmitted Infections 2000; 76: 80-7.
  4. Laga M., Meheus A., Piot P. Epidemiology and control of gonococcal ophthalmia neonatorum. Bulletin of the World Health Organization 1989; 67: 471-8.
  5. Whitcher J. P., Srinivasan M., Upadhyay M. P. Corneal blindness: a global perspective. Bulletin of the World Health Organization 2001; 79: 214-21.
  6. Приказ Минздравсоцразвития РФ № 43 от 17.01.2007 «Об утверждении стандарта медицинской помощи больным с ранним сифилисом при оказании специализированной помощи».
  7. Приказ Минздравсоцразвития РФ № 176 от 25.02.2005 «Об утверждении стандарта медицинской помощи больным гонококковой инфекцией».
  8. Кубанова А. А. (ред.) Методические материалы по диагностике и лечению наиболее распространенных инфекций, передаваемых половым путем (ИППП), и заболеваний кожи. Протоколы ведения больных, лекарственные средства. М.: ГЭОТАР-Медиа 2003.
  9. Кубанова А. А. (ред.) Дерматовенерология. Клинические рекомендации РОДВ. М.: ГЭОТАР-Медиа 2006.
  10. Кулаков В. И., Прилепская В. Е., Радзинский В. Е. (ред.) Руководство по амбулаторно-поликлинической помощи в акушерстве и гинекологии. М.: ГЭОТАР-Медиа 2007.
  11. Shann S., Wilson J. Treatment of neurosyphilis with ceftriaxone. Sexually Transmitted Infections 2003; 79: 415-6.
  12. Smith N. H., Musher D. M., Huang D. B., et al. Response of HIV-infected patients with asymptomatic syphilis to intensive intramuscular therapy with ceftriaxone or procaine penicillin. International Journal of STD & AIDS 2004; 15: 328-32.
  13. Резистентность возбудителей ИППП к антибактериальным препаратам. Информационный бюллетень. 2008 г. М.: ООО «ДЭКС-ПРЕСС»; 2008.
  14. C. Sexually transmitted diseases treatment guidelines, 2006. Morbidity and Mortality Weekly Report 2006; 55(No. RR-11).
  15. Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) Steering Group. GRASP year 2005 report. London, England: Health Protection Agency; 2006.
  16. Ross J. D., Jensen J. S. Mycoplasma genitalium as a sexually transmitted infection: implications for screening, testing, and treatment. Sexually Transmitted Infections 2006; 82(4): 269-71.
  17. Yokoi S., Maeda S., Kubota Y., et al. The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis. Clinical Infectious Diseases 2007; 45(7): 866-71.
  18. Кубанова А. А., Рахматулина М. Р. Урогенитальные инфекционные заболевания, вызванные генитальными микоплазмами. Клинические рекомендации. Consilium Medicum 2009; 6: 32-6.

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