The problem of rational antibiotic therapy of pneumonia is one of the most relevant in modern medicine. So far, a large number of the factors have been identified that determine the optimal quality of antimicrobial therapy: the maximum effectiveness with the lowest toxicity of drugs should be combined with their proper cost. In order to study the clinical efficacy and therapeutic tolerability of the drug class of macrolides, clarithromycin for parenteral use in the treatment of patients with community−acquired pneumonia, 20 patients were examined. All the patients had clinical symptoms of severe infectious lesions of the lower respiratory tract. The complex therapy (detoxification, mucolytic drugs, multivitamins, metabolites) included "Clarithromycin−MB", which was administered intravenously for 60 minutes at a dose of 500 mg 2 times a day for 7−10 days. The clinical effectiveness of antibacterial therapy was assessed by the dynamics of the activity of the inflammatory process in the lungs. For this purpose, the following clinical and laboratory parameters characterizing the activity of the inflammatory process (temperature response, tachycardia, respiratory rate, leukocytosis, number of immature granulocytes, change in erythrocyte sedimentation rate), severity of pain, radiological changes in the lungs were determined. Macrolide "Clarithromycin−MB" in a parenteral form is a highly effective antibacterial drug for the treatment of community−acquired pneumonia with severe course. Positive dynamics of clinical manifestations of the disease was observed on the third day from the beginning of therapy. "Clarithromycin−MB" has good therapeutic tolerability, the dosage regimen allows to maintain the required concentration in the site of inflammation, which affects the clinical and bacteriological efficacy of treatment of the patients with community−acquired pneumonia. Key words: community−acquired pneumonia, macrolides, "Clarithromycin−MB".
Study of the role of lipid peroxidation and antioxidant system in patients with infectious diseases is of great interest to researchers. Numerous studies have led to a common understanding of their contribution to the pathogenesis of infectious diseases, as well as to the complications development. However, the state of lipid peroxidation and antioxidant protection in patients with chickenpox (varicella) has not been sufficiently studied which is important for the development of new targeted treatments. The aim of the research - to assess the state of lipid peroxidation (LPO) and the antioxidant system (AOS) in the dynamics in patients with chickenpox, depending on the severity of the disease. Materials and methods. We selected for participating in the study 240 chickenpox patients (142 women and 98 men) aged 18-40 years. Chickenpox was diagnosed using clinical, serological, and molecular genetic methods. The state assessment of LPO in chickenpox patients was based on the determination of serum diene conjugates (DC), malondialdehyde (MDA) levels and the total oxidative activity (TOA) of blood plasma. Results. Study showed that the process of lipid peroxidation increases and the activity of the antioxidant system decreases in patients with chickenpox during the acute period of the disease. The extent of these processes becomes greater as the severity of chickenpox increases. A decrease in the activity of antioxidant enzymes and a disruption in the functioning of the glutathione system in patients with moderate to severe hypertension leads to disruption of protective mechanisms and, as a result, to an increase in the free radical chain reactions, the uncontrolled growth of which causes irreversible damage to the membranes of various cells, which underlies visceropathy in chickenpox patients. Conclusions. Antioxidant system is activated in the acute period in patients with mild chickenpox. It is evidenced by an increase in the overall antioxidant activity of blood plasma (p=0.045) and red blood cells (p=0.00087), in the activity of catalase (p=0.001), superoxide dismutase (p=0.0093), glutathione peroxidase (p=0.036), glutathione reductase of plasma and red blood cells, and an increase in the concentration of oxidized and reduced glutathione in blood. Lipid peroxidation is hyperactivated in the acute period in patients with a moderate and severe course of the disease and an excess amount of primary and secondary hydroperoxides of fatty acids accumulates in the blood. This is accompanied by indicates a developing imbalance between the oxidative and antioxidant systems in group of patients with moderate and severe chickenpox. Our findings confirm the usefulness of antioxidants in the treatment of chickenpox.
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