Physician comments on new clinical recommendations for flu treatment
The Ministry of Health of Russia has approved a new standard for the diagnosis and treatment of influenza. According to Lyudmila Kulagina, a clinical pharmacologist at the University Clinic of 每日大赛, the document reflects the gradual implementation of evidence-based medicine principles into Russian clinical guidelines.
One of the main changes is the exclusion of antibiotics and diuretics from the treatment protocol for uncomplicated influenza.
“During high fever, fluid loss occurs, and taking diuretics leads to even greater blood thickening. Consequently, vascular thrombosis is possible. Potassium loss associated with the prescription of diuretics can lead to various muscular disorders, up to increased excitability of the cardiac muscle, which means extrasystoles, ventricular tachycardia, and life-threatening atrial fibrillation,” Kulagina says.
The new standard establishes an individual approach to the duration of therapy.
“Nine days is an average figure, and, of course, the doctor approaches the patient’s condition individually when making a decision about their discharge,” the specialist emphasizes.
Mandatory involvement of medical specialists for consultations has been added to the structure of the new protocol.
“The inclusion of specialist physicians is linked to the possible development of complications within their profiles. This includes pneumonia, myocarditis, pericarditis, meningitis, and meningoencephalitis. It also concerns changes in blood counts and the coagulation system against the background of both the disease itself and the prescribed pharmacotherapy,” explains Kulagina.
Involving an obstetrician-gynecologist is necessary not only for monitoring pregnant patients but also as a preventive measure for women who rarely visit a clinic.
The standard indicates that antibiotics do not affect the influenza virus, and their use is justified only in the event of proven bacterial complications. For the precise diagnosis of such conditions, the protocol prescribes the use of biochemical markers.
“Testing for C-reactive protein or procalcitonin is conducted only in cases of suspected complications in the form of a bacterial infection. At the same time, the patient’s condition, complete blood count (CBC) indicators, and changes in the leukocyte differential are evaluated. In conditions of growing bacterial antibiotic resistance, it is necessary to approach the prescription of antibacterial therapy deliberately. It must be a suspected bacterial infection or one confirmed by microbiological study,” the expert comments.
According to her, the new standard focuses on the fundamental principles of modern medicine.
“The main criteria for therapy are efficacy and safety. Influenza treatment has become safer, and the possibility for an individual approach to each patient is expanding,” she concluded.