ABSTRACT
We have performed a post-hoc analysis of the results of using antibacterial therapy in patients with pleural empyema. The cost-effectiveness analysis of rational and empiric antibacterial therapies was performed. The cost-effectiveness ratio for rational antibacterial therapy was lower than for empiric one (2889 and 4480 rubles for 1 treated patient correspondingly). The use of the rules of rational antibacterial therapy in practice leads to proved saving of economic costs.
Subject(s)
Anti-Bacterial Agents/economics , Anti-Bacterial Agents/therapeutic use , Empyema, Pleural/drug therapy , Empyema, Pleural/economics , Hospitals, Military , Military Personnel , Anti-Bacterial Agents/administration & dosage , Cost Savings , Cost-Benefit Analysis , Dose-Response Relationship, Drug , Drug Therapy, Combination , Health Care Costs , Humans , Retrospective Studies , Russia , Treatment OutcomeABSTRACT
AIM: Clinical-microbiological description of the first case in Russia of isolation of S. algae bacteria from clinical material. MATERIALS AND METHODS: Patient P., 23 years of age, diagnosis: right-sided distal pneumonia, severe course; parapneumonic empyema of pleura. Bacteria isolation, cultural and biochemical tests differentiating S. algae and Shewanella putrefaciens were performed according to Holt H.M. et al., 2005. Identification of bacteria, tests of sensitivity to antibiotics were carried out by automatic system Vitek 2 (bioMerieux) and additionally by disc-diffusion method. RESULTS: S. algae in association with Serratia marcescens were isolated from pleural exudate of the patient with pneumonia. S. algae bacteria had typical taxonomical features and pathogenicity factors (lipase, gelatinase, beta-hemolysin); were resistant to benzylpenicillin, amoxicillin, cefazolin and sensitive to other beta-lactam antibiotics, aminoglycosides, fluoroquinolones, macrolides, tetracycline. CONCLUSION: S. algae bacteria isolated from pleural exudate of the patient with pneumonia are etiologically significant in parapneumonic empyema of pleura.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Serratia marcescens/isolation & purification , Shewanella/isolation & purification , Bacterial Typing Techniques , Drug Resistance, Multiple, Bacterial , Empyema/complications , Empyema/drug therapy , Empyema/microbiology , Gram-Negative Bacterial Infections/complications , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Microbial Sensitivity Tests , Pleura/drug effects , Pleura/microbiology , Pleural Effusion/microbiology , Pneumonia, Bacterial/complications , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/microbiology , Serratia marcescens/drug effects , Serratia marcescens/growth & development , Shewanella/drug effects , Shewanella/growth & development , Young AdultABSTRACT
An analysis of results and treatment outcomes of 178 patients has been made. The patients were examined 1, 3, 6, 12, 24 months after discharge from hospital. The parameters characterizing residual cavities, pneumofibrosis, pleural fibrosis and changes in the bronchial tree were analyzed. Recovery was noted in 172 patients (96.63%). According to CT scan data positive dynamics in the reparative processes in the lungs and pleural cavity could be seen. No relapses of the purulent processes and development of lung cirrhosis were noted.