Comparative analysis of ceftriaxone, cefotaxime and amikacin empirical use in secondary widespread peritonitis in the age aspect 

Sergey A. Markosyan, Doctor of medical sciences, associate professor, professor of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: markosyansa@mail.ru
Aleksey P. Vlasov, Doctor of medical sciences, professor, head of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: vap.61@yandex.ru
Stepan A. Charyshkin, Postgraduate student, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: stepansaranskiy@yandex.ru 

Background. A significant threat to the children health is posed by widespread forms of secondary peritonitis, which account for 16.8-42.88% of cases, and the postoperative complications frequency reaches 4%. The purpose of the study was to evaluate the empirical use effecacy of ceftriaxone, cefotaxime and amikacin in different age children with secondary widespread peritonitis. Materials and methods. In 63 children (44.4%) of different age groups with secondary widespread peritonitis, the dynamics of changes in inflammatory markers before surgery and in the early postoperative period were assessed, and a bacteriological examination of the abdominal cavity contents was carried out to identify the microflora sensitivity to ceftriaxone, cefotaxime and amikacin. Results. A conducted study of children with secondary widespread peritonitis demonstrated its highest incidence at an early age. The maximum content of inflammatory markers was determined before surgery and 1 day after surgery in all patients without exception. At the same time, at younger age groups of patients, the increase in these indicators occurred to a greater extent, and their normalization was slower, that indicated a more severe course of the purulent-inflammatory process in the abdominal cavity. Bacteriological examination of the abdominal cavity contents demonstrated the most common occurrence of E. coli (38%) both as a monovalent culture and in association with other pathogenic microorganisms. The most effective antibacterial drug was amikacin (88.2%). Ceftriaxone (79.4%) and cefotaxime (82.4%) showed less antimicrobial effect. The sensitivity lack of the microorganisms association to prescribed antibiotics was the reason for the abdominal abscesses development in 2 children in the postoperative period. Conclusion. Empirical antibacterial therapy plays an important role in the treatment of secondary widespread peritonitis. The use of amikacin as a starting antibiotic promotes the most effective effect on pathogenic microflora in secondary widespread peritonitis. 

children, age, secondary widespread peritonitis, pathogenic microflora, empirical antibacterial therapy 

Markosyan S.A., Vlasov A.P., Charyshkin S.A. Comparative analysis of ceftriaxone, cefotaxime and amikacin empirical use in secondary widespread peritonitis in the age aspect. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2024;(3):69–82. (In Russ.). doi: 10.21685/2072-3032-2024-3-6