Comparative Analysis of Drug Interactions with Antibacterial Agents in the Treatment of Community-Acquired Pneumonia

According to the World Health Organisation, pneumonia and other lower respiratory tract infections are one of the leading causes of death all over the world. Simultaneous treatment of pneumonia with antibacterial drugs and concomitant medicines may result in adverse drug reactions (ADRs). 

The aim of the study was to analyse ADRs resulting from drug-drug interactions in different empiric antibiotic treatment regimens used for mild community-acquired pneumonia (CAP), taking into account the concomitant symptomatic non-antibacterial treatment and chronic disease treatment. 

Materials and methods: the authors analysed spontaneous reports in the VigiBase global database (starting from the date the database was created and until 15 February 2021) on ADRs resulting from interactions of medicinal products included in the Russian clinical guidelines for CAP.

Results: the authors compiled a list of antibacterial drugs (amoxicillin+clavulanic acid, amoxicillin, ampicillin, azithromycin, clarithromycin, levofloxacin, moxifloxacin, cefotaxime, ceftriaxone, linezolid), as well as lists of medicinal products for symptomatic and concomitant treatment, based on the approved guidelines for management of CAP and frequent comorbid chronic diseases. They searched VigiBase for ADRs that may have resulted from drug-drug interactions involving these medicinal products. 

Conclusions: the analysis of adverse reactions used for mild CAP treatment demonstrated that the largest number of ADRs were associated with drug-drug interactions involving azithromycin, while the smallest number of ADRs were associated with cefotaxime and ceftriaxone. Further study of drug-drug interactions will help to prevent potential ADRs, identify rational drug combinations, and improve the existing patient management strategies.

1. Murdoch DR, Howie SRC. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018;18(11):1191–210. https://doi.org/10.1016/S1473-3099(18)30310-4

2. Zaitsev AA. Community-acquired pneumonia: epidemiology, diagnosis and antimicrobial therapy. Terapiya = Therapy. 2018;(1):63–71 (In Russ.)

3. Zyryanov SK, Butranova OI. Modern approaches to the rational choice of antibiotic for treatment of community-acquired pneumonia in various categories of patients. Kachestvennaya klinicheskaya praktika = Good Clinical Practice. 2019;(1):97–113 (In Russ.)

4. Matveev AV, Krasheninnikov AE, Egorova EA, Konyaeva EI. Retrospective analysis of adverse drug reaction reporting forms associated with penicillin family antibiotics (PCNE-DRP 9.0) based on drug-related approach. Farmatsiya i farmakologiya = Pharmacy and Pharmacology. 2020;8(1):57–64 (In Russ.) https://doi.org/10.19163/2307-9266-2020-8-1-57-64

5. Sirenko NV, Alekseenko SI, Tsurikova GP, Volkova MO. Paratonsillar abscess in children. Clinical and microbiological methods of investigation. Antibiotiki i khimioterapiya = Antibiotics and Chemotherapy. 2017;62(1–2):35–9 (In Russ.)

6. Lukina MV, Morozova TE, Andrushchishina TB, Chukina MA, Ramenskaya GV, Shok­hin IE. Vancomycin clearance calculation according to the mathematical modeling and pharmacokinetic research. Meditsinskiy vestnik Severnogo Kavkaza = Medical News of the North Caucasus. 2020;15(1):72–7 (In Russ.) https://doi.org/10.14300/mnnc.2020.15016