DATA OF CHANGE OF MICROFLORA ANTIBACTERIAL SENSITIVITY TO ANTIBIOTICS IN PATIENTS WITH CHRONIC CALCULOUS PYELONEPHRITIS AND DIABETES MELLITUS OF TYPE 2
Among the confounding diseases for calculous pyelonephritis, the leading place is occupied by diabetes mellitus, which is associated with a reduced immune response, worsening of renal hemodynamics, decreased sensitivity to antibiotics. The purpose of research - to improve the results of treatment of patients with calculous pyelonephritis and type 2 diabetes mellitus. Materials and methods. 179 people were surveyed. This was a retrospective pharmacoepidemiological analysis of medical records of patients treated in 2009 and 2013 in a hospital in Volgograd. Women in the study were more than 99 (55.4 %), men - 80 (44.6 %). All patients underwent standard clinical examination, with the mandatory bacteriological urinalysis, ultrasound of kidneys. Results. In patients with an infection of the upper urinary tract and diabetes strong tendency to reduce sensitivity to all groups of antibiotics is observed. Sensitivity to unprotected penicillins and fluoroquinolones declined almost twice that does not allow to assign these agents as empirical therapy. Aminoglycoside resistance in patients of this group increased by 23 %. Today, patients with chronic calculous pyelonephritis with type 2 diabetes mellitus still have high sensitivity of the main infectious agents to cephalosporins of the third and fourth generation (92 %), to the protected beta-lactam penicillins (amoxicillin / klavolunat) - 86.4 %, derivatives of carbapenems - 89,4% (p < 0,05). Results. Thus, for the treatment of upper urinary tract infections in patients with diabetes, protected beta-lactam penicillins, cephalosporins of third and fourth generation and derivatives of carbapenems can be recommended.