In order to assess the forecast of the effectiveness of antimicrobial therapy, phenotypic predictors characterizing the seriousness of the inflammatory process and the level of beta-lactamase activity (BLA) of blood serum were studied in 55 patients with exacerbation of chronic obstructive pulmonary disease and 40 patients with hospital-acquired pneumonia. According to the results, it was found that the serum beta-lactamase activity level is determined by phenotypic and clinical variables: age over 60 years, severe respiratory pathology, fever over 380, peripheral blood leukocyte level over 10x109, C-reactive protein over 40 mg/L and saturation less than 93%, correlating with an increase in UAV levels, and are predictors of low efficacy of treatment with beta-lactam antibiotics. A direct correlation was revealed between the level of serum beta-lactamase activity and the duration of antimicrobial therapy during the year (r=+0.86, p=0.001), the number of antimicrobial drugs prescribed simultaneously (r=+0.69, p=0.001), the fact of receiving beta-lactam reserve antibiotics – cefepime, imipenem, meropenem (r=+0.71, p=0.001), the fact of prescribing reserve antibiotics not related to the beta-lactam series – rifampicin, azithromycin, vancomycin, linezolid, levofloxacin (r=+0.59, p=0.001). Predicting the effectiveness of successful treatment with antibacterial drugs of the first-line beta-lactam group in the framework of evidence-based medicine, the need to determine the level of beta-lactamase activity of biological substrates is justified. Assessment of the level of beta-lactamase activity before the start of antibiotic therapy will reduce the unjustified use of beta-lactam antibiotics by up to 30%.
| Mualliflar | Мухсинов Фарход Мунисович, Ливерко Ирина Владимировна |
|---|---|
| Jurnal | Journal of cardiorespiratory research/Kardiorespirator tadqiqotlar jurnali |
| Nashr sanasi | 2022-10-07 |
| Jild | 3 |
| Son | 3 |
| Til | Rus |
бета-лактамазная активность, эффективность антимикробной терапии, бета-лактамные антибиотики, предикторы неэффективности, прогноз антибактериальной терапии, beta-lactamase activity, effectiveness of antimicrobial therapy, beta-lactam antibiotics, predictors of inefficiency, prognosis of antibacterial therapy, beta-laktamaz faolligi, antimikrob terapiyaning samaradorligi, beta-laktam antibiotiklari, samarasizlik belgilari, antibakterial terapiya prognozi.
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