По всем вопросам звоните:

+7 495 274-22-22

УДК: 000.00 + 000.00.1 DOI:10.33920/med-10-2105-05

Применение антибиотиков при различных операциях

Ибрагим Хелифи Российский университет дружбы народов (РУДН), 117198, г. Москва, ул. Миклухо-Маклая, д. 6, ORCID ID 0000-0003-3474-6305
Мехаил Шехата Фахри Мехаил Российский университет дружбы народов (РУДН), 117198, г. Москва, ул. Миклухо-Маклая, д. 6, ORCID ID 0000-0002-0381-3379
Айт Амират Ахcен Амин Российский университет дружбы народов (РУДН), 117198, г. Москва, ул. Миклухо-Маклая, д. 6, ORCID ID 0000-0002-4556-2635
Ризк Марко Джордж Российский университет дружбы народов (РУДН), 117198, г. Москва, ул. Миклухо-Маклая, д. 6, ORCID ID 0000-0002-3895-3048

Риск, связанный с использованием антибиотиков в хирургических операциях для профилактики и лечения, почти не обсуждался в течение последнего десятилетия. Контроль источника инфекции — основной вопрос, о котором знают почти все врачи, хотя большинство из них недооценивают проблему и прописывают антибиотики чрезмерно. В связи с этим необходимо спланировать множество стратегий и улучшить системное лечение антибиотиками, поскольку угроза со стороны устойчивых бактерий является важным фактором при принятии клинических решений. Цель данной статьи — рассмотреть использование противомикробных препаратов в общей и наиболее распространенной медицинской хирургии, а также изучить риски и последствия чрезмерного использования этих препаратов в долгосрочной перспективе.

Литература:

1. McGowan JE Jr. Cost and benefit of perioperative antimicrobial prophylaxis: methods for economic analysis. Rev Infect Dis 1991;13 (Suppl 10):S879–89.

2. Dettenkofer M, Forster DH, Ebner W, Gastmeier P, Ruden H, Daschner FD. The practice of perioperative antibiotic prophylaxis in eight German hospitals. Infection 2002;30:164–7.

3. Therapeutic Guidelines: Antibiotic. Version 12. Melbourne: Therapeutic Guidelines Limited; 2003.

4. Munckhof, W. (2005). Antibiotics for surgical prophylaxis. Australian Prescriber, 28 (2), 38–40. https://doi.org/10.18773/austprescr.2005.030

5. Tourmousoglou, C. E., Yiannakopoulou, E. Ch., Kalapothaki, V., Bramis, J., & Papadopoulos, J. St. (2007). Adherence to guidelines for antibiotic prophylaxis in general surgery: A critical appraisal. Journal of Antimicrobial Chemotherapy, 61 (1), 214–218. https://doi.org/10.1093/jac/dkm406

6. Howard JM, Barker WF, Culbertson WR, Grotzinger PJ, Iovine VM, Keehn RJ, et al. Postoperative wound infections: the influence of ultraviolet irradiation of the operative room and of various other factors. Ann Surg 1964;160 (Suppl 2): 1–196.

7. Kernodle DS, Barg NL, Kaiser AB. Low-level colonization of hospitalized patients with methicillin-resistant coagulase-negative staphylococci and emergence of the organisms during surgical antimicrobial prophylaxis. Antimicrob Agents Chemother 1988; 32: 202–8.

8. Terpstra S, Noodhoek GT, Voesten HG et al. Rapid emergence of resistant coagulase-negative staphylococci on the skin after antimicrobial prophylaxis. J Hosp Infect 1999; 43: 195–202.

9. Cosgrove, S. E. (2006). The relationship between antimicrobial resistance and patient outcomes: Mortality, length of hospital stay, and health care costs. Clinical Infectious Diseases, 42 (Supplement_2), S82 — S89. https://doi.org/10.1086/499406

10. Leaper D, van Goor H, Reilly J et al. Surgical site infection — a European perspective of incidence and economic burden. Int Wound J 2004; 1: 247–73.

11. Niederman MS. Use of broad-spectrum antimicrobials for the treatment of pneumonia in seriously ill patients: maximizing clinical outcomes and minimizing selection of resistant organisms, Clin Infect Dis, 2006, vol. 42 (Suppl 2) (pg. 72–81) (in this supplement)

12. Lodise TP, McKinnon PS, Swiderski L, Rybak MJ. Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia, Clin Infect Dis, 2003, vol. 36 (pg. 1418–23)

13. Linden PK, Pasculle AW, Manez R, et al. Differences in outcomes for patients with bacteremia due to vancomycin-resistant Enterococcus faecium or vancomycin-susceptible E. faecium, Clin Infect Dis, 1996, vol. 22 (pg. 663–70)

14. Harris A, Torres-Viera C, Venkataraman L, DeGirolami P, Samore M, Carmeli Y. Epidemiology and clinical outcomes of patients with multiresistant Pseudomonas aeruginosa, Clin Infect Dis, 1999, vol. 28 (pg. 1128–33)

15. Paterson DL. The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals, Clin Infect Dis, 2006, vol. 42 Suppl 2 (pg. 90–5) (in this supplement)

16. Rahal JJ, Urban C, Horn D, et al. Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella, JAMA, 1998, vol. 280 (pg. 1233–7)

Antibiotics are drugs used to treat and prevent microbial infections, same as in medical surgery, the usage of antibiotic drugs is used to treat early infections likewise on the perioperative period. Some evolving infections are caused by a major factor which is the inappropriate use of antibiotics in healthcare centers; this one is serving in the development of antimicrobial resistance and giving less choice other than the development of new agents which is a very hard process or resolving the main problem and try to optimize on the use of the actual antibiotic agents.

One of the most common infections on the surgical field is the infected wounds, while administering prophylactic treatment, additional drugs in first case, can result on an increasing on the financial plan of the clinic center, on contrast treating patients with multidrug resistance can be more costly than an infected patient [1].

The treatment used to prevent infections at the surgical site known as Surgical prophylaxis, composed essentially by antibiotics are used nearly 30 to 50 % of the general use of antibiotics still 30 % to 90 % of this usage is given in the wrong time or continued for too long, and contested to be inappropriate [2].

In general terms, the selection of antibiotics using in preoperative period depends in quite a lot of factors likewise the type of the infection, the patient allergies, the type of the medical surgery and more. The commonly used antibiotics are the beta-lactamas, first generation cephalosporins and gentamicin are used on intravenous as well as metronidazole in case of anaerobic infection in this case oral tinidazole can be used too; on condition that methicillin-susceptible staphylococcal infection is possible, the most likely treatment to use are flucoxacillin or vanocomycin on intravenous. [3,4]

In the study by Tourmousoglou et al. [5], occurring on 876 patients treated with prophylactic antibiotic, 15 types and other antibiotic was used, the more common are penicillin and cephalosporin, the antibiotics was resumed in table 1 and classified from the most used to the less.

Для Цитирования:
Ибрагим Хелифи, Мехаил Шехата Фахри Мехаил, Айт Амират Ахcен Амин, Ризк Марко Джордж, Применение антибиотиков при различных операциях. Справочник врача общей практики. 2021;5.
Полная версия статьи доступна подписчикам журнала
Язык статьи:
Действия с выбранными: