Therapy of acute respiratory infections in adults: Focus at antiviral drugs


DOI: https://dx.doi.org/10.18565/therapy.2024.10.92-96

Rubleva O.V., Nikolaeva S.V., Shushakova E.K., Khlypovka Yu.N., Lyubimova E.N., Ploskireva A.A.

1) “Biolab-R” LLC, Domodedovo; 2) Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow
Abstract. Respiratory infections occupy a leading position in the structure of infectious pathology. No specific prophylaxis has been developed against the vast majority of respiratory pathogens, therefore, timely administration of drugs with antiviral activity comes to the fore.
The aim: to study the effect of using a drug from the group of interferon inducers at the clinical course of acute respiratory infections (ARI) in outpatients.
Material and methods. The study was performed from August 2021 to June 2024. 70 patients aged 18-63 years were examined. They were divided into two groups. The 1st (n = 45) included study participants who used Kagocel, the 2nd – those who did not receive antiviral drugs (n = 25). A comparison of the severity of the course of respiratory infection, as well as the frequency of prescribing antibacterial agents depending on the use of antiviral therapy was made.
Results. When Kagocel was prescribed in the 1st group, the disease lasted less long comparatively to the 2nd (5.0 ± 0.32 versus 6.5 ± 0.47 days, p = 0.010357). In the 1st group, the vast majority of patients (n = 39 patients; 86.7%) had upper respiratory tract lesions with the development of nasopharyngitis, while in the 2nd group it was observed in 68% of cases (p < 0.001). Antibacterial drugs were prescribed more often in the 2nd group than in the 1st (56 versus 13.3%, p < 0.001).
Conclusion. Presented data show a positive effect of antiviral drugs use in adult patients with ARI in the form of a decrease in the duration of the disease, fewer complications and reduction in the prescription of antibiotics.
Keywords: interferon inducers, respiratory infections, antiviral therapy
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Literature

1. Государственный доклад «О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации в 2023 году». Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека. URL: https://www.rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=27779&ysclid=m0cjpzlqqn332074685 (дата обращения – 11.12.2024). (State report “On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2023”. Federal Service for Supervision of Consumer Rights Protection and Human Welfare. URL: https://www.rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=27779&ysclid=m0cjpzlqqn332074685 (date of access – 11.12.2024) (In Russ.)).


2. Amato M., Werba J.P., Frigerio B. et al. Relationship between influenza vaccination coverage rate and COVID-19 outbreak: An Italian ecological study. Vaccines (Basel). 2020; 8(3): 535.


https://doi.org/10.3390/vaccines8030535. PMID: 32947988. PMCID: PMC7563271.


3. Marin-Hernandez D., Schwartz R.E., Nixon D.F. Epidemiological evidence for association between higher influenza vaccine uptake in the elderly and lower COVID-19 deaths in Italy. J Med Virol. 2021; 93(1): 64–65.


https://doi.org/10.1002/jmv.26120. PMID: 32497290. PMCID: PMC7300995.


4. Arokiaraj М.С. Correlation of influenza vaccination and the COVID-19 severity. Front Public Health. 2020; 8: 444.


https://doi.org/10.3389/fpubh.2020.00444. PMID: 33072682. PMCID: PMC7537040.


5. Debisarun P.A., Struycken P., Domínguez-Andrés J. еt al. The effect of influenza vaccination on trained immunity: Impact on COVID-19. medRxiv. 2020; 2020.10.14.20212498.


https://doi.org/10.1101/2020.10.14.20212498. Preprint.


6. Zanettini C., Omar M., Dinalankara W. еt al. Influenza vaccination and COVID19 mortality in the USA. medRxiv. 2020; 2020.06.24.20129817.


https://doi.org/10.1101/2020.06.24.20129817. Preprint.


7. Шубин И.В., Мишланов В.Ю., Хисамов А.Р. с соавт. Особенности клинической картины внебольничной пневмонии в зависимости от предупредительной вакцинации против гриппа и пневмококковой инфекции. Уральский медицинский журнал. 2019; (8): 73–78. (Shubin I.V., Mishlanov V.Yu., Khisamov A.R. et al. Clinical picture features of community-acquired pneumonia depending on the preventive vaccination against influenza and pneumococcal infection. Ural’skiy meditsinskiy zhurnal = Ural Medical Journal. 2019; (8): 73–78 (In Russ.)).


https://doi.org/10.25694/URMJ.2019.08.30. EDN: YOJLOY.


8. van Heuvel L., Paget J., Duckers M., Caini S. The impact of influenza and pneumococcal vaccination on antibiotic use: An updated systematic review and meta-analysis. Antimicrob Resist Infect Control. 2023; 12(1): 70.


https://doi.org/10.1186/s13756-023-01272-6. PMID: 37452389. PMCID: PMC10347879.


9. Kaplan S.L., Barson W.J., Lin P.L. et al. Early trends for invasive pneumococcal infections in children after the introduction of the 13-valent pneumococcal conjugate vaccine. Pediatr Infect Dis J. 2013; 32(3): 203–7.


https://doi.org/10.1097/inf.0b013e318275614b. PMID: 23558320.


10. Головачева Е.Г., Тимонина В.С., Афанасьева О.И. с соавт. Влияние вакцинации от гриппа на заболеваемость другими острыми респираторными инфекциями у детей. Проблемы медицинской микологии. 2021; 23(2): 70. (Golovacheva E.G., Timonina V.S., Afanaseva O.I. et al. The impact of influenza vaccination on the incidence of other acute respiratory infections in children. Problemy meditsinskoy mikologii = Problems in Medical Mycology. 2021; 23(2): 70 (In Russ.)). EDN: URRROO.


11. Rozenbaum M.H., Sanders E.A.M., van Hoek A.J. et al. Cost effectiveness of pneumococcal vaccination among Dutch infants: An economic analysis of the seven valent pneumococcal conjugated vaccine and forecast for the 10 valent and 13 valent vaccines. BMJ. 2010; 340: с2509.


https://doi.org/10.1136/bmj.c2509. PMID: 20519267.


12. Озерова И.В., Малышев Н.А. Эффективность препарата Кагоцел в неспецифической профилактике острых респираторных вирусных инфекций и гриппа. Морская медицина. 2019; (3): 68–76. (Ozerova I.V., Malyshev N.A. Efficacy of Kagocel in nonspecific prevention of acute respiratory viral infections and influenza. Morskaya meditsina = Marine Medicine. 2019; (3): 68–76 (In Russ.)).


https://doi.org/10.22328/2413-5747-2019-5-3-68-76. EDN: TGRXAO.


13. Тихонова Т.Ю., Кузьмина Е.П., Калинина Ю.С. Оценка профилактического эффекта индуктора поздних интерферонов. Лечащий врач. 2018; (10): 28. (Tikhonova T.Yu., Kuzmina E.P., Kalinina Yu.S. Evaluation of the prophylactic effect of the late interferon inducer. Lechashchiy vrach = Attending Physician. 2018; (10): 28 (In Russ.)). EDN: YMHKXR.


14. Фазылов В.Х., Ситников И.Г., Малышев Н.А. с соавт. Влияние противовирусной терапии на частоту развития бактериальных осложнений и назначения антибактериальных препаратов для системного использования у пациентов с ОРВИ и гриппом (результаты международного когортного наблюдательного исследования FLU-EE). Антибиотики и химиотерапия. 2016; 61(11– 12): 39–47. (Fazylov V.Kh., Sitnikov I.G., Malyshev N.A. et al. The effect of antiviral therapy on the incidence of bacterial aggravations and administration of systemic antibiotics in patients with acute respiratory viral infections and influenza (results of international cohort observational study). Antibiotiki i khimioterapiya = Antibiotics and Chemotherapy. 2016; 61(11–12): 39–47 (In Russ.)). EDN: YJTQAB.


15. Максакова В.Л., Васильева И.А., Ерофеева М.К. Применение препарата Кагоцел для лечения и профилактики гриппа и других острых респираторных вирусных инфекций. Медлайн-Экспресс. 2009; (1): 42–45. (Maksakova V.L., Vasilyeva I.A., Erofeeva M.K. The use of Kagocel for the treatment and prevention of influenza and other acute respiratory viral infections. Medlayn-Ekspress = Medline Express. 2009; (1): 42–45 (In Russ.)).


16. Ситников И.Г., Фазылов В.Х., Силина Е.В. с соавт. Влияние сроков начала терапии острой респираторной вирусной инфекции и гриппа на динамику клинических симптомов и исхода заболевания (результаты когортного международного наблюдательного исследования FLU-EE). Клиническая медицина. 2017; 95(7): 634–641. (Sitnikov I.G., Fazylov V.Kh., Silina E.V. et al. The influence of ARVI and influenza treatment start time on the dynamics of clinical symptoms and outcomes of the diseases (the results of the international cohort observational study FLU-EE). Klinicheskaya meditsina = Clinical Medicine. 2017; 95(7): 634–641 (In Russ.)).


http://dx.doi.org/10.18821/0023-2149-2017-95-7-634-641. EDN: ZHRJLP.


About the Autors

Olga V. Rubleva, MD, PhD (Medicine), chief physician of “Biolab-R” LLC. Address: 142000, Domodedovo, 18/1 Kuryzhova St.
E-mail: og@rcbd.org
ORCID: https://orcid.org/0000-0002-1524-2868
Svetlana V. Nikolaeva, MD, Dr. Sci. (Medicine), leading researcher at the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: nikolaeva008@list.ru
Ekaterina K. Shushakova, MD, PhD (Medicine), junior researcher at the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: ketlu@bk.ru
Yulia N. Khlypovka, MD, PhD (Medicine), researcher at the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: ve-stu@mail.ru
Ekaterina N. Lyubimova, MD, otolaryngologist at “Biolab-R”LLC. Address: 142000, Domodedovo, 18/1 Kuryzhova St.
E-mail: kl86@rambler.ru
Antonina A. Ploskireva, MD, Dr. Sci. (Medicine), professor of RAS, deputy director for clinical work of the Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3A Novogireevskaya St.
E-mail: zdk@pcr.ru
ORCID: https://orcid.org/0000-0002-3612-1889


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