Summary. Introduction. One of the most difficult problems in surgery today is the treatment of acute pancreatitis, which remains the third most frequent acute surgical disease. The frequency of the latter is growing every year. Despite the achievements of pharmacotherapy and infusion therapy, mortality in acute pancreatitis remains at the level of 15–45 %, and in the development of purulent complications it reaches 70–80 %. The urgency of the problem. The use of antibiotics for complicated pancreatic necrosis is obvious, but antibiotic therapy does not always lead to the desired result. Given this, the attitudes of surgeons to the use of antibiotics do not coincide, especially when it comes to their preventive use. The above determines the urgency of the problem. Purpose of work. To study the possibilities of new ways of supplying antibiotics to the pancreas in its acute inflammation. Materials and methods. We have studied the immediate results of the use of antibiotics in acute pancreatitis in the conditions of their introduction by the lymphotropic route. The examination of patients was performed according to generally accepted methods, including ultrasound at admission and on the 4th day of treatment. Results and discussion. During the first 4 days of treatment, the patient’s condition almost normalized: the pain in the first day was localized in the epigastrium, changing from cutting and «tearing» to dull; weakness, dry mouth disappeared and the temperature returned to normal. The number of leukocytes decreased from (10,5 ± 3,8)×109/l to (6,6 ± 2,4) × 109/l. The leukocyte index of intoxication according to Calf-Calif decreased by (2,63 ± 0,7) cu, ESR – normalized, the amount of blood amylase decreased on average from 500 cu. up to 50 cu. This was due to a decrease in the volume of the pancreas in the head, body, cauda by 6,4 – 3,9 – 7,0 mm, respectively. Conclusions. The lymphotropic route of administration of antibiotics to the inflamed pancreas contributed to its reduction, which was accompanied by an improvement in the indicators of the inflammatory process according to Calf-Caliph, a decrease in the number of leukocytes and ESR, reduced gland volume and elimination of pain and other signs of the disease by the 4th day.

Relevance of the problem: In respect that, lack dynamic of morbidity incidence of acute appendicitis and frequency of postoperative complications, against the backdrop of increasing the number of antibiotics. The problem of prevention of purulent-inflammatory complications during its surgical treatment remains relevant. Materials and methods: The authors compared the intensity of accumulation of ceftriaxone in the appendix tissues depending on the method of injection. Results: It turned out that with the intramuscular injection of ceftriaxone in 1–2 hours before the operation, its accumulation in appendix in an amount sufficient to delay the growth of the laboratory culture of Escherichia coli is not observed. After intravenous injection of the drug, accumulation occurs slowly, significantly far behind to the lymphotropic technique. With the lymphotropic injection of ceftriaxone, 1 hour before the operation, a dose of growth retardant culture test is already fixed, and with the intjection of 2 hours before the operation – the dose of ceftriaxone practically corresponds to the maximum possible, that is, the action of a “pure” antibacterial drug. Conclusions: The method of selecting antibiotic therapy for acute appendicitis is the introduction of ceftriaxone by lymphotropic route. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.268-273

The aim: To explore the possibilities of rationalizing antibacterial therapy by comparative analysis of the accumulation of ceftriaxone administered lymphotropically and intramuscularly. Materials and methods: The research used a method of studying the sensitivity of microorganisms to antibacterial drugs, which is based on the diffusion of antibacterial drugs from the carrier (homogenate of the test organ) in a dense nutrient medium, which, depending on the sensitivity of microorganisms, inhibits the growth of the studied culture and is accompanied by the formation of a growth inhibition zone (GIZ) in the nutrient medium. For control purposes, a commercial disk with ceftriaxone was used, which caused GIZ of microorganisms at the level of 27.05 ± 0.9 mm. Results: The homogenate of organ samples obtained from rabbits administered with the antibiotic lymphotropically, inhibited the growth of test cultures around the discs in all cases. The inhibition was slightly less than the control inoculation, but the result clearly indicated the presence of antibiotics in the test material in the quantity sufficient to inhibit the growth of the pathogen. Concurrently, after intramuscular administration of the antibiotic, biopsy specimens from various growth inhibition organs of test cultures were either not induced at all or were induced in small amounts, which was certainly insufficient for the inhibitory action of the drug administered by this method. Conclusions: The administration of the antibiotic lymphotropically promotes its accumulation in all organs in the quantity sufficient for antibacterial action, which allows us to recommend lymphotropic therapy as a rational method of antibiotic therapy.

Summary. Aim. The purpose of the work was to study the possibility of alternative antibacterial therapy by the type of lymphotropic targeted accumulative antibiotic therapy for injuries of the abdominal cavity. Materials and methods. To implement it, we studied in an experiment the accumulation of the antibiotic in the tissues of various organs of rabbits after its lymphotropic administration. Results of the research. The experiment proved, that lymphotropic antibiotic therapy, depending on the place of regional administration of the drug, contributes to the targeted accumulation of the antibiotic in the corresponding organ in an amount sufficient for a persistent antibacterial effect. Conclusions. The proposed method of administration of antibacterial drugs may be the most appropriate for injuries of the abdominal cavity and retroperitoneal space, as it significantly reduces the likelihood of purulent-septic complications and makes it possible to significantly reduce the length of stay of patients in the hospital, reduce the amount of financial costs and early return to socially useful work.

Summary. Traumatism around the world is taking on unmanageable proportions. Suffice it to say that every year on a global scale, several million people die from traffic accidents and industrial and domestic injuries. Some die from the actual damage, and most die from purulent-inflammatory complications. The urgency of the problem. Treatment of inflammatory complications requires significant funds for antibacterial drugs, but their more considerable amount is insufficient given the resistance of the microflora. Aim. To substantiate the expediency of antibacterial therapy and methods of its application. Materials and methods. Several experimental studies were conducted on rabbits to reveal the inhibitory effect of antibacterial drugs that enter the internal organs with various administration methods. Results and their discussion. It turned out that after intramuscular administration, ceftriaxone accumulates in the organs of the abdominal cavity in an insufficient amount to inhibit the growth of microflora. After intravenous administration, ceftriaxone gets in the appendix in 60 % of the control after 1 hour, and after 2 hours, it decreases to 30 %, which is not very effective. After lymphotropic administration, the antibiotic accumulates after 1 hour in an amount sufficient for antibacterial action (70 %) and after 2 hours — in 95 %, which is evidence of the targeting and accumulation of antibiotics with such administration of the drug. Conclusions. Taking into account the significant disruption of microcirculation in the impression zone, the «mileage» of the vascular bed, the aggregation of formed blood elements in microvessels, and the formation of microthrombi, the intravenous method of drug administration in traumatic disease cannot be considered optimal. This need is met by the lymphotropic way of delivering antibiotics to various organs of the abdominal and thoracic cavities.