CHOICE OF ANTISEPTICS FOR LOCAL SANITATION OF LIVER ABSCESSES

Antiseptic sanitation of liver abscess cavity in postoperative period leads to fast suppression of bacterial activity, liquidation of microorganisms in purulent focus and more rapid recovery of the patient. Aim. To investigate and compare the local antisep-tics for complex treatment of patients with liver abscesses. Materials and methods. A comparative study was performed to investigate antimicrobial efficacy for next antiseptics: Decametoxin 0,02%, Povidone-iodine 10%, Dioxydine 1%, Octenidin 0,1%. 60 patients with liver ab-scesses were included into the study. They were divided into 4 groups of 15 patients each, according to the use of antiseptic. Antimicrobial activity was assessed according to the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBcC) in μg/ml of the main antiseptic active ingredient. Antimicrobial efficacy was determined by the index of antiseptic activity (IAA). Results. The greatest sensitivity to Decametoxin 0.02% was determined in the bacteria of the genera Staphylo-coccus and Enterococcus. Dioxydine showed significantly lower sensitivity to these microorganisms. Thus, even the bacteriostatic concentrations of Dioxydine against Staphylo-coccus were 56 times greater than those of Decametoxin, and Enterococcus 47.2 times (p<0.05). The bacteriostatic effect on Escherichia coli was determined in the presence of 8.92 μg/ml Decametoxin and 10.42 μg/ml Octenidin. For Klebsiella spp. MIC wаs 11.31 and 18.87 μg/ml, respectively. According to the results of the Staphylococci and Enterococci sensitivity, Dioxydine showed lower effectiveness to Decametoxin (p<0.05) and Octenidin (p<0.001). Povidone-iodine had significantly less efficacy against Staphylococcus than Octenidin (p<0.001) and Decametoxin (p<0.05). Povidone-iodine was found as less effective to Enterococus than Octe-nidin and Decametoxin (p<0.001). Pseudomonas aeruginosa has a natural resistance to a number of antimicrobial agents and it was significantly more resistant to the influence of antiseptics. However, it was found that Octenidin, Decame-toxin and Povidone-iodine possessed by a sufficient bacterio-static effect on Pseudomonas aeruginosa. The bacteriostatic effect of Dioxydine on Pseudomonas aeruginosa was in 3.7 times lower than the same Octenidin effect, and in 3.2 times lower than the same Decametoxin effect (p<0.05). Applying Decametoxin on the third postoperative day, Enterococci and Gram-negative microorganisms (Pseudomonas aeruginosa and Proteus) were isolated from the patients, and after seven days of treatment, only Pseudomonas aeruginosa and Proteus vulgaris were detected in single cases. Discussion. The carried out researches became the theoretical justification of expediency of antiseptic application in complex therapy of patients with liver abscesses. Finally, all investigated solutions for local sanitation of purulent cavities are considered as effective. High antimicrobial activity against Staphylococcus, Enterococus, Escherichia coli, Klebsiella spp. was found in Decametoxin and Octenidin. The microorganisms exhibited a lower sensitivity to Dioxydine and Povidone-iodine. Conclusions. Decametoxin 0.02% showed the highest efficiency for local sanitation of liver abscesses in comparison with other local antiseptics based on Octenidin, Dioxydine and Povidone-iodine.