Optimization of starting empirical antibacterial therapy in patients with HIV infection – specialized hospital patients

Abstract

Objective: to analyze the adequacy of the scheme of empirical antibiotic therapy in patients with complicated forms of HIV infection in a specialized hospital and propose a set of measures for its optimization.Materials and methods: Clinical and demographic characteristics, results of bacteriological studies, risk factors of infection with resistant and multiresistant pathogens were studied in patients with HIV infection at the stage of progression with infectious complications of bacterial etiology, and the adequacy of empirical antibiotic therapy was evaluated. Results: The analysis of bacterial infectious complications in 21 HIV-infected patients with advanced stages of the disease was carried out. It was established that the profiles of the starting ABT only in 47% of cases coincide with the results of the antibiogram. To increase the effectiveness of empirical antibacterial therapy, stratification of risk groups for the detection of multiresistant bacterial pathogens has been developed. The basis of stratification: the severity of immunodeficiency, the presence of previously conducted antibacterial therapy, the period and place of detection of infectious complications, the localization of the infectious process.Conclusion: the use in clinical practice of a differentiated approach to the appointment of antibacterial drugs for starting empirical therapy in patients with HIV infection can improve the quality of treatment of infectious complications in patients with immunosuppression.