safetyriskБезопасность и риск фармакотерапииSafety and Risk of Pharmacotherapy2312-78212619-1164Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)10.30895/2312-7821-2019-7-2-72-83safetyrisk-145Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESФторхинолоновые антибиотики: безопасность применения на примере ципрофлоксацинаFluoroquinolone antibiotics: safety of use by the example of ciprofloxacinhttps://orcid.org/0000-0003-2430-0107МолчанН. В.MolchanN. V.

Молчан Нина Валерьевна, кандидат фармацевтических наук 

Nina V. Molchan, Candidate of Pharmaceutical Sciences

 

molchan@expmed.ruhttps://orcid.org/0000-0002-8606-1810СмирноваЮ. А.SmirnovaYu. A.

Смирнова Юлия Анатольевна, кандидат фармацевтических наук научный редактор

 

Yulia A. Smirnova,  Candidate of Pharmaceutical Sciences

smirnovaja@expmed.ruhttps://orcid.org/0000-0002-9514-6322ВельцН. Ю.VeltsN. Yu.

Вельц Наталья Юрьевна,  кандидат биологических наук, доцент

 

Natalia Y. Velts,  Candidate of Biological Sciences, Associate Professor

 

Velts@expmed.ruhttps://orcid.org/0000-0001-9662-3701ДармостуковаМ. А.DarmostukovaM. A.

Дармостукова Мария Андреевна  

Maria A. Darmostukova

 

Darmostukova@expmed.ruhttps://orcid.org/0000-0003-2665-796XКазаковА. С.KazakovA. S.

Казаков Александр Сергеевич, кандидат медицинских наук 

Alexander S. Kazakov, Candidate of Medical Sciences

 

KazakovAS@expmed.ruПоливановВ. А.PolivanovV. A.

Поливанов Виталий Анатольевич

Scopus Author ID: https://www.scopus.com/authid/detail.uri?authorId=57193928059

Vitaly A. Polivanov

 

Scopus Author ID: https://www.scopus.com/authid/detail.uri?authorId=57193928059

polivanov123@mail.ruФедеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской ФедерацииРоссияScientific Centre for Expert Evaluation of Medicinal ProductsRussian FederationФедеральное государственное бюджетное учреждение «Информационно-методический центр по экспертизе, учету и анализу обращения средств медицинского применения» РосздравнадзораРоссияInformation and Methodological Centre for Expert Evaluation, Recording and Analysis of Circulation of Medicinal ProductsRussian Federation201917052019727283Copyright © Молчан Н.В., Смирнова Ю.А., Вельц Н.Ю., Дармостукова М.А., Казаков А.С., Поливанов В.А., 20192019Молчан Н.В., Смирнова Ю.А., Вельц Н.Ю., Дармостукова М.А., Казаков А.С., Поливанов В.А.Molchan N.V., Smirnova Y.A., Velts N.Y., Darmostukova M.A., Kazakov A.S., Polivanov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.risksafety.ru/jour/article/view/145

В связи с повторяющимися сообщениями о побочных эффектах при  применении антибиотиков фторхинолоновой группы эти  препараты вновь  и вновь  становятся объектом пристального внимания специалистов фармаконадзора и  врачей. Цель  работы:  изучение частоты и характера нежелательных реакций, связанных с применением препарата ципрофлоксацин, на основе  анализа спонтанных сообщений, поступивших в российскую службу фармаконадзора. Материалы и методы: проведен ретроспективный анализ спонтанных сообщений о препарате ципрофлоксацин за период с 2008  по 2018  г. по базе данных «Фармаконадзор»  автоматизированной  информационной  системы Росздравнадзора.  Результаты: всего  было  зарегистрировано 3403  нежелательные реакции, возникшие у 2083  пациентов при  применении ципрофлоксацина. Чаще всего  развивались реакции со стороны кожи и подкожных тканей (37,3 %), общие расстройства и нарушения в месте введения (21,1 %), реакции со стороны желудочно-кишечного тракта (14,9 %). Более трети сообщений содержали информацию о серьезных нежелательных реакциях. Были выявлены непредвиденные реакции, не зафиксированные в инструкции по медицинскому применению ципрофлоксацина: брадикардия, предсердная аритмия, цианоз, повышение артериального давления. Выводы: антибиотики фторхинолонового ряда с доказанной эффективностью и многолетним опытом клинического применения продолжают оставаться препаратами, безопасность которых требует постоянного контроля. Результаты исследования подтвердили возможность выявления широкого спектра нежелательных реакций методом спонтанных сообщений. Регуляторным органам Российской Федерации целесообразно рекомендовать держателям  регистрационных  удостоверений внести в инструкцию по медицинскому применению ципрофлоксацина информацию о нежелательных реакциях, которые были  зарегистрированы в постмаркетинговый период.

Due  to repeated reports of adverse effects with the  use  of fluoroquinolone antibiotics,  these drugs become  over  and  over  again the  object of the  close  attention of pharmacovigilance  specialists and  health care  specialists. The aim: to study the  frequency and  the  nature of adverse reactions associated with the  use  of ciprofloxacin, based  on the  analysis of the  spontaneous reports received by  the  Russian pharmacovigilance service. Materials and  Methods: A retrospective analysis of the  spontaneous reports of ciprofloxacin was conducted on the  data-base «Pharmacovigilance» of the  automated information system of Roszdravnadzor from 2008 to 2018. Results: 3403  adverse reactions that occurred in 2083  patients using ciprofloxacin were recorded. The  most frequently developed reactions were  from skin and  subcutaneous tissues (37.3 %), general disorders and  disorders at the  injection site (21.1 %), gastrointestinal tract reactions (14.9 %). More than a one third of the  reports contained information about serious adverse reactions. Unexpected reactions were identified as not  recorded in the  instructions for the medical use of ciprofloxacin: bradycardia, atrial arrhythmia, cyanosis, increased blood pressure. Conclusions: fluoroquinolone antibiotics with proven efficacy and years of experience in clinical use, continue to be drugs whose  safety requires constant monitoring. The  results of the  study confirmed the  possibility of detecting a wide  range of the  adverse reactions using the  method of spontaneous reports. Regulatory authorities of the  Russian Federation should recommend to registration certificate holders to include the  information of adverse reactions of ciprofloxacin that were registered in the  post-marketing period in the  instructions for medical use.

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The authors declare that there are no conflicts of interest present.