A New Concept of Enhancing the Efficacy of Antimicrobial Therapy of Pyo-Inflammatory Diseases in Children

Pyo-inflammatory diseases are quite common among various surgical diseases in children. Etiotropic antimicrobial therapy of these conditions is of primary importance. Modern pathogenic bacteria possess a high degree of drug resistance to antimicrobials, which significantly reduces the effectiveness of treatment and contributes to the spread of infection and the development of pyo-inflammatory complications. The objective of the research was to study peculiar properties of virulence factors production by S. aureus within 24 hours as well as to determine on this basis the directions of improving the efficiency of antimicrobial therapy of pyo-inflammatory diseases in children. Materials and methods. There were conducted in vitro experimental microbiological studies concerning the study of the daily dynamics of virulence factors of causative agents of purulent-inflammatory diseases in children. The materials for the study were as follows: wound tissues, purulent exudate, dressings and suture material, catheters and drainage elements. Results. Microbiological studies revealed that drug resistance of pathogenic microorganisms originates from the production of various factors of bacterial aggression including the formation of biofilms. The study showed that the level of production of virulence factors and the sensitivity of S. aureus to antimicrobial agents were not constant over the day. Recorded peaks of increasing adhesive activity, teichoic acids content, production of planktonic cells and formation of dense biofilms by S. aureus depended on the time of administration of antimicrobials and maximum concentration of the medication in an organism. Conclusions. The regularity observed allowed us to develop a new concept to increase the efficiency of treatment of pyo-inflammatory diseases in children by means of change in the time for administration of antimicrobial agents during the day so that the period of maximum action would coincide with periods of minimal drug resistance of pathogens. This will allow us to significantly improve the effectiveness of antimicrobial therapy without increasing doses of medications that are administered.