RATIONAL USE OF ANTIBIOTICS IN ACUTE INTESTINAL INFECTIONS

Abstract

Background. The irrational use of antibacterial drugs (AB) in the treatment of acute intestinal infections (AII) leads to increased bacterial resistance. Objective. To evaluate the appropriateness of prescribing antibiotics and their efficacy as initial therapy for AII. Material and Methods. We conducted a retrospective analysis of 171 medical records of patients diagnosed with AII of bacterial and viral-bacterial etiology, confirmed by the detection of the pathogen in stool and admitted to the Grodno Regional Infectious Diseases Clinical Hospital in 2023-2024. The patients were divided into the following groups: Group 1 – 121 patients in whom the identified AII pathogen was sensitive to the prescribed AB; Group 2 – 18 patients in whom the microorganism showed resistance to the prescribed AB; Group 3 – 11 patients with no antibiotic susceptibility testing performed; Group 4 – 21 patients who did not receive antibacterial therapy. Results. Among the 171 isolates from patients with AII, enterobacteria, particularly Salmonella (p<0.05), predominated (p<0.05). The majority of AII patients (150/87.7%) received antibacterial therapy. Of the 171 isolates, 16 (9.3%) were
multidrug-resistant based on antibiotic susceptibility testing. Salmonella demonstrated moderate resistance to the prescribed antibiotics (9/10.5%). Of the total number of microorganisms, 13.2% were resistant to ciprofloxacin, and 12.1% to ceftriaxone. Conclusion. A resistance rate exceeding 10% is a warning sign that may indicate an increasing trend. The choice of empirical antibacterial therapy for acute intestinal infections should be based on the assessment of the disease severity, its manifestations (invasive diarrhea), the patient's age as well as coprogram and antibiotic susceptibility testing findings.