ANTIBACTERIAL THERAPY IN INFECTED FORMS OF NECROTIC PANCREATITIS

Abstract

Summary: Evaluation of the effectiveness of antibacterial therapy at different stages of necrotic pancreatitis (NP) is the most important area of ​​scientific and practical research on the course of necrotic pancreatitis and the development of sepsis. The work is based on the results of a comprehensive examination and treatment of 54 patients with necrotic pancreatitis in the intensive care unit of city Hospital № 3, Zaporizhia in 2017-2019 pp. Objective: Optimize the use of antibacterial therapy in the complex treatment of infected forms of NP depending on the microbial spectrum of infection, the course of the disease and the development of sepsis. Material and methods of research. The study included 54 patients with infected forms of NP who were treated in the Department of Anesthesiology and Intensive Care of the 3rd City Hospital. Research results and their discussion. Thus, the analysis of antibiotic sensitivity showed that high activity against pathogens, based on the perception of the main pathogens characteristic of infected forms of NP, is observed in meropenem, taigecycline and tobramycin. When studying the species composition of microorganisms, it was found that the NP is dominated by gram-negative flora: Pseudomonas aeruginosa - 26.5%, Acinetobacter spp. - 21.2%, family Enterobacteriaceae: Klebsiella pneumoniae - 10.2% and Escherichia coli - 15.6%. Resistant strains of Ps were found in 22% of patients. Aeruginosa. The use of detoxification therapy with the inclusion of extracorporeal detoxification methods (discrete plasmapheresis) in combination with two-component antibacterial therapy (meropenem + linezolid) led to a positive trend in the course of the disease. Conclusions. Analyzing the course of the disease in patients with infected NP and its complications on the basis of constant monitoring of bacterial flora with optimal antibacterial therapy, prevention of nosocomial infection and modern strategy of surgical interventions, especially minimally invasive, noted a positive trend in the course of sepsis and sepsis.