Affiliation:
1. National Pirogov Memorial Medical University, Vinnytsya; Zhytomyr Regional Clinical Hospital named after O. F. Herbachevsky
Abstract
Introduction. Nosocomial pneumonia (NP) is the second leading frequency and mortality among nosocomial infections. NP is a frequent complication of severe traumatic brain injury (TBI). The difficulty in diagnosis and monitoring of disease NP on the background of TBI is that the usual signs NP "masked" manifestations of the underlying disease.
The aim of our study was to improve the diagnosis and assess the effectiveness of the treatment of nosocomial pneumonia with clarithromycin by studying of serum interleukins in patients with nosocomial pneumonia on the background of traumatic brain injury.
Materials and methods. We determined levels of TNFα, IL-4, IL-6, IL-8, IL-10. We examined 45 patients with isolated TBI, 44 patients with NP (standard treatment scheme), 49 patients with NP, each therapy with clarithromycin. The control group was 33 relatively healthy people.
Conclusions. The study revealed a significant increase in the concentration of interleukin TNFα, IL-6, IL-8, IL-10 in the serum of patients with NP on the background of TBI compared with patients with isolated TBI and healthy individuals. Our study found significantly lower concentrations of interleukin TNFα, IL-6, IL-8, IL-10 in the serum of patients after treatment with the addition of clarithromycin compared with patients with standard therapy.
Reference23 articles.
1. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia (2005). American Journal of Respiratory and Critical Care Medicine, 171 (4), 388–416. doi: 10.1164/rccm.200405-644st
2. Barbier, F., Andremont, A., Wolff, M., Bouadma, L. (2013). Hospital-acquired pneumonia and ventilator-associated pneumonia. Current Opinion in Pulmonary Medicine, 19 (3), 216–228. doi: 10.1097/mcp.0b013e32835f27be
3. Chuchalin, A. G. (2015). Pneumonia as an actual medical problem of the 21th century. Pulmonology, 25 (2), 133–142. doi: 10.18093/0869-0189-2015-25-2-133-142
4. Feshchenko, Yu. I., Dziublyk, Yu. I., Simonov, S. S. (2012). Hospitalna (nozokomialna) pnevmoniia u doroslykh osib: etiolohiia, patohenez, klasyfikatsiia, diahnostyka, antybakterialna terapiia [Hospital (nosocomial) pneumonia in adults: etiology, pathogenesis, classification, diagnosis, antibiotic therapy]. Zdorovia Ukrainy, 1 (278), 35–36.
5. Giamarellos-Bourboulis, E. J., Mylona, V., Antonopoulou, A., Tsangaris, I., Koutelidakis, I., Marioli, A. et. al. (2013). Effect of clarithromycin in patients with suspected Gram-negative sepsis: results of a randomized controlled trial. Journal of Antimicrobial Chemotherapy, 69 (4), 1111–1118. doi: 10.1093/jac/dkt475