PRE-AUTHORIZATION OF ANTIBACTERIAL DRUGS IN THE TREATMENT OF CHILDREN WITH ACUTE PERIANAL ABSCESS

Abstract

Relevance. Acute perianal abscess mainly occurs in boys in the first year of life, but can occur in girls and in older age, often progressing to anal fistula. After surgery and drainage, it is advisable to administer antibiotics because antibiotic therapy reduces the risk of fistula. Objective is to evaluate the possibility of using antibacterial drugs, mainly Access and Watch groups with a narrow spectrum of action, in the treatment of children with perianal abscess. Materials and methods. A retrospective analysis of the results of treatment of 26 boys and 4 girls aged 3 months to 17 years. The study of biological material was performed by the culture method. Species identification of microorganisms was performed on automatic microbiological analyzers Vitek2Compact (bioMerieux) and VitekMS (bioMerieux). All children underwent surgical removal of the crypt and drainage of the abscess. Antibacterial therapy was prescribed for a period of 3 to 12 days, depending on the course of the disease and the results of microbiological monitoring. Results. A total of 48 prescriptions of antibacterial agents were made, of which 33 (68.7%) were antibacterial agents from the Access group. 16 children were treated only with Access group antibacterial drugs. Of these, 14 children, mostly in the first year of life, received only narrow-spectrum antibacterial agents (amikacin in monotherapy or in combination with metronidazole, clindamycin). In the scheme of treatment of children 14 children, mostly older people included a drug from the group of cephalosporins of the third generation. Half of these patients also received amikacin and 3 received metronidazole. Conclusions. Children with acute perianal abscess in the first year of life should be treated as mono- or combination therapy with narrow-spectrum drugs from the Access group, while older children - with the inclusion of a combination of antimicrobial drugs broad-spectrum drugs Watch group.