Sequential therapy for bacterial infections. Linessa.
The first studies on sequential therapy appeared in the late 1970s, when the clinical efficacy of a stepwise approach using parenteral and oral forms of β-lactam antibiotics was shown in the treatment of young children with haematogenous osteomyelitis and infectious arthritis. Today, sequential therapy (step-down therapy, switch therapy) is understood as a two-stage use of anti-infectious drugs by switching from parenteral to non-parenteral (usually oral) route of administration as soon as possible, taking into account the patient's clinical condition. This approach is one of the components of the reasonable management of patients with infectious pathology "Start Smart - Then Focus" Antimicrobial Stewardship Toolkit for English Hospitals, Update 2015. The main idea of sequential therapy is to reduce the duration of parenteral administration of an anti-infective drug, reduce the risk of developing catheter-associated infections, and shorten the length of hospital stay, which can significantly reduce the cost of treatment for both the patient and reduce the burden on medical personnel and reduce overall health care costs (FM Buyle et al., 2012).
Ananta Medicare has Linessa (linezolid) in the form of 300 ml solution for intravenous infusion. However, in April, the company is launching linezolid in forte tablets of 600 mg for oral administration under the brand name Linessa. Pharmacodynamic parameters, namely 100% bioavailability of linezolid taken in tablet form, provide the possibility of sequential therapy, which is especially important during COVID-19 pandemic. Linezolid is included in the American, European and Ukrainian standards and protocols for the management of patients with severe hospital-acquired pneumonia and those with bacterial pneumonia caused by COVID infection. One of the most recent American guidelines (Joshua P. Metlay et al., Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. 2019) strongly recommends as follows: The switch from parenteral to oral antibiotics should be done by using the same agent or the same class of antibiotics.
Linessa (linezolid) solution for infusion 300 ml/600 mg and Linessa (linezolid) tab. 600 mg No.5 fully allow to implement the sequential therapy in severe patients with bacterial infection.