Currently, much attention is paid to pathogenetic methods of treatment of community-acquired pneumonia. As a rule, pneumonia is accompanied by a violation of the balance of formation and discharge of bronchial secretions. In order to normalize the drainage function of the bronchi, both pharmacological and mechanical methods of influencing the muciliary clearance are successfully used. The comprehensive use of the entire arsenal of therapeutic capabilities allows you to minimize the duration of the patient's stay in a hospital bed, as well as speed up the process of restoring impaired lung functions after pneumonia. The study was conducted in the pulmonology Department of the district hospital of the Eastern military district. The effectiveness of using the device of vibroacoustic influence on the chest using the BARK VibroLUNG device in the treatment of community-acquired pneumonia was studied. In addition to the traditional therapy regimens, 5 to 7 sessions of hardware vibration massage were performed. In patients who received a course of vibroacoustic massage, there was a decrease in the duration of General intoxication, productive cough, and physical signs of lung tissue consolidation. Regression of the main clinical manifestations of pneumonia was accompanied by an increase in sputum discharge, simultaneously with a decrease in the time of its production. The main group of patients was characterized by the best time for normalization of acute-phase indicators, restoration of lung ventilation function, and resolution of pneumonic infiltration according to X-ray data. The use of a course of vibration exposure to the chest allowed to reduce the duration of stationary treatment by an average of 3 days.

The lack of effective etiotropic methods of treatment and prevention of the new coronavirus infection (COVID-19), which caused the pandemic in 2020, determines the relevance of the review of researches of medicines for etiotropic and pathogenetic therapy. Most patients are diagnosed with pneumonia, the disease is especially difficult in people with concomitant chronic diseases, since COVID-19 leads to their decompensation, which can lead to death. To assess risk factors for mortality, scientists are developing programs to transfer the patient to appropriate treatment in a timely manner. This article analyzes the clinical efficacy of various agents for etiotropic and pathogenetic treatment of a new coronavirus infection based on data from international researches. Etiotropic medicines used at the beginning of the pandemic did not show their effectiveness in reducing the duration of treatment, the development of death, and preventing the transition to the use of mechanical ventilation. There are described researches of vaccines against a new coronavirus infection, developed in the Russian Federation, the USA, Germany and the UK, which showed the greatest efficiency (more than 90%) in preventing COVID-19. The World Health Organization initiated the international clinical research SOLIDARITY, according to which all medicines participating in the trials have little or no effect on overall mortality, the onset of ventilation requirements and the length of hospital stay in hospitalized patients. Now, only systemic glucocorticosteroids have proven effective against severe and critical forms of COVID-19. Thus, effective etiotropic drugs for the treatment of COVID-19 have not been developing, however, an active search for these funds and the development of vaccines to prevent the incidence of coronavirus infection are underway.

The relevance of pneumonia remains at the forefront and has recently attracted the attention of not only the entire medical community, but also all political and economic institutions of most countries of the planet. This nosology continues to be in the center of attention, identifying one of the key causes in the frequency of mortality of the population. The presented article accumulates the most up-to-date theses regarding viral pneumonia on the basis of a review of a large number of scientific literature, domestic and foreign studies. Although the term “viral pneumonia” has been used in medical practice for more than a century, nevertheless, there is no final diagnostic algorithm and an established final concept. The article reflects special historical medical and philosophical aspects in the study of pneumonia from the time of Hippocrates to the present. The epidemiological features, etiology, and also the terminological base of viral pneumonia are updated, thereby the concept of viral pneumonia in medical categories is fixed. A promising classification of viral pneumonia according to ICD-XI is presented. Attention is drawn to the autopsy morphological characteristics of the bronchopulmonary organ complex in viral pneumonia, post-mortem descriptions are given with links to authoritative research sources. The main modern diagnostic capabilities of the scientific medical community in the detection of pneumonia are described, the issues of the formation of new diagnostic algorithms are reflected. The clinical picture of viral pneumonia is described in detail, the clinical concept of the phase course of the disease based on pathomorphological data is presented for the first time. The main modern groups of drugs for etiotropic and pathogenetic treatment of the disease are considered. The conclusion reflects the main problematic postulates and prospects for further study of the disease.

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The problem of community-acquired pneumonia is one of the most relevant for military medicine. The relevance of community-acquired pneumonia is determined by the high incidence of conscription by military personnel, the severity of the clinical course, the presence of severe complications, the duration of labor losses, the tendency to epidemic spread, and the risk of deaths. It is necessary to improve laboratory research methods with the introduction of express methods for verifying bacterial and viral agents, determining the clinical features of the viral-bacterial pneumonia, and justifying the inclusion of antiviral agents in the etiotropic treatment regimen. An expanded complex of microbiological diagnosis of pneumonia has been developed, combining classical bacteriological methods with express methods (polymerase chain reaction, enzyme- linked immunosorbent assay, immunochromatography), which made it possible to determine atypical pathogens and viruses in addition to agents of a bacterial nature. Using these techniques, the modern etiological structure of community-acquired pneumonia in the military has been established, the prevalence of viral-bacterial pneumonia has been revealed. Among viruses, the leadership of adenovirus infection has been established, clinical and laboratory features of the disease are shown depending on the pathogens identified, the feasibility of additional prescribing of antiviral agents in addition to antibiotics in the treatment of viral-bacterial pneumonia is justified.