APPLICATION OF ANTIBIOTICS AND PROBIOTICS FOR PREVENTION OF ANTIBIOTIC-ASSOCIATED DISBIOSIS IN PATIENTS WITH GENERALIZED PERITONITIS AND ENTERAL DYSFUNCTION SUPPORTS STAFF AWARENESS

Abstract

OBJECTIVE: The aim: To clarify the efficacy of probiotics use as a preventive measure for post-antibiotic treatment in acute peritonitis and increase staff awareness related to antibiotic and probiotic use. PATIENTS AND METHODS: Materials and methods: The study design included determination of the proper antibiotic and probiotic strain combination and clinical application of probiotic strains. The control group consisted of 63 (48.46%) patients who underwent traditional multimodal treatment of peritonitis and the study group of 67 (51.54%) individuals, with inclusion of different antibiotic/probiotic combinations. RESULTS: Results: Prior to antimicrobial therapy 67.7% patients of both groups' patients had severe dysbiosis, proving dysbiosis as a sign of peritonitis. S. boulardii showed widest resistance spectrum and was used for probiotic therapy in study group. Intestinal dysbiosis grades distribution in control group significantly worsened, while in study group ratio of severe dysbiosis significantly dropped from 58.2% to 38.8% with significant growth of grade II dysbiosis to 61.2%. No visible differences in disease course and clinical picture, duration or complications rate between study and control groups were observed. CONCLUSION: Conclusions: Most of probiotic strains lack antibacterial resistance that makes meaningless their use during systemic antibiotic therapy of acute peritonitis. It is characterized by harsh changes of intestinal microbiota (severe intestinal dysbiosis). While probiotic strains showed antibiotic tolerance, their use presented no significant clinical efficacy, though high level of positive influence on intestinal dysbiosis was observed.