Approaches to the management of surgical patients with antibiotic-associated mild diarrhea

Abstract

The paper  highlights  the issues  of antibiotic-associated diarrhea  (AAD) of mild severity in the treatment of surgical patients, its epidemiology, etiology, features  of the clinical picture and approaches to therapy. The mild course of AAD includes diarrhea without  signs  of intoxication,  leukocytosis  and  fever. Stool  disorder  in patients receiving  antibiotics  who are  in a surgical hospital  is an urgent  medical  problem, since  this pathology  prolongs  the  time  of hospitalization, increases  economic  costs, reduces  the quality of life and can even be the cause of the patient’s death. According to various authors, AAD develops  in 40% of people  receiving antibacterial therapy. A clinical example  of the management of a patient  with AAD and injury of the musculoskeletal system is considered in detail.The abolition of antibiotics  is not a method  of solving this problem, since the severity of the patient’s injuries requires  further surgical treatment and prevention of purulent-septic complications. The key point in the  treatment of mild AAD will be the  appointment of probiotic  drugs, which have  an effect  on the  pathogenetic  links of AAD. Probiotics  are  microorganisms that  have  been  known  since  ancient  times  and  are  purposefully  used  for health improvement and longevity. One of the first probiotic drugs used before the era of the discovery of antibiotics  can be considered  Mechnikov curdled  milk with  unique  medicinal  properties.  Prescribing  probiotic  therapy  from the  first day of taking antibiotics, without  waiting for the results  of laboratory examination, will significantly reduce  the prevalence of clinical manifestations of both clostridial  diarrhea  and idiopathic AAD.