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https://doi.org/10.14300/mnnc.2020.15115

Effect of microbial landscape on the character of antibacterial therapy in newborns with necrotizing enterocolitis

[Pediatrics]
Izabella Mikhailovna Veshkurtseva; Mikhail Aksel’rov; Sergey Minaev; Svetlana Suprunec; Viktoria Emel’janova; Svetlana N. Gordiychuk,; Tatiana Sergienko; Alexander Leonidovich Barinov; Evgeniy Kolesnikov;

A clinical and microbiological assessment of the treatment of 67 newborns operated on for progressive necrotizing enterocolitis (NEC) was carried out. Taking into account the results obtained, initial antibiotic therapy (ABT) was corrected, including meropenem and vancomycin (70.7 %): vancomycin was replaced with linezolid, and meropenem – with ceftazidime/cefepime. Ciprofloxacin (9.8 %) was used to identify resistant Gr– microflora. When the non-fermenting microorganism S. maltophilia was inoculated, co-trimoxazole (6.4 %) was prescribed, if Candida non-albicans fungi were found, micafungin or amphotericin (8.0 %) was prescribed. The average number of ABT regimens in children with stage 3 NEC was 3.35±0.31. Thus, the use of a differentiated approach to NEC therapy, taking into account the data of a microbiological study, made it possible to reduce the mortality of patients to 39.3±6.57 %.

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Keywords: infants, necrotizing enterocolitis, microbiological research, antibacterial therapy