Postoperative infectious complications in diffuse peritonitis
In order to determine the most rational and affordable methods of drug prevention and treatment of infectious complications in acute diffuse peritonitis 243 patients with this pathology were examined and treated. It has been established that hospital bacterial flora is mainly represented by polyresistant strains of Gram-negative facultative anaerobic bacteria that were resistant to antibiotics most often used in the clinic. A change in typical pathogens of peritonitis to hospital microflora occurs in 3 days after surgery. Risk factors for the development of infectious complications in acute diffuse peritonitis are: the value of the Mannheim peritoneal index is more than 20, the source of peritonitis is the lower gastrointestinal tract, the duration of artificial lung ventilation for more than 8 hours, a combination of concomitant diseases of the respiratory and cardiovascular systems, obesity, diabetes mellitus, alcoholism and drug addiction. For empirical therapy of acute diffuse peritonitis in patients with risk factors for infectious complications it is advisable to use the first-generation fluoroquinolone or the third-generation cephalosporin in combination with Amikacin and Metronidazole.