АNTIBACTERIAL THERAPY IN PATIENTS WITH PNEUMOEMPYEMA

Abstract

Summary. Purpose of the work. To study the structure of the pathogenic flora in pneumoempyema and its sensitivity to antibacterial agents. Materials and methods. It were examined 159 patients of both sexes, with pneumoempyema. We detected the species of microflora, and its sensitivity to antibacterial agents. The material for bacteriological studies was pleural exudates, wich we obtained from the pleural cavity by the puncture method. Research results. The characteristic of the pleurals flora has been revealed, the sensitivity of these pathogens to antibacterial drugs has also been detected. We have made antibacterial therapy schemes for patients with pneumoempyema. Conclusions. In the etiology of pneumoempyema predominate next gram-positive bacteria: Streptococcus pneumoniae, Staphylococcus epidermidis, Staphylococcus aureus, which were sensitive to inhibitor-protected penicillins, and 4th generation cephalosporins. Gram-negative flora was represented by Pseudomonada aerugenosa, Escherichia Coli, Enterobacter spp., which were sensitive to fluorchinolones of III and IV generations and carbapenems. We have proposed schemes of antibacterial therapy: A. Initial therapy: 4th generation cephalosporin + 3th–4th generation fluoroquinolone. B. Reserve scheme: inhibitor-protected penicillin + carbapenems. These combinations are most effective against 96.0 % of microorganisms identified by us. In case of prescribing two or more antibacterial agents, as well as with antibacterial therapy for seven days or more, antifungal agents should be prescribed.