EVALUATION OF CLINICAL EFFICIENCY OF RESTRICTIVE TACTICS OF ANTIBACTERIAL THERAPY IN CASE OF UNPROVED INFECTION IN NEONATAL INTENSIVE CARE DEPARTMENT

Goal of the article: comparative analysis of correlation of liberal and restrictive tactics of anti-bacterial therapy (ABT) in newborns with respiratory distress syndrome (RDSS) and suspected congenial pneumonia with drug resistant bacterial population in neonatal intensive care department (ICD). Methods. The study was designed as prospective, controlled, one-center, non-randomized. Enrollment criteria were the following: gestational age of 25-32 weeks, body weight of 1001-2499 g., RDSS or suspected congenial pneumonia, artificial pulmonary ventilation (APV) from the first day of birth, procalcitonin level tests. The study lasted from 01.01.2015 to 26.12.2015. 697 newborns were included into the study. Restrictive ABT was used in the treatment group (n=515), prescription of antibiotics for preventive purposes was used in the comparison group (n=182). Samples were collected from sterile cavities of the host - tracheal aspirate, content of urinary bladder and stomach. Results. 2535 gram negative and 299 gram positive isolates of pathogenic microorganisms were examined. Kl. pneumonia was the most prevalent among gram negative microorganisms (1 202 isolates, 47.4% of all strains), St. aureus was the most prevalent among gram positive bacteria (207 isolates). Conclusions. Restrictive ABT tactics provided no impact on duration of the newborns' stay in the intensive care department and general hospital stay; the tendency for mortality reduction in the intensive care department was observed, the duration of APV reduced to statistically significant extend, and this allowed constraining drug resistance of certain nosocomial strains of microorganisms.

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