[Analysis of current diagnostic and treatment approaches for acute rhinosinusitis according polyclinics data of the outpatient service of Administrative Directorate of the President of the Russian Federation].

Autor:	Savlevich EL; Central State Medical Academy of Administrative Directorate of the President of the Russian Federation, Moscow, Russia., Kozlov VS; Central State Medical Academy of Administrative Directorate of the President of the Russian Federation, Moscow, Russia., Farikov SE; Central State Medical Academy of Administrative Directorate of the President of the Russian Federation, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Vestnik otorinolaringologii [Vestn Otorinolaringol] 2020; Vol. 85 (4), pp. 51-57.
DOI:	10.17116/otorino20208504151
Abstrakt:	Acute rhinosinusitis is one of the most common outpatient diseases. The duration of antibiotic therapy in practice can be a cause of disagreement. The latest European guideline for rhinosinusitis EPOS 2020 does not specify clear terms for antibacterial therapy for acute bacterial rhinosinusitis, which suggests that they are determined by the attending physician based on the rate of regression of clinical manifestations in each specific clinical case. Objective: To analyze the treatment regimens of adult patients with acute rhinosinusitis in the system of the outpatient service of Administrative Directorate of the President of the Russian Federation in Moscow and compare these schemes with guidelines. Material and Methods: A retrospective analysis of 2267 outpatient disease histories of patients who were on outpatient treatment with a diagnosis of acute rhinosinusitis treated by otorhinolaryngologists from 7 ambulance clinics for the period from January 2016 to May 2018 was performed. Diagnostic methods and treatment regimens of these patients were evaluated. Results: At the diagnostic stage, X-ray methods were recommended in 87% of cases, and ultrasound examination of the paranasal sinuses was performed in 4% of cases. Elimination and irrigation therapy was prescribed in 88.05% of cases (1996 people), maxillary sinus punctures were performed in 9.82% of cases, the average number of procedures was 2±1.3, treatment by displacement was performed in 31.8% of patients, the average number of procedures was 3±1.2. Antibiotic therapy was recommended in 77.4% of cases (1755 people), penicillin group drugs were prescribed in 41.5% of cases, macrolides in 30.5% of cases, cephalosporins in 20.7% of cases, and fluoroquinolones in 7.3% of cases. Intranasal glucocorticosteroids were submitted by 67.7% of patients (1535 people), mucolytics and mucoregulatory drugs - 41% of patients, decongestants for acute rhinosinusitis were recommended in 60.9% of cases, antihistamines - in 36.8% of cases. An average course of antibacterial therapy was 5.9±1.34 days, the recovery of the patients was observed on the background of complex treatment. Conclusions: In general, in the system of the outpatient service of Administrative Directorate of the President of the Russian Federation, diagnostic and therapeutic measures are carried out in accordance with current clinical recommendations. There is a fairly high percentage of prescribing macrolides (30.5%) and fluoroquinolones (7.3%) in starting therapy, which is a violation of the principles of starting antibacterial therapy.
Databáze:	MEDLINE
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