CONTROVERSIAL ISSUES OF ANTIBIOTIC THERAPY DURATION IN PATIENTS AFTER INJURIES AND SURGERIES ON MUSCULOSKELETAL SYSTEM

Abstract

Improvements in surgical techniques and the introduction of minimally invasive osteosynthesis technologies have had a beneficial effect on the patient treatment after injuries and surgeries on the musculoskeletal system. However, the problem of treating infectious complications, especially in elderly patients with high comorbidity, has not lost its relevance. The purpose of the paper is to study the effectiveness of antibiotic therapy in elderly patients after injuries and surgeries on the musculoskeletal system in comorbidity. Materials and methods. An open prospective cohort study was conducted with a 12-month follow-up period. We examined 53 elderly and senile patients (24 men and 29 women, average age 69.1±7.3) who were hospitalized. The combined endpoint of treatment outcome was assessed. Comorbidity and duration of antibiotic therapy were determined in all patients. The GerontoNet ADR Risk Score was used to assess the risk of drug therapy complications. Results. The comorbidity index in elderly patients was 4 (3; 5) points. One third of patients (19 people; 35.9 %) had high comorbidity rates. The average number of antibacterial drugs was 2 (1; 2). Total course of administration was 8 (5; 21) days. Therapy duration less than 7 days was observed in 24 (45.3 %) patients. In 13 (24.5 %) patients, the result exceeded 5 points on the GerontoNet scale. During the observation period, a positive result was achieved in 45 (84.9 %) patients. There was no significant difference in achieving positive results based on the duration of antibiotic therapy (p>0.05). Conclusion. The use of long-term systemic antibiotic therapy in elderly patients after injuries and surgeries on the musculoskeletal system does not lead to better results compared to shorter treatment modalities, which help us avoid unwanted side effects and drug interactions, given the high comorbidity of this group of patients.