The effectiveness of the use of antibiotic treatment of different groups of the severity of patients with viral and bacterial pneumonia in the post-pandemic period and the pandemic year 2009/2011
Purpose. An analysis of the effectiveness of the allocated antimicrobial therapy in patients with viral and bacterial pneumonia on different severity levels in the epidemic and post-pandemic period (October 2009 -February 2011). Materials and methods. A retrospective analysis of 85 medical records of patients at the mean age of 35,92 ± 13,3 years, of which 31 were observed and treated in ICU, was conducted. Division of the patients into groups was conducted by the criterion - PaO <sub>2</sub>/FiO <sub>2</sub>: PaO <sub>2</sub>/FiO <sub>2</sub> >300: 54 patients; PaO <sub>2</sub>/FiO <sub>2</sub> < 300: 26 patients; PaO <sub>2</sub>/FiO <sub>2</sub> < 200: 5 patients. Results. The importance of antimicrobial therapy use in admitted patients, burdened by risk factors PaO <sub>2</sub>/FiO <sub>2</sub> on the level of > 300, was proved by regression analysis. Proceeding from the results of dynamic bacteriological research the fact of the hospital reinfection with multiresistant microscopic flora with the inability to perform targeted antibiotic therapy was revealed in all negative care patient outcomes with PaO <sub>2</sub>/FiO <sub>2</sub> < 200 in ICU. Conclusion. Early use of antimicrobial therapy in patients, burdened with PaO <sub>2</sub> / FiO <sub>2</sub> > 300, burdened by risks, improves the disease prognosis. Dynamic analysis of broncho-alveolar lavage fluid with the transition to targeted antibiotic therapy should be carried out for all patients with PaO <sub>2</sub>/ FiO <sub>2</sub> < 300 after failure of antibiotic pneumonia. Patients with PaO <sub>2</sub>/ FiO <sub>2</sub> < 200 have the highest risk of nosocomial reinfection with difficulties in adequate antibiotic therapy selection. The significant correlation with the detection of multiresistant microbial flora and mortality in ICU is traced.