Optimizing antibacterial treatment in acute pancreatitis (experimental and clinical research)

Abstract

Aim. To examine the effectiveness of interstitial electrophoresis in antibacterial treatment in animals with experimental pancreatitis and in patients with acute pancreatitis. Methods. Cefotaxime concentration was studied by highly effective chromatography at different routes of administration in 40 rats of both gender with body weight of 150-250 g at the department of surgery of Kazan State Medical Academy and department of pharmacology of Kazan State Medical University. The clinical part of the research compared treatment results in group of patients (n=27) in whom interstitial electroforesis was performed together with antibacterial treatment with group of patients (n=26) who were treated conventionally. Results. Antibiotic introduction using galvanizing in experimental pancreatitis is more effective compared with traditional antibiotic introduction 24 hours after acute pancreatitis modulation. In the clinical part of the research in the main group complications were registered in 14.8% of cases, localized forms of infection (3 effusions, 1 retroperitoneal abscess) were the most common. In control group complications were seen in 34.6% of cases, generalized infections were the most common type (omental and retroperitoneal abscess - in 15.4% of cases, retroperitoneal pyogenic cellulitis - in 19.2% of cases). So, in the basic group less invasive procedures were more common compared with laparotomy, marsupialization, lumbotomy being more common in control group. Mortality rate was 11.1% in the main group and 15.4 in control group (р 0.05). Conclusion. Using interstitial electrophoresis in antibacterial treatment decreases the frequency of purulent complications, with localized forms of the infection being more prevalent, and allows to decrease the mortality rate in patients with acute destructive pancreatitis.

Аntibacterial and Antifungal Therapy for Patients with Acute Pancreatitis at High Risk of Pancreatogenic Sepsis (Review)

“…Imipenem shows the greatest empirical efficacy as it penetrates into deep tissue and preserves its activity for a long time; from this study, tigecycline and linezolid cannot be recommended for local treatment [ 100 ]. Several studies have demonstrated the efficacy of antibacterial and antifungal agents when applied topically, including the way of interstitial electrophoresis [ 3 , 101 , 102 ].…”