MEDICAL AND SOCIAL ASPECTS OF ACUTE RHINOSINUSITIS TREATMENT

The problem of acute inflammatory diseases of the upper respiratory tract, acute rhinosinusitis, in particular, is one of the urrent problems of modern otolaryngology. The purpose of the study was retrospectively analyze the incidence of acute rhinosinusitis in different regions of Ukraine and identifying the current trends in pharmacotherapy. The research was conducted on the basis of statistical reporting SE Center for Health Statistics of Health of Ukraine on the level of primary morbidity of acute rhinosinusitis in adults for 2012-2017 years. It was determined that the highest prevalence of rhinosinusitis among the population was registered in Kyiv. It was about 1095.7 cases per 100,000 population for 6 years. Also, the high rates of prevalence were determined for the Kharkiv and Rivne regions for the research period. In the Kharkiv region, in 2012, 984.0 cases per 100,000 population were registered and in 2017 this rate increased to 1028.3 cases. However, in the Rivne region, we have observed a tendency towards a decrease in the prevalence of rhinosinusitis in the research period. So in the Rivne region in 2012 were 799.5 cases per 100,000 population, then in 2017 there were 614.0 cases per 100,000 population, but still the rate was quite high in comparable with other regions of Ukraine. The lowest level of acute rhinosinusitis was observed in Zaporizhzhia (188.2 cases per 100,000 population) and Kirovograd (268.2 cases per 100,000 population) regions in 2012 year. The analysis of data after 5 years has shown the similar trend 207.7 and 264.6 cases per 100,000 population, respectively, for these regions. In the Dnipropetrovsk region we was established a significant increase in the prevalence of rhinosinusitis in 510.8 cases in 2012 and already 754.5 cases per 100,000 population in 2017. Modern scientists, family physicians and otorhinolaryngologists continue to seek optimal treatment for acute rhinosinusitis, depending on the etiology and clinical features of the disease, taking into account evidencebased medicine and the results of new randomized clinical trials. For example, in Spain, not only the features of the pharmacotherapy of acute rhinosinusitis have been studied, but also the need to determine the impact of the disease on the quality of patients life, also have been discussed the importance of monitoring this category of patients for further clinical support and differential diagnosis of complications. Scientists from the Peoples Republic of China were found significant pharmacotherapeutic advantage of ceftriaxone (1000 mg) over amoxicillin/clavulanate (825 mg/125 mg) for treatment acute bacterial rhinosinusitis in 120 patients on 3-4 days of the disease. In Germany researchers have analyzed the use of local corticosteroids in patients with acute rhinosinusitis and polyps in the nasal cavity. The study involved 26,768 patients with acute rhinosinusitis and 516 patients with nasal polyps. It has been established that the use of corticosteroids in patients with acute rhinosinusitis is low effective, however, in a complex pharmacotherapy of polyps of the nasal cavity and rhinosinusitis, they are first-line medicines with a high efficiency rate. The analysis of the modern protocol for the provision of medical care to the population at the primary and secondary level of medical care for patients with acute rhinosinusitis showed that modern approaches to the pharmacotherapy of acute rhinosinusitis are multipurpose and are directed to the main components of the disease etiopathogenesis (85 of 02.11.2016). However, the recent data of 2018 are testify about the need for a constant updating of the acute rhinosinusitis treatment approaches regarding to pharmacotherapeutic support of patients