ESTIMATION OF MATERIAL LOSSES DURING THE REGISTRATION OF THE DRUG «AMOXICILLIN + CLAVULANIC ACID» IN INFUSION THERAPY OF COMMUNIT Y-ACQUIRED PNEUMONIA IN CHILDREN
Authors: Abdullina Yu.A. , Egorova S.N. , Sidullina S.A. , Kabanova A.V. 
Published: May 2023

Patients diagnosed with community-acquired pneumonia are recommended to receive anti- biotic therapy. In case of severe pneumonia in hospital, infusion of Amoxicillin preparations is used. In the Russian pharmaceutical market during the study period, there are no solutions for parenteral administration in pediatric dosages, which leads to high financial losses of medical organization and environmental risks in the disposal of antibiotics. Objective of the study evaluation of losses of drug weight and financial losses when using «adult» doses of anti- bacterial agents for infusion therapy of community-acquired pneumonia in children (on the example of the drug «Amoxicillin+clavulanic acid, powder for preparation of solution for intravenous injection»). Materials and methods the objects of the study were clinical guidelines on treatment of community-acquired pneu- monia in children, information from the State Register of Medicines, instructions for medical use. The source of data on prices was the information from the State Register of maximum selling prices. Analytical, statistical, logical, and computational-constructive methods of re- search were used in the work. Results: the study calculated the material losses of the drug in mg per vial and 12 vials (treat- ment course of 4 days). With a single therapeutic dose of 300 mg, the material losses of the drug, using a dosage of 1200 mg, were: 1200 - 300 = 900 mg (75% of the dosage form). Fi- nancial losses in rubles calculated for the course of treatment with the drug Amoxicillin + clavulanic acid 1200 mg amounted to 756.00 rubles (79.05%) per 1 child, and for treatment with the dosage of 600 mg - 252.00 rubles (52.70% of the cost of the drug). The development of the dosage forms for intravenous administration of Amoxicillin + clavu- lanic acid in the doses of 180 and 240 mg would allow decreasing considerably the losses of the drug during preparation of infusion solutions in pediatric practice. Conclusion 1. When administering antibacterial therapy for community-acquired pneumonia in chil- dren, the drug Amoxicillin + clavulanic acid, powder for preparation of solution for intrave- nous injection, manufactured in doses of 1200 mg and 600 mg, is used. 2. Modeling of weight losses of Amoxicillin + clavulanic acid powder for intravenous solu- tion preparation for treatment of community-acquired pneumonia in children aged 1 year showed that when 1200 mg dosage was used, losses were 900 mg/ vial (10800 mg per treat- ment course), and in 600 mg dosage - 300 mg/ vial (3600 mg per course); 75 and 50% of drug weight respectively. 3. Calculations have been made and significant financial losses have been established in treatment of community-acquired pneumonia in children under 5 years old with the drug «Amoxicillin + clavulanic acid, powder for preparation of solution for intravenous injection» 1200 mg and 600 mg, due to incomplete use of the package. The financial loss for the course of treatment with the drug Amoxicillin + clavulanic acid in the dosage of 1200 mg amounted to 756.00 rubles (79.05%) for 1 child aged 1 year, and for treatment with the dosage of 600 mg - 252.00 rubles (52.70% of the cost of the drug for the course of treatment). 4. For treatment of community-acquired pneumonia in children aged 5-11 years it is reason- able to use Amoxicillin + clavulanic acid 600 mg dosage. 5. For treatment of community-acquired pneumonia in children under 5 years old it is advis- able to commercially release the medicinal product «Amoxicillin + clavulanic acid, powder for preparation of solution for intravenous injection» in doses of 180 mg (150+30 mg) and 240 mg (200+40 mg).