THE PROBLEM OF CHOOSING STARTING ETHIOTROPIC THERAPY IN SURGICAL PRACTICE
Introduction. The choice of an effective starting antibiotic therapy is a key problem at the stage of treatment of purulent-infectious diseases in a surgical hospital. Justified prescription of certain pharmacological groups of drugs with a certain duration of the course in accordance with the sensitivity of the pathogen prevents the development of antibiotic resistance, which has now acquired a global character. The aim of the study identification of the most common causative agents purulent-septic diseases in patients of a surgical hospital and monitoring of their sensitivity to antibacterial drugs in order to select the optimal empirical starting therapy. Materials and methods. A statistical analysis of the results of bacteriological examination of purulent discharge from foci of surgical infection of 285 patients of the surgical department of the City Clinical Hospital 7 in Tver is presented. Results and its discussion. The analysis of the results of bacteriological research revealed a wide range of microorganisms in a surgical hospital, such as Escherichia coli, Klebsiella oxytoca, Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis and a number of microorganisms from the category «other» with less frequency of occurrence sensitivity to antibacterial drugs. The results obtained were compared with the data for the Russian Federation and global statistics. Conclusions. The dominant gram-negative microorganisms were Escherichia coli and gram-positive ones - Staphylococcus aureus. Local sensitivity assessment showed that the predominant percentage of microorganisms is sensitive to gentamicin, chloramphenicol and ciprofloxacin. The data obtained simplifies the selection of an effective starting antibiotic therapy, which reduces the rate of formation of multidrug resistance. However, taking into account the rate of development of antibiotic resistance, at the moment, there remains a need for constant monitoring of the sensitivity of pathogens to antibacterial drugs within each specific department of a medical and prophylactic institution.