The purpose of this review was to conduct a comparative assessment of the concepts of therapy for pediatric patients with COVID-19 in the framework of global clinical practice. A structural analysis of the range of drugs and treatment strategies in the context of etiotropic, pathogenetic, and symptomatic therapy has shown that in the global context and in real clinical practice, the etiotropic-pathogenetic approach based on information about the effectiveness of individual medical technologies prevails today. It has been established that eight international nonproprietary/grouping names are present in international practice as means of etiotropic therapy for pediatric patients with COVID-19, and 18 positions are used for pathogenetic therapy. In terms of frequency of occurrence, the leading positions are occupied by remdesivir and the combination of nirmatrelvir with ritonavir, as well as dexamethasone and tocilizumab. The paper emphasizes the relevance of research in the field of evaluating the effectiveness of individual treatment regimens as well as the analysis of the delayed consequences of pathology suffered in childhood under the conditions of using various approaches to pharmacotherapy.
The article presents a study on the structural assessment of the range of drugs for the treatment of hepatitis C. Methods of content analysis, data aggregation, grouping, comparative and marketing analysis have been used. The information base of the study was the State Register of Medicines and National Register of Medicines of April 24, 2020, as well as instructions for the medical use of drugs. It was revealed that 52 trade names of medicinal products (23 INN) and 17 substances had been registered in the Russian Federation. The analysis carried out by pharmaceutical producing countries has shown that the leading positions in the supply structure are occupied by Russian manufacturers (73.08%). Structuring by dosage forms enables to isolate tablets, covering 32.69%, as well as solutions and capsules, which are 23.08%, respectively. The largest share in the structure of the assortment of substances is occupied by interferon alpha-2b (20.93%). The results of the analysis has shown that the manufacturer carries out all stages of production for the majority of drugs. The index of renewal of the researched drug market over the past 5 years is 16.27%.
The aim of the study is to determine the limits of using the mathematical-statistical analysis for the evaluation of pharmacotherapy costs in pediatric inpatients diagnosed with community-acquired pneumonia. Materials and methods. The report is based on the assessment of 547 medical records of patients with community-acquired pneumonia, who underwent the treatment in four pediatric hospitals in St. Petersburg. The data array was created from a number of factors that characterize the patients’ profile (gender, duration of hospital stay, cost of therapy, number of prescribed drugs, number of affected lung segments, pathogen location, leukocyte count, and eSR). Results. Correlation analysis allowed us to identify factors contributing to the cost of pharmacotherapy (at a significance of p=0.05); those were: the duration of hospital stay (r=0.34), the number of prescribed drugs (r=0.26), and the number of affected lung segments (r=0.21). Dispersion analysis of qualitative factors (gender, location of pneumonic infiltrate) showed no significant impact of these factors on the costs or the number of prescribed drugs in the total data set. From the regression analysis, we obtained formulas for the dependence of the resulting parameters (cost of pharmacotherapy, number of prescribed drugs) on a set of independent variables. Conclusion. The treatment cost optimization in pediatric patients with community-acquired pneumonia should include the use of antibacterial drugs with proven efficacy and safety, as well as a reduction in non-necessary supporting therapy, e.g., medications aimed to correct morphological and functional changes in the respiratory system.
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