rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2007-3-90rmt-1029Research ArticleОСТРАЯ ДЫХАТЕЛЬНАЯ НЕДОСТАТОЧНОСТЬACUTE RESPIRATORY FAILUREАнтибактериальная терапия нозокоминальных пневмоний, вызванных полирезистентной флорой у больных в критических состоянияхAntibacterial Therapy for Nosocomial Pneumonias Caused by Multidrug-Resistant Microorganisms in Critical 1ll PatientsМорозВ. ВMorozV. V.-МарченковЮ. ВMarchenkovYu. V.-ЛысенкоД. В.LysenkoD. V.-КарпунН. А.KarpunN. A.-МорозоваО. А.MorozovaO. A.-20072006200733Том III № 3 2007 г.9090Copyright © Мороз В.В., Марченков Ю.В., Лысенко Д.В., Карпун Н.А., Морозова О.А., 20072007Мороз В.В., Марченков Ю.В., Лысенко Д.В., Карпун Н.А., Морозова О.А.Moroz V.V., Marchenkov Y.V., Lysenko D.V., Karpun N.A., Morozova O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1029

В работе представлены результаты применения цефалоспорина четвертого поколения максицефа при лечении 20 случаев нозокомиальной пневмонии у больных с тяжелой сочетанной травмой. Контрольную группу составили 20 больных, у которых была использована комбинация цефтазидима с амикацином. Общая эффективность антибактериальной терапии составила: в группе максицефа — 68,5%, в контрольной группе 40,9% (р<0,05). Необходимость модификации терапии имела место в 42% в группе максицефа и 72,7% в группе комбинации антибиотиков (р<0,05). Средняя стоимость лечения в группе максицефа составила 518 (429—606) долларов США, а в группе комбинации антибиотиков — 482 (368—596) долларов США. В группе больных, получавших комбинацию антибиотиков в 9% случаев была отмечена нефротоксичность. Также проведен анализ активности максицефа in vitro. Результаты исследования продемонстрировали, что максицеф in vitro высокоактивен в отношении большинства грамположительных и грамотрицательных возбудителей. В отношении возбудителей, наиболее часто отвечающих за возникновение инфекции у больных с тяжелой сочетанной травмой (P. aeruginosa, S.aureus, E.coli, K.pneumonia), его эффективность была значительно выше эффективности цефтазидима in vitro. Результаты сравнительного исследования показывают возможность использования цефалоспорина IV поколения — максицефа в качестве альтернативы стандартной комбинированной терапии. Ключевые слова: сочетанная травма, максицеф, нозокомиальная пневмония, комбинация цефта-зидима с аминогликозидом, возбудители нозокомиальной инфекции.

The paper presents the results of using the fourth-generation cephalosporin maxicef in the treatment of 20 patients with nosocomial pneumonia and severe concomitant injury. A control group comprised 20 patients receiving a combination of ceftazidime and amikacin. The total efficiency of the antibacterial therapy was 68.5% in the maxicef group and 40.9% in the control group (р<0.05). The therapy had to be modified in 42% of the maxicef group and in 72.7% in the control group (р<0.05). The average treatment cost was US $518 (429—606) and US $482 (368—596) in the maxicef and control groups, respectively. Nephrotoxicity was observed in 9% of the patients receiving a combination of the antibiotics. The activity of maxicef was also analyzed in vitro. Results. Maxicef was demonstrated to be highly active against the majority of gram-negative and gram-positive bacteria in vitro. Its efficacy against the most common bacteria (P.aeruginosa, S.aureus, E.coli, K.pneumonia) causing infections in severe injury was in vitro significantly higher than that of ceftazidime. The comparative study indicates that the fourth-generation cephalosporin maxicef may be used as an alternative to the standard combined therapy. Key words: concomitant injury, maxicef, nosocomial pneumonia, a combination of ceftazidime and aminoglycoside, nosocomial infection pathogens.

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The authors declare that there are no conflicts of interest present.