Alternative mode

Our experience of meronema in patients with AS against the backdrop of widespread peritonitis to determine the effectiveness of this drug and its place in the pharmacotherapy of the AU. According to our observations, clinical efficacy meronema (cure and improvement) in patients with the severity of SAPS 20-25 points (which corresponds to a projected 61-67% mortality) was 81% in patients with the severity of SAPS 15-19 points (projected mortality 34-42%) - meron was effective in 91% cases, the severity of the condition of patients by SAPS no more than 15 points (forecast mortality 25-30%) - 94%. Of course, adequate antibiotic therapy plays a supporting, role of adjuvant (relative to surgery) in saving lives of patients. However, our results suggest meron very promising drug. It should be noted that the loss of only 3 patients we observed was associated with continued sepsis, the remaining Post-mortem signs of sepsis were not.

Thus, we can determine the location meronema in the treatment of surgical AU as a drug I turn in a special clinical situation (post-operative period, multiple organ failure, need to combine with KFOR, and resistance to other drugs) and how the drug provision (II-III line) with multi-antimicrobial therapy . It should be noted the role of another new antibiotic - cephalosporin Generation IV - Kate (tsefpirona) in the treatment of AS [10]. Our own experience of using this drug in the treatment of AS and nosocomial pneumonia can draw some conclusions. A wide range of Keita against Gram-positive aerobes and gram enables its effective priority application, but only in combination with antianaerobnym drug (metronidazole or clindamycin). Keith activity against enterococci makes it the drug of choice in the treatment of superinfections caused by these microorganisms. This is especially important after aminoglycoside therapy.

In addition, the antistaphylococcal action spectrum Keita (eg S.aureus and S.epidermidis) enables its effective use in the "catheter" sepsis - a common complication of sepsis of other origin [1]. As regards the application by Keith nosocomial brand viagra pneumonia, the treatment results of our 32 patients with evidence of its efficiency - in 31 patients the treatment was successful.

Describing this publication new antibiotics in the treatment of AS, we do not in any way diminish the importance of a relatively "old", already known antimicrobial agents. We believe that a rational approach to long-term and multi-stage treatment of the AU makes effective use of drugs of different groups.

In modern conditions, with full availability of high-tech pharmacological agents (but, unfortunately, limited financial resources), each clinic, dealing with emergency surgery, and planned, too, must have a "bank" of antibiotics, including: penicillins (including - unazin, tazotsin), cephalosporins (including - Mandola, klaforan, Fortum, tsefobid, Rocephin, Kate), carbapenems (especially Meron), aminoglycosides (tobramycin (nebtsin), amikacin, netromitsin) linkosamidy (including clindamycin ), fluoroquinolones (tarivid, pefloksatsina, ciprofloxacin), antifungal drugs (Diflucan, amphotericin B), etc.

Some remarks on the prevention of fungal colonization and pathological superinfection during prolonged antibiotic therapy. Unfortunately, recent years have revealed the lack of effectiveness in this regard polyene drugs (nystatin, levorin) [9, 15]. Very effective means of prevention was Diflucan (fluconazole) in a daily dose of 50-100 mg.

Numerous comparative studies show that the Diflucan and effectively prevents colonization of the fungi Candida, and better tolerated. Our clinical experience fully confirms these observations. Moreover, we have included an alternative mode of Diflucan in KFOR.

In conclusion, I would like to recall the words of AN Bakulev (spoken by about peritonitis): Optimization of treatment of abdominal sepsis is "still ageless problem surgery."

tactics
hormones
once a day
baroreflex activity
opposite effect