CLINICAL AND MICROBIOLOLGICAL ASPECTS OF COMPLICATED ACUTE APPENDICITIS TREATMENT
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Keywords

acute appendicitis
appendicular peritonitis
microflora
antibiotic therapy

Abstract

The bacteriological investigation with determining of the microflora nature enables a rational antibiotic therapy.The aim of the research was to verify the specific composition according to the results of bacteriological investigation on appendix lumen and peritoneal extraction, and to analyze its sensitivity to antibiotics in patients with appendicular peritonitis.Materials and methods. 356 hospital records of the patients with acute appendicitis were analyzed. Local sampling of biological material was conducted during the operation to perform microbiological investigations. The antibacterial efficiency of 33 antibiotics was investigated.Results and discussion. High frequency of aerobic and anaerobic microbial associations and considerable identity of appendix and abdominal exudation microflora were confirmed. The positive result of bacteriological investigation of the pus from the abdominal cavity during appendicular peritonitis was collected in 44 (88.0%) patients. No flora growing was observed in 6 (12.0%) cases. The most efficient were gatifloxacin (100.0%), imipenem (86.1%), meropenem (85.7%).Conclusions. Growing of Escherichia coli colonies in monoculture as well as in association with other bacteria, such as Staphylococcus aureus and Staphylococсus epidermidis (28.0%) was stated in 71.1% of cases. According to the results of investigations, appropriated bacterial cultures where sensitive to ftorxenolons, carbopenems and cefalosporines of the third generation and not sensitive to the antibacterial agents from the aminoglycosides, penicillin, glycopeptides, lincosamides, oxazolidones groups.
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