Evidence base for the efficacy and safety of flavonoids and the opinion of outpatient doctors in the focus of choice of approaches to treatment of ARI
Authors:   SI «Dnipropetrovsk medical academy of the Ministry of Health of Ukraine», Dnipro, Vysochyna I.L. , Kramarchuk V.V. ,   SI «Dnipropetrovsk medical academy of the Ministry of Health of Ukraine», Dnipro
Published: December 2020

Numerous publications, meta-analyzes and systematic reviews suggest different approaches to the treatment and prevention of ARI, therefore, in the practice of a doctor both in Ukraine and in other countries, there is a variety of schemes, protocols, regulations and professional recommendations for the management of these patients. Therefore, for competent, effective and safe treatment and prevention of ARI among national and world standards, a doctor needs to find the most optimal and effective algorithm for the management and treatment of viral infections of the respiratory tract, which ideally has a high level of evidence-based medicine and can be used in specific practice with the point of view of patient management and routing. Purpose — to analyze the knowledge of the existing in Ukraine and the world of the regulatory framework and national protocols for the management of patients with ARI by general practitioners — family medicine, as well as to study the opinion of family doctors about the efficacy and safety of using flavonoids in the treatment and prevention of ARI. Materials and methods. Anonymous survey of 149 family doctors in the city of Dnipro and the region was conducted in the current 2020. Among the respondents there were 55 doctors with a primary specialization in Pediatrics (37%), 37 doctors with a primary specialization in Internal Medicine (25%) and 57 with a primary specialization in Family Medicine (38%). The distribution normality was checked using the Kolmogorov+Smirnov test. Considering that 90% of the data were normally distributed, we used parametric statistics methods. To assess relationships between binary features, the ϕ-coefficient of mutual conjugation was used. The critical level of statistical significance was accepted as <5% (p<0.05). Results. Family physicians are aware of current trends in the strategy of therapy and prevention of ARI. According to family doctors, drugs with the active substance Proteflazid, when prescribed for the treatment and prevention of acute respiratory viral infections, are safe (no toxic effect) and effective (according to our own observations) by reducing the duration and severity of the disease, the severity of fever and manifestations of intoxication syndrome, reducing the frequency of acute respiratory diseases (frequency rate per year), and that the above effects obtained in their own practice are associated with direct antiviral action, suppression of viral reproduction and multiple mechanisms of action of Proteflazid bioflavonoids. In addition to the professional opinion of family doctors, the opinion of parents about the effectiveness of drugs with the active substance Proteflazid for the treatment and prevention of ARI (feedback from a doctor) in the form of their positive feedback and a note that they are often used for self+treatment, and their choice is associated with the fact that Proteflazid preparations shorten the period of illness and, according to parents, children are less ill with ARI. Conclusions. The presence of the proven antiviral action of flavonoids, as a class of polyphenolic compounds, and the fact that the flavonoids that make up Flavovir have a proven mechanism of antiviral activity, which is confirmed in clinical outpatient practice by the positive experience of primary care physicians (pronounced clinical efficacy) allows you to recommend Flavovir syrup for the treatment and prevention of influenza and seasonal ARI to children from birth. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the doctors was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: ARI, flavonoids, treatment, outpatient practice, evidence-based medicine.