DOI: https://doi.org/10.22141/2224-0586.16.1.2020.196929

Clinical experience with Imibacid in burn injury

G.I. Oleinyk, A.V. Korshunov

Abstract


According to various authors, the microflora of burn wounds is represented, as a rule, by associations of opportunistic Gram-positive and Gram-negative microorganisms. The associations of methicillin-resistant staphylococci and beta-lactamase-producing strains of Pseudomonas aeruginosa with enterococci, protea, Escherichia coli, fungi, and acinetobacter are most common. The main causative agents of burn infection are currently Staphylococcus aureus and Pseudomonas aeruginosa. The most dangerous are hospital strains of microorganisms that have a high degree of resistance to antimicrobial agents. In addition to the immediate threat to the patient’s life, an existing infection significantly slows down the epithelization of burn wounds, including hindering timely surgical treatment to restore the skin, and also leads to the formation of hypertrophic scars and keloids. Infection of burn wounds with prolonged existence can be complicated by generalization, the development of sepsis, leads to a systemic inflammatory response, which can result in multiple organ failure and death. Systemic antibiotic therapy along with such methods as treatment in an abacterial environment, timely surgical treatment or excision of a burn wound, immunotherapy and immunoprophylaxis, enteral and parenteral nutrition, and many others, is an important method for the control of burn wound infection and infectious complications of burn disease. An increase in the number of multiresistant strains of microorganisms sown from burn wounds, mainly P.aeruginosa and S.aureus strains, which are highly resistant to most antimicrobials used today, necessitates the application of new effective antibacterial drugs to fight burn infection. In recent years, one of the leading places in systemic antibacterial chemotherapy for various infections belong to carbapenems, which have a wide spectrum of antimicrobial action, high degree of antimicrobial activity, good bioavailability, the ability to accumulate in various organs and tissues and create high concentrations in patients’ blood that exceed the minimal inhibitory concentration for most burn pathogens. Thus, the above data indicate that at the present stage in severe infections, it is fundamentally important to prescribe an adequate regime of antibacterial therapy already at the first stage of treatment. The presented work summarizes the small experience of using Imibacid in comprehensive therapy of patients with burns. The results of examination and treatment of 16 individuals with burns (3 women and 13 men) aged 17 to 79 years (average age of 37.9 ± 4.0 years) were analyzed, in 6 of them skin burns were combined with thermo-inhalation damage to the respiratory tract. The total lesion area in patients of the study group ranged from 3 to 70 % of the body surface, while the area of deep burns degrees IIIB–IV was from 1 to 40 % of the body surface, 4 people had extensive superficial and borderline infected burns. Clinical and laboratory observations have shown that Imibacid is effective in the treatment and prevention of infectious complications in patients with burns and at a dose of 500/500 mg every 12 hours is indicated as a therapeutic agent for the initial and mild inflammatory process in the wound, as well as for the prevention of the development of infectious complications for 3–5 days. The use of the drug during the period of burn shock and burn toxemia makes it possible to control the development of infectious complications in wounds and prepare patients for early surgical treatment faster. This is also confirmed by cytological studies of imprint smears from wounds during treatment: a more favorable effect on reparative processes and the morphological (cellular) composition of burn wounds is noted compared with conventional therapy.

Keywords


burn injury; nosocomial infection; Imibacid

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