Topical issues on the diagnosis of resistance of microorganisms to antibiotics and other drugs and the development of treatment regimens in patients with antimicrobial resistance were discussed by participants of the joint seminar of the Bacteriological Laboratory and the School of a Young Clinician, which was held at the S.P. Botkin Clinical Infectious Diseases Hospital in St. Petersburg.
Tatyana Sergeeva, Head of the Department of Clinical Pharmacology at St. Petersburg State Medical Institution Botkin Hospital, and Olga Ruina, clinical pharmacologist at GAU NO NIIKO, paid special attention to medical errors in prescribing antibacterial drugs as one of the main risk factors for the development of resistance. Especially often, uncontrolled administration of antibacterial drugs is observed in the outpatient field, where the doctor often decides on the prescription of drugs based only on the clinical picture, without prescribing laboratory tests.
The most accurate selection of the drug is possible only based on the results of studies conducted by specialized laboratories. The Centralized Bacteriological Laboratory of the S.P. Botkin Clinical Infectious Diseases Hospital conducts such studies for 70 medical organizations in St. Petersburg. The main task is to determine the sensitivity of microorganisms to a particular antibiotic as early as possible in order to minimize the time of use of broad–spectrum drugs. Svetlana Gordeeva, head of the Centralized Bacteriological Laboratory of the S.P. Botkin Clinical Infectious Diseases Hospital, said that resistance is usually characteristic of microorganisms in the intensive care unit, the highest level is characteristic of pneumonia, including pan-resistance (resistance to all drugs).
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Experts have high hopes for the changes that will take place on January 1, 2025, when clinical recommendations will become mandatory. "Following adequate recommendations on the use of antibiotics, refusing to prescribe antimicrobial drugs (AMP) for any acute respiratory disease caused by viruses, but not bacteria, will undoubtedly be a positive factor in the fight against AMP resistance," said the interlocutor of the MEDIA TALK, Deputy Chief Physician of the S.P. Botkin Clinical Infectious Diseases Hospital for Medical Vladimir Musatov
also added that the prevention of the formation of antimicrobial resistance is a complex task. And here, an important component of the program is the training of doctors, nurses, pharmacists and pharmacists, as well as citizens, in an adequate and correct attitude to the use of antibiotics. Neither doctors nor we can influence the use of antibiotics in agriculture and animal husbandry in any way (just as we cannot control this when buying products), but it is quite possible to observe discipline when using drugs strictly according to their intended purpose. By the way, the fact that it is now impossible to purchase such drugs without a prescription is supported by every single representative of the medical community.
You should not count on the appearance of a new generation of drugs that will be more effective. The invention of antimicrobial drugs is a long and laborious process. According to Sergey Sidorenko, Professor of the Department of Medical Microbiology at the I.I. Mechnikov Northwestern Medical University, the economic factor also plays a role: it is not profitable for the pharmaceutical business. The specialist also noted that Russia is not a leader in this work, and named only one new drug in recent years - the superantibiotic Fluorothiazinone, registered this spring by the Gamalei Center.
The problem of resistance is a challenge for doctors. And there is reason for optimism here. At the profile seminar, one of the reports described a clinical case of pneumonia caused by an antibiotic-resistant strain in a patient who was being treated at the S.P. Botkin Clinical Infectious Diseases Hospital. Timely laboratory studies of the pathogen that caused the disease and the selection of an adequate treatment regimen with the revealed resistance of the microorganism to most antibiotics led to the patient's recovery. Such cases show that even extremely severe forms of diseases in the presence of resistance of the microorganism to drugs can be successfully treated.
Sometimes performing real miracles, doctors always rely on the consciousness of patients. And the easiest way to self–prevent resistance is not to use antibiotics without a doctor's prescription and not to self-medicate. Only by reducing consumption can the "life span" of the drug be extended so that in a critical situation it still works.
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