Volume 03 Issue 05-2023
84
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
:
84-89
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The successes of modern medicine in the field of pediatric surgery are beyond doubt. Despite this, the incidence of
destructive pneumonia in children does not tend to decrease and remains one of the causes of child mortality. All this
necessitates a more thorough study of the etiopathogenesis and clinic of this pathology.
KEYWORDS
Acute bacterial destructive pneumonia, empirical therapy, thoracocentesis.
INTRODUCTION
Acute bacterial destructive pneumonia (ABDP) in
children has been and remains one of the most severe
diseases of childhood, causing serious damage to the
health of the child [2,11,19]. ABDP are severe
pathological conditions characterized by inflammatory
infiltration and subsequent purulent or putrefactive
decay
(destruction)
of
the
lung
tissue
[1,3,12,18,19,20,21]. Depending on the state of the
patient's div's defenses, the pathogenicity of the
microflora, the ratio of damaging and regenerative
processes in the lungs, either the delimitation of
necrotic areas occurs, or the progressive spread of
purulent-putrefactive fusion of the lung tissue
[4,7,13,16,22,24,26].
Research Article
EMPIRICAL ANTIBACTERIAL THERAPY FOR ACUTE BACTERIAL
DESTRUCTIVE PNEUMONIA IN CHILDREN
Submission Date:
May 20, 2023,
Accepted Date:
May 25, 2023,
Published Date:
May 30, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue05-12
Raupov F.S.
Bukhara State Medical Institute, Bukhara, Uzbekistan
Shavkatov Sh.Kh.
Bukhara State Medical Institute, Bukhara, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 05-2023
85
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
:
84-89
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
In the etiology of ABDP, the main role is played by gram
positive and gram negative flora, in addition, in most
cases a viral infection is identified, which, according to
some authors, is a factor against which the respiratory
tract is damaged with the development of severe
damage to the lung tissue [5,8,14 ,15,25]. Behindthe last
decade there has been a gradual displacement of
staphylococcus from etiological agents due to a wide
range of gram-negative flora (1,5,14,23).To date, the
issue of early detection of ABDP pathogens has not
been resolved, which does not allow the initiation of
targeted and immediate antibiotic therapy. Treatment
of patients with ADBP is carried out in a complex
manner using surgical and medical methods aimed at
reorganizing the focus, stopping the intoxication
syndrome and activating the div's anti-infective
resistance (8,10,13). To date, the issue of early
detection of ODBP pathogens in the first hours of the
patient's admission to the hospital has not been
resolved, which does not allow for immediate and
targeted effective antibiotic therapy (4,6,7,15). Despite
all of the above ongoing treatment, morbidity and
mortality from this pathology does not tend to
decrease.All this indicates the presence of unresolved
and controversial issues in relation to the diagnosis and
treatment of ABDP in children, which indicate the need
for further study of this pathology and improvement of
the treatment method [6,12,17].
Target.Analysis of the results of empirical, initial
therapy for acute bacterial destructive pneumonia in
children.
MATERIAL AND METHODS
We analyzed the results of the treatment of ABDP in 74
children aged from 1 month to 14 years, who were
treated at the pediatric surgery clinic of the Bukhara
State Medical Institute, for the period 2020-2022. When
analyzing patients admitted to the hospital, the
pulmonary form was found in 25 (34%) cases, the
pulmonary-pleural form was found in 49 (66%)
patients. Of these, 42 (57%) patients underwent
surgical intervention in the form of thoracentesis and
the imposition of passive drainage according to the
Bulau method, thoracotomy was performed in 3 (4%)
patients, the remaining 29 (39%) patients were treated
with a puncture method.When studying the etiological
structure of ABDP obtained with a tank. sowing, we
used two indicators: the frequency of detection of the
pathogen from among all examined and from among
the positive results of the tank of sowing.Analysis of
the results of bacteriological studies of purulent
contents in 39 patients showed that more than half of
the cases - 21 (54%) the causative agent of the purulent
process was St.aureus, in other cases the following
results were obtained: E. coli - 6 (15%), Ps.aeroginoza -
4
(10%),
St.epidermidis
-
2
(5%),Marked
associationmicroorganisms,
more
often
staphylococcus with Pseudomonas aeruginosa and
Volume 03 Issue 05-2023
86
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
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84-89
SJIF
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FACTOR
(2021:
5.
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(2022:
5.
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)
(2023:
6.
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)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Escherichia coli
–
(8%) and the result of “no growth”
was registered in 3 (8%) cases.
Considering that antibiotic therapy is urgent, it would
be rational to prescribe antibiotics targeted, taking
into account the pathogen and its sensitivity to
antibiotics.Due to the low frequency of registration of
pathogens and the duration of the study, traditional
methods of bacteriological study of the focus of
destruction do not allow the initiation of targeted,
timely antibiotic therapy. In addition, it is often
impossible to obtain material for a tank. sowing from
the focus of the pathological process (inflammatory
infiltrate,
pneumothorax,
bullae,
fibrinous
pleurisy).However, the determination of the causative
agent of the disease at the initial stages of the disease
is not realistic, therefore, at the initial stages, we
prescribed antibiotics based on the staphylococcal
etiology of the disease, or gram-negative, less often
mixed. Antistaphylococcal antibiotics and broad-
spectrum antibiotics, 3rd or 4th generation
cephalosporins (ceftriaxone, rocephin, etc.) in
combination with amnoglycosides, were used to treat
OBDL, which clinically in most cases gave a positive
result from the first days of treatment. As the results
of bacteriological studies were obtained, antibiotics
were prescribed taking into account the sensitivity of
the isolated pathogens of the pathological process.
Reducing intoxication, normalizing temperature,
appetite, reducing the amount of content from the
drainage tube and during puncture, improving
breathing,
CONCLUSION
1. The etiology of ABDP is most often bacterial in nature
and is caused by a wide range of pathogens, among
which staphylococcus aureus is the leader.
2. The outcome of ABDP largely depends on early
diagnosis and initial, empirical antibiotic therapy and
the subsequent prescription of antibiotics, taking into
account the sensitivity of the isolated pathogens of the
pathological process.
3. There is a needto the search for alternative
approaches to determining the etiology of the ABDP
pathogen that are not related to obtaining material
from the lesion and traditional cultivation of bacteria.
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