Rachina Svetlana, Belkova Yuliya, Kozlov Roman, Kurkova Anastasia, Boven Annelies, Versporten Ann, Pauwels Ines, Vlieghe Erika, Stafeev Aleksandr, Zyryanov Sergey, Kukava Veriko, Bochanova Elena, Eliseeva Ekaterina, Ketova Galina, Luchsheva Elena, Palyutin Shamil, Panshina Irina, Portnyagina Ulyana, Reshetko Olga, Shegimova Vera, Shutov Mikhail, Titova Natalya, Yakushin Sergey
Department of Hospital Therapy #2, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Department of Clinical Pharmacology, Smolensk State Medical University, Smolensk, Russian Federation.
Infect Chemother. 2025 Jun;57(2):261-273. doi: 10.3947/ic.2024.0144. Epub 2025 Apr 29.
Detailed surveillance of antimicrobials' use in the community is an essential strategy to control their overuse and misuse. This study aimed to evaluate prescribing patterns of antimicrobials in Russian outpatients in 2024 and quantify the prescribing in relation to quality indicators.
A point prevalence study was conducted during January-April 2024 in 14 healthcare facilities in 11 Russian cities (Chelyabinsk, Ekaterinburg, Krasnoyarsk, Moscow, Novokuznetsk, Saratov, Smolensk, Ulan-Ude, Vladivostok, Yakutsk, and Yaroslavl) in accordance with the outpatient protocol of Global-PPS project. Detailed data on antimicrobials, age, gender, and drug indications were collected for each outpatient receiving at least one agent for prophylaxis or treatment.
A total of 5,084 outpatients from 149 units were surveyed, of which 487 (9.6%) received at least one antimicrobial agent. The highest rates of antimicrobial prescribing were observed at upper respiratory tract (33.2%), gastroenterology (22.6%), hematology (13.6%), ear nose and throat (13.5%), and gynecology units (11.6%). Antibacterials accounted for 63.4% of antimicrobials on average, followed by antivirals (35.4%). Penicillins (41.4%), for the most part penicillin/beta-lactamase inhibitor combinations (30.1%), cephalosporins (18.3%), including third generation (17.7%), fluoroquinolones (16.1%), and macrolides (11.5%) were the top classes of antibiotics prescribed. Umifenovir (23.8%) and amoxicillin/clavulanic acid (19.0%) were the top antimicrobials prescribed. The administered antibacterials were almost equally distributed between "access" (46.5%) and "watch" (53.5%) AWaRe groups. On average, choice of antimicrobials followed the national guidelines issued by the Ministry of Health in 73.2% of cases.
The pooled rates of antimicrobial prescribing in outpatient settings was 9.6% with the substantial differences in patterns of consumption overall and among the units of different types. Broad-spectrum antibacterials such as penicillin/beta-lactamase inhibitor combinations, III-IV generation cephalosporins, fluoroquinolones, and macrolides together amounted to 48% of prescriptions. Common concerns in antimicrobial drug usage included low guidelines compliance and low rate of "access" group antibacterials.
详细监测社区抗菌药物的使用情况是控制其过度使用和滥用的一项重要策略。本研究旨在评估2024年俄罗斯门诊患者抗菌药物的处方模式，并根据质量指标对处方进行量化。
2024年1月至4月期间，按照全球PPS项目的门诊方案，在俄罗斯11个城市（车里雅宾斯克、叶卡捷琳堡、克拉斯诺亚尔斯克、莫斯科、新库兹涅茨克、萨拉托夫、斯摩棱斯克、乌兰乌德、符拉迪沃斯托克、雅库茨克和 Yaroslavl）的14家医疗机构开展了一项现况调查研究。收集了每位接受至少一种预防或治疗药物的门诊患者的抗菌药物、年龄、性别和药物适应症的详细数据。
共对来自149个科室的5084名门诊患者进行了调查，其中487名（9.6%）接受了至少一种抗菌药物。抗菌药物处方率最高的科室为上呼吸道科（33.2%）、胃肠病科（22.6%）、血液科（13.6%）、耳鼻喉科（13.5%）和妇科（11.6%）。抗菌药物中平均63.4%为抗菌药，其次是抗病毒药（35.4%）。青霉素类（41.4%），大部分为青霉素/β-内酰胺酶抑制剂组合（30.1%）、头孢菌素类（18.3%），包括第三代（17.7%）、氟喹诺酮类（16.1%）和大环内酯类（11.5%）是处方量最多的抗生素类别。乌米芬诺韦（23.8%）和阿莫西林/克拉维酸（19.0%）是处方量最多的抗菌药物。所使用的抗菌药在“可及”（46.5%）和“观察”（53.5%）AWaRe组之间分布几乎相等。平均而言，73.2%的病例中抗菌药物的选择遵循了卫生部发布的国家指南。
门诊环境中抗菌药物的总体处方率为9.6%，总体消费模式以及不同类型科室之间存在显著差异。青霉素/β-内酰胺酶抑制剂组合、Ⅲ-Ⅳ代头孢菌素、氟喹诺酮类和大环内酯类等广谱抗菌药合计占处方量的48%。抗菌药物使用中常见的问题包括指南依从性低和“可及”组抗菌药使用率低。
