Therapeutic solutions for patients with community-acquired pneumonia in Bulgaria. Yavor Ivanov, Pavlina Nikolova, Tsanya Popova, Plamen Pavlov University Pulmonary Clinic Pleven, Bulgaria. Incidence of CAP in Bulgaria. Incidence of CAP in Bulgaria 1995-2004 ( provided by NCHI ). - PowerPoint PPT Presentation
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Therapeutic solutions Therapeutic solutions for patients with for patients with community-acquired community-acquired pneumonia in Bulgariapneumonia in BulgariaYavor Ivanov, Pavlina Nikolova,Yavor Ivanov, Pavlina Nikolova,Tsanya Popova, Plamen PavlovTsanya Popova, Plamen PavlovUniversity Pulmonary ClinicUniversity Pulmonary ClinicPleven, BulgariaPleven, Bulgaria
Incidence of CAP in Incidence of CAP in BulgariaBulgaria
Mortality from CAP in Bulgaria 1995-2004 (provided by NCHI)
years
per 100 000 population
40.1
16.915.7
14.5
10.5 2.3S. pneumoniae
H. influenzae
K. pneumoniae
M. catarrhalis
P. aeruginosa
Other
EtiologyEtiology
•4669 patients hospitalized for CAP4669 patients hospitalized for CAP•21,5% had positive sputum result21,5% had positive sputum result
24.7
16.4
6
9.6
19.4
8.5
6.3
Penicillin
Erytromycin
Azithromycin
Clindamycin
Doxycycline
Ceftriaxone
Rifampin
S. pneumoniae resistanceS. pneumoniae resistance
Clinical considerationsClinical considerations
Assess the patientAssess the patient– Clinical condition – CRB 65Clinical condition – CRB 65– As a host of a probable agentAs a host of a probable agent– As a social beingAs a social being
The key advice for the The key advice for the prescribing doctorprescribing doctor
MIC Concentration at the site of infection Power
Number of antibiotics Number of antibiotics till clinical curetill clinical cure
150 outpatients vs 150 hospitalized patients150 outpatients vs 150 hospitalized patients
0
10
20
30
40
50
60
70
Outpatients Hospitalised
Macrolides
Quinolones
Amoxicillin/clavulanate
Ceftriaxone
Doctors’ solutionsDoctors’ solutions
11,47days
10,17days
Outpatients Hospitalized
Duration of treatment
21,1 €
72,06 €
Outpatients Hospitalized
Average cost of antibiotic treatment per patient
Summary – practical Summary – practical solutionssolutions Simple and clear guidelinesSimple and clear guidelines Teach the doctorsTeach the doctors Inform the regulatorsInform the regulators Follow the tendenciesFollow the tendencies
– Health outcomesHealth outcomes– Drug prescriptionsDrug prescriptions– Microbiological dataMicrobiological data– ExpensesExpenses