Atopic dermatitis: the use of antihistamines for children in outpatient clinical practice

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RELEVANCE

Currently, clinical pharmacologists focus on the correct use of various drugs for the treatment of patients. The main document authorizing the use of drugs in Russia is the State Register of Medicines (SRM). Information about the drug is described in the manufacturer’s instructions. The main document defining the tactics of treating patients with atopic dermatitis (AtD) are the Federal Clinical Recommendations (FCR). Assessing the correctness of the choice of drugs for the treatment of AtD by doctors is aimed at eliminating the shortcomings.

OBJECTIVE

Evaluation by the method of retrospective analysis of outpatient cards till 2017—2019 years the real using by dermatologists of AGP for the treatment of AtD of children and teenagers.

MATERIAL AND METHODS

The analysis of the SRM and the instructions of the manufacturers of AGP registered in Russia is carried out. A retrospective analysis of 251 outpatient cards of children and teenagers with AtD is performed. The author’s version of the «Individual Registration Card» was used. For statistical processing of the research results, the Pearson criterion (χ²) was used.

RESULTS

Discrepancies detected in SRM and FCR of the Russian Society of Dermatovenerologists and Cosmetologists (2015). A retrospective analysis of the outpatient cards of patients with AtD indicates the presence of serious violations in the appointment of AGP by doctors in clinical practice. With a mild severity, practically all patients were unreasonably prescribed non-recommended of state register of medicines data about AGP of 1 and 2 generations. With a mild severity, AGP of 1 (91.4%) and 2 (94.8%) generations was unreasonably prescribed to almost all patients. With moderate severity of AtD in violation of state register of medicines data, 2 generations of AGP were used more often than 1. Age-related disorders were recorded in 2.6% of cases for 4 drugs. Of the 8 AGP of 2 generations, only 3 are allowed for the treatment of AtD (levocetirizine, loratadine and cetirizine). Doctors mistakenly prescribed another 5 drugs recommended for the treatment of allergic rhinitis/conjunctivitis. The correct choice of AGP of the 2nd generation in AD with an «atopic march» was registered in only 54.4% of patients.

CONCLUSION

The analysis of AGP registered in SRM, the study of instructions of manufacturers firms revealed some inconsistencies between SRM and FCR of the Russian Society of Dermatovenerologists and Cosmetologists (2015) and serious violations in their appointment by doctors in clinical outpatient practice found. The elimination of the identified deficiencies is one of the directions for improving the treatment of AtD.

Keywords:

atopic dermatitis

antihistamines

doctors mistake

Authors:

Sokolova T.V.

Medical Institute of Continuing Education of the Federal State Budgetary Institution of Higher Education «Moscow State University of Food Production»

SPIN RSCI: 6402-9066
Scopus AuthorID: 57213089279
ORCID: 0000-0003-3573-0874

Davidenko M.S.

Medical Institute of Continuing Education of the Moscow State University of Food Production

Menshikova A.I.

Institute of Medicine, Ecology and Physical Culture of the Ulyanovsk State University

Received:

05.02.2020

Accepted:

06.08.2020

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