Efficiency of Early Use of Lymphotropic Antibacterial Therapy in Patients With Acute Pancreatitis

Acute pancreatitis (AP) is an urgent surgical disease. In the etiology and pathogenesis of acute pancreatitis, several external and internal factors contribute to the contamination of micro- and macronecrosis with acute intestinal microflora, the formation of infected acute pancreatitis (IAP), and multiple organ failure (MOF). Lethality is in the range of 7–15 – 40–70 %. One of the ways to optimize treatment is antibiotic therapy along with improving medication routes of administration. Aim. To compare the effectiveness of antibiotic therapy with different medication routes of administration, studying the degree of intoxication on the background of changes in the proteolytic system. Materials and methods. The influence of standard and lymphotropic antibiotic therapy on the clinical course and dynamics of intoxication syndromes on the background of changes in the parameters of the proteolytic system was studied. Results and discussion. During early hospitalization (up to 24 h), the level of neutrophil elastase (NE) decreased on the 5th day under the influence of lymphotropic therapy by 154,2 nmol/min, and during late hospitalization (after 24 h) with the same therapy – by 126,2 nmol/min, while with standard antibacterial therapy in the first subgroup, the reduction occurred by 85,8 nmol/min, and in the second subgroup by 89,8 nmol/min. In accordance with changes in NE, there was a synchronous decrease in intoxication indicators. Conclusions. The intensity of inflammatory changes in the pancreas depends on the duration of the process. With lymphotropic therapy, the better dynamics of NE indicators exceed those of standard antibacterial therapy.