SU1572640A1 - Method of treating enterocolitis in sepsis of children of the first three months - Google Patents

Abstract

The invention relates to medicine, namely to pediatrics and pediatric surgery, and can be used to treat children of the first three months of life in whom the septic course of purulent-inflammatory diseases is accompanied by enterocolitis against the background of dysbacteriosis caused by pathogenic flora. The aim of the invention is to reduce the duration of treatment. This is achieved by incorporating in the complex of medicinal preparations oral administration of the enterosorbent SUMS-1 with carbenicillin applied on it in the amount of 35 - 80 mg / ml of sorbent. The method makes it possible to increase the effectiveness of the treatment of this category of patients, to reduce the duration of their treatment by 1.4-2 times as compared with the conventional methods, to reduce the incidence of complications and the consumption of antibiotics.

Description

The invention relates to medicine, namely to pediatrics and pediatric surgery, and can be used to treat children of the first three months of life in whom the septic course of purulent-inflammatory diseases is accompanied by enterocolitis against the background of dysbacteriosis caused by pathogenic flora.

The aim of the invention is to reduce the duration of treatment.

Go to the goal is achieved by including in the complex of medicinal preparations of oral administration of the enterosorbent SUMS-1 with a wide range of antibiotic applied with carbenicillin in the amount of 35-80 mg / ml of sorbent.

The method is carried out as follows.

The antibiotic sorbent is administered to patients in the amount of 35-80 mg / ml of sorbent and in a volume of 0.5 cm3 / kg body weight 30-40 minutes before feeding 3-4 times a day in 2 ml of sterile vaseline oil. The course of treatment 6 -12 days. The speed of evacuation of the sorbent from the gastrointestinal tract (GIT) depends on the function of the intestine, the frequency and nature of the stool. In the first 2-3 days, the evacuation is accelerated, the sorbent appears in the stool 4-6 hours after administration. As the stool was normalized and normalized, the child's condition improved, appetite appeared, the frequency of regurgitation decreased, the child gradually gained body weight, and from 6-10 days there was a steady positive dynamics of weight, signs of intoxication decreased, and sanitation of purulent foci accelerated. Treatment efficacy was assessed by clinic and controlled by bacteriology.

VS

ND O O

When studying the contents of the stomach and intestines before and on days 6–10 of treatment, in the baconalis on days 6–10, the growth of pathogenic flora was absent, and the saprophytic flora was close to the age norm by quantitative and qualitative composition.

The method allows to shorten the treatment time by 1.4-2 times in comparison with the known one, to reduce the incidence of complications and the consumption of antibiotics.

Carbenicillin on the sorbent is not destroyed in the acidic environment of the stomach, maintaining bactericidal properties for the entire period of the passage through the gastrointestinal tract. Purposefully, a series of studies have shown that carbenicillin does not wash off the surface of the sorbent and works on it bactericidal with respect to the pathogenic flora during the entire passage through the gastrointestinal tract. After evacuation from the intestine, the sorbent that was washed from the feces with a physiological solution retains its bactericidal properties during bacteriological examination of the lawn of pathogenic staphylococcus.

In the clinic of pediatric surgery in the complex of enterocolitis therapy, a sorbent was prescribed for children with various forms of surgical sepsis according to the procedure described, taking into account the antibiogram of the pathogenic intestinal flora. Enterosorption was part of the traditional complex of treatment of enterocolitis. Intramuscular administration of the antibiotic was replaced with SUMS-1 enterosorption with carbenicillin applied to it. In case of enterocolitis, after the cure of a purulent focus, antibacterial therapy was performed only enterally, i.e. with a sorbent, against the background of traditional therapy: ingestion of enzymes, biologics, etc.

Example 1. A boy A., 18 days old, was treated in the surgical department of newborns for the skin form of sepsis: pseudofurunculosis, foci of staphylococcal bilateral pneumonia, staphylococcal dysbacteriosis, anemia, hypotrophy II, enterocolitis. The child became acutely ill; he was at home without treatment for 2 days. He entered in a bad condition: restless, after eating, regurgitation, fever, stools increased up to 7 times a day, shortness of breath to 50 per minute, abdomen swollen. Body weight is 3150 g, at birth - 3100 g. At the beginning, complex therapy of sepsis was started, including a surgical manual. The traditional treatment of enterocolitis is supplemented with enterosorption of the SUMS-1 sorbent with carbenicillin 50 mg / cm3 applied on it. The child received the specified suspension in vaseline oil for

40 minutes before feeding 4 times a day. On the first day of treatment, the evacuation of the sorbent along the gastrointestinal tract lasted 6-7 hours. By the end of the second day of complex therapy, the paresis disappeared.

The gastrointestinal tract, shortness of breath decreased, a reduction in regurgitation and stool frequency was noted, but pathological impurities remained. The results of the research: blood growth of Staphylococcus aureus, in the content

0 intestine and pus also growth of Staphylococcus aureus. Mother's milk is sterile. In the following days of treatment, the child's condition improved, and on the 7th day the body mass began to grow steadily, new purulent foci from 10

5 days of treatment did not appear. Enterosorption was discontinued after 7 days of treatment, and the child received biological products for 18 days. The general condition, clinical and bacteriological control, biochemical studies of the body's media allowed the child to be discharged home after 21 days with recovery. Body weight at discharge 3850 g

Example 2. Girl G., 2 months, was treated in the ward of newborns with a diagnosis of bilateral otitis media, single pseudo furuncles on the body; enterocolitis, dysbacteriosis, hypochromic anemia, perinatal encephalopathy. Child at risk by

0 toxemia of the second half of pregnancy: mother nephropati, threatened miscarriage. Treated for a long time at home. The state at admission of average body weight: reduced appetite, low-grade fever, body weight

5 does not dial, periodically spit up, the chair is diluted up to 6 times a day, hypochromic anemia, moderate leukocytosis. Started a comprehensive treatment. The traditional therapy of dysbacteriosis immediately included enterosorbc-and SUMS-1 with carbenicillin at a dose of 35 mg / cm in the amount of 0.5 ml of suspension per kg 3 times a day. Previously, the child was given several courses of antibiotic therapy, in connection with which

5 dose of antibiotic on the sorbent is taken as minimal. On the third day, positive dynamics was observed in the state: the girl's appetite improved, the mushroom stool 3-4 times a day, a gradual increase in

0 body weight. In the analysis of the contents of the intestine, the growth of Staphylococcus aureus, infection of other body media was not detected. A week later, the course of enterosorption was completed; control bacanza 5 leases were taken: the growth of pathogenic flora in the intestine was not found. Continued treatment with biologics and enzymes. Discharged with recovery.

Example 3. Boy V., 25 days old, was admitted to the surgical department of newborns with a diagnosis of umbilical sepsis, a septic form, phlegmy omphalitis, enterocolitis with dysbacteriosis, post-gyno cardiopathy, hypochromic anemia, ARVI, DN II stage. The admission condition is very heavy. A child at risk of hypoxia. Weight 2600. Sucks into lo, spits up, stools accelerated up to 7 times a day with pathological impurities, intestinal pararez II, dyspnea to 60 per minute, low-grade fever. Upon receipt, clinical, biochemical, and bacteriological analyzes of body fluids are taken. Started complex therapy of umbilical sepsis and local treatment of omphalitis. Regarding gastroenterocolitis, traditional therapy has been prescribed. In the bacteriological analysis of mother's milk - the growth of pathogenic white staphylococcus, in the contents of the intestine - Staphylococcus aureus, f suppressed the enzymatic activity of the Chick Sticks, the amount of bifidoflbry is reduced. After 3 days of treatment, the baby's condition improved somewhat. The purulent process in the umbilical region was stopped, but the intestinal syndrome persisted, which was indicated for the purpose of administering SUMS-1 sorbent with 80 mg / cm3 of sorbent on its surface to the complex of the traditional enterocolitis therapy. Sorbent assigned 1.5 cm3 in suspension

5 vaseline oil 4 times a day 40 minutes before meals. Course 7 days. The first portion of the antibiotic sorbent was evacuated from the intestine after 4 hours. The following days, the intestinal syndrome was arrested. From the 5th day of treatment, the child actively sucks the lactic acid mixture, does not regurgitate, and began to gain weight. Control analyzes and examination of the contents of the intestine for dysbacteriosis: flora was not found. Saprophytic flora

Claims (1)

5, is close in composition to the age norm. There are no new inflammatory foci. After 3 weeks, the child was discharged home after recovery, weighing 3270. The formula of the invention 0 A method of treating enterocolitis in sepsis in children of the first three months of life by administering a complex of drugs, including carbenicillin, characterized in that In order to shorten the treatment time, carbanicillin is administered orally in the form of 35-80 mg / ml sorbent applied to the SUMS-1 sorbent.