RU2007184C1 - Method of treatment of salmonellosis infection - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: additionally to commonly used treatment scheme injections with human leukocytic interferon is carried out. Its dose is 2×10⁴ IU, the preparation is injected intramuscularly. Treatment course is 3 injections, interval between the first one and the second injections is 72 h, interval between the second and the third injections is 48 h. Treatment course is repeated in 10 days. EFFECT: improves efficiency of the method, decreases treatment time.

Description

 The invention relates to medicine and can be used to treat salmonella infection in humans.

 Known methods of treating salmonella infection, including antibiotic therapy, cholecystectomy in combination with antibiotics, transfusion of leukocytes obtained from convalescents after the disease.

However, the known methods of treatment are not very effective and they have the following disadvantages:
high frequency of the formation of chronic bacterial carriage (up to 20%);
body allergization during transfusion of a foreign antigen;
the occurrence of dysbiosis of the gastrointestinal tract;
contraindications for surgical intervention for elderly and middle-aged people.

There is also known a method for the treatment and prevention of salmonella infection by the combined use of antibiotic immunotherapy: chloramphenicol + specific V ₁ antigen.

However, this method is not always effective, since it requires prolonged use of drugs, it can cause adverse reactions, the immunosuppressive properties of antibiotics create the conditions for the formation of bacteriocarriers and cases of repeated diseases, and also inhibit the functional activity of macrophages. As for the use of the V ₁ antigen for the treatment of patients, in many cases, after its administration, the titer of the corresponding antibodies decreases, but compared with the pre-grafting level.

 The aim of the invention is to reduce the treatment of salmonella infection, the prevention of complications and the formation of bacteria.

 This is achieved by the additional introduction of leukinferon into the treatment regimen for salmonella infection.

 PRI me R 1. Patient D., 20 years. Diagnosis: generalized salmonellosis, septic form; bacterio-toxic shock; acute renal failure; salmonella ulcerative enterocolitis with perforation of colon ulcers, intestinal bleeding.

She became acutely ill on 05.28.84 after eating the cake. Pain in the abdomen of herpes zoster, severe pain in the epigastric region, frequent loose stools, vomiting. Raising the temperature to 39 ° ^C. Due to the sharp deterioration of state admitted to the emergency department of Lutsk, and then flown to the intensive care unit of the regional hospital in Kyiv. In crops - Salmonella typhimurium. Despite the ongoing antibiotic therapy, the patient's condition progressively worsened, disorders of the cardiovascular system appeared, the amount of urine decreased sharply - up to 50 ml per day. Given the severity of the condition, the patient was transferred to the intensive care unit of hospital N 14 in Kiev.

06/08/84, the patient was operated on for suturing colon ulcers, cecostomy, intubation of the large and small intestines, drainage of the abdominal cavity. Conducted antibiotic therapy: chloramphenicol, cloforan, Trichopolum intravenously in conventional dosages was ineffective. Since 06/20/84, human leukocyte interferon for injection-2 (leukinferon) was included in the treatment regimen. The drug was administered intramuscularly at 2 × 10 ⁴ IU with subsequent injections of the drug 72 hours after the first, 48 hours after the second, and after 10 days off, the course was repeated. After the first two injections of leukinferon, a decrease in temperature was noted, subsequently, peripheral blood and urine indicators changed in the direction of improvement. The total number of lymphocytes and T-active lymphocytes increased, the phagocytic activity of neutrophils and monocytes and their bactericidal activity increased. The patient became more active, appetite appeared, and stool returned to normal. July 6, 1984 - the crops are sterile, the patient was transferred from the intensive care unit to the proctology department of hospital No. 22 in Kiev.

PRI me R 2. Patient B., 16 years. Diagnosis: typhoid fever of moderate severity. Ill 7.26.84 of acute rise in temperature to 39 ^C. 8.2.84 g of ambulance hospitalized infectious ward N 7 Kiev a high temperature with suspected typhoid. The diagnosis is confirmed microbiologically by inoculation of Salmonella typhi gr. D. Repeated antibiotic therapy was prescribed: ampicillin 0.5 x 4 times from August 24 to August 26, which was canceled when an itchy rash appears. From August 27 to September 4, furazolidone was applied 0.1x 4 times. In the crops dated August 28, S. typhimurium was again found.

From September 7, the treatment is supplemented with the introduction of leukinferon at 2 × 10 ⁴ IU intramuscularly according to the developed scheme. Crops of feces, urine, and bile on September 17 and September 19 gave negative results. Crops from 2.10 and 4˙10 were also sterile. Neutrophil phagocytosis indices of 28.08 - 30.2%, 14.09 - 58%. Indicators of bactericidal activity of monocytes and neutrophils are included in the table.

 The patient was discharged in satisfactory condition under the supervision of an infectious disease doctor at the place of residence. After 2 months urine, bile, and stool tests were done - cultures of samples for salmonellosis are negative. The following analysis was done after 1 year (April 16 and April 18, 85). Crops of feces, urine and bile also gave a negative result. The term of treatment of patients with salmonella infection (typhoid fever) with available methods is on average 27.5 ± 2.5 days, and in complicated cases 38.0 ± 4 days. Additional administration of leukinferon reduces these periods by 7-12 days.

When studying the long-term consequences of the possible formation of bacterial carriage after a salmonella infection, it was found:
1) in patients treated with conventional methods (randomly taken 10 patients), in 2 cases, carriage continued for 4 months. , in 1 person - within 6 months. after discharge from the hospital;
2) among 32 people in whose treatment the drug of interferon was introduced, carriages of Salmonella were not found within 12 months. (follow-up) for multiple examinations. Relapses and complications in these patients were not.

 The term of the clinical examination of ill 1-2 g with 10 bacteriological examinations per year, and in the case of re-isolation of salmonella - the number of patients doubled. Introduction to the treatment course of leukinferon reduces the number of examinations, which in turn reduces the costs.

Claims (1)

METHOD FOR TREATMENT OF SALMONELLOSIS INFECTION, including the introduction of antibiotics, characterized in that, in order to increase the effectiveness of treatment, leukocyte interferon injection-2 is additionally administered intramuscularly at a dose of 2 · 10 ⁴ IU with subsequent injections of the drug 72 hours after the first, 48 hours after the second and repeat the course after 10 days.