2009-4

.: Дата публікації 2009-12-22 :: Переглядів: 6 :: :.

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SEMISYNTHETIC PENICILLINUMS USE IN ABDOMINAL SURGERY WITH THE PREVENTIVE AND TREATING PURPOSE
V.G. Mishalov, A.A.Burka, L.Yu. Markulan, S.M. Vamush, N.I. Shtypuk

The aim – to estimate efficiency of application amoxicillin/sulbactam («Trifamox», by «Laboratories Bago S.A.») for antibacterial preventive measures (АPM) and antibacterial therapy (АBТ) in abdominal surgery.

Materials and methods. 48 patients (27 men and 21 woman at the age from 18 till 70 years), participated In research were treated in surgical unit during the period from September, 2008 till March, 2009 and receiving amoxicillin/sulbaktam after operation in abdominal surgery. Amoxicillin was prescribed on 1.0 g intramuscularly or intravenously 2–3 times per day. The dose is resulted in recalculation on amoxicillin. A dosage regimen selected individually depending on severity, infection localization, and bacterial sensitivity. Duration of treatment was from 1 till 7 days. After peristalsis restoration medication was prescribed perorally. Other antibacterial medication was not applied.

Results and discussion. 47 strains of microorganisms were allocated. The Gram-negative microflora was found out in 53.6 %, Grampositive – in 29.7 % of patients, a monoculture – in 35.7 %, microbes’ associations – in 64.3 %. Among a Gram-negative microflora prevailed: E. coli – 23.4 %, Proteus spp. – 18.2 %, Enterobacter spp. – 14.7 %; among Gram-positive – Staphylococcus aureus – 16.3 %. Microflora sensitivity to amoxicillin/sulbactam has made 97.8 %. For 5 days of the postoperative period significant (р < 0.005) reducing of leucocytes number and leukocytes’ intoxication index rate was noted. For 3 days after operation bacteriemic flora was revealed in 2 (4.1 %) patients, for 5 days – in one. The positive clinical effect was noted in all patients.

Conclusions. Amoxicillin/sulbactam application in ABP regimen and АBТ in abdominal surgery in patients with conditionally pure and polluted operations allows reaching positive bacteriological effect in all patients, has high clinical efficiency. The medication can be applied in a monotherapy regimen.