Evaluation of Drug Therapy for Respiratory Viral Infections in Outpatient Practice

Abstract

The aim of the study is to evaluate the current practice of prescribing drug treatment for acute respiratory viral infections (ARVI) in outpatient practice.
Materials and methods. The article presents the results of a pilot assessment of the current practice of prescribing antiviral and symptomatic drugs for the treatment of ARVI based on the results of a one-time voluntary anonymous survey of outpatient doctors using Google forms. Participants — 33 physicians of outpatient departments of the Sverdlovsk Region hospitals. The respondents reported seeing 12 to 40 patients per day, ARVI being the cause of visit in 10 % to 50 % cases. Three respondents worked as ARVI symptoms elected emergency room physicians.
Results. All survey participants emphasized the importance of rapid tests to exclude influenza and COVID-19. The most common symptoms of ARVI according to respondents were dry cough, weakness, fatigue and subfebrile temperature. 8 physicians have always prescribed antiviral drugs for their patients, 10 — do so for most patients, 10 — do it for about every second patient, 3 — prescribe these drugs extremely rarely, 2 — not prescribing. The prescribed range of antiviral drugs was limited and did not comply with current clinical guidelines. All physicians who prescribed oseltamivir did so exclusively for the indication “flu”. Umifenovir and interferon preparations were most often used to treat ARVI. All participants noted paracetamol as the main symptomatic therapy, with 28 out of 33 preferring fixed combinations with adrenomimetics and antihistamines. Acetylcysteine was prescribed only for productive cough and only after completing paracetamol intake. Three respondents allowed the prescription of antibacterial drugs on the first visit for ARVI, 30 physicians considered it necessary to identify signs of a bacterial infection, and 20 of them emphasized the importance of having laboratory or radiological confirmation. 
Conclusions. Internal medicicne, cardiology, geriatrics, pulmonology, phthisiology and dietetics residents, who combine the educational process with practical activities in the outpatient primary care, demonstrated a high level of knowledge in the field of therapy of acute respiratory viral infections. However, during real clinical practice they make a number of erroneous decisions. This indicates the need to adjust the educational process with an emphasis on the most complex aspects covered in this study.

For citation
Popov AA, Sabitov AU, Izmozherova NV, Shambatov MA, Bakhtin VM. Evaluation of drug therapy for respiratory viral infections in outpatient practice. USMU Medical Bulletin. 2024;(4):17–26. (In Russ.). EDN: https://elibrary.ru/XNQJRN.