Антибактеріальна терапія аутоінфекційних стоматитів при мікст-інфекції

Abstract

Мікст-інфекції, в порівнянні з моноінфекціями, складніше виявити та лікувати. В дослідженні брали участь 48 хворих із різними проявами аутоінфекційних уражень слизової оболонки порожнини рота. Авторами проведено комбіноване застосування офлоксацину та орнідазолу при ураженнях слизової оболонки порожнини рота мікст-інфекціями. При довготривалих запальних станах таке поєднання антибак- теріальних препаратів є найбільш оптимальним, що підтверджується результатами мікробіологічного дослідження в динаміці лікування хворих; Микст-инфекцию, в сравнении с моноинфекцией, сложнее выявлять и лечить. В исследовании принимали участие 48 пациентов з разными проявлениями аутоинфекционных поражений слизистой оболочки полости рта. Авторами проведено комбинированное применение офлоксацина и орнидазола при поражении слизистой оболочки полости рта микст-инфекцией. При длительно протекающих воспалительных процессах такая комбинация антибактериальных препаратов является наиболее оптимальной, что подтверждается результатами микробиологического исследования в динамике лечения пациентов; Before thirty different microorganisms are causal organisms of infections oral mucosa, which often have asymptomatic course. Complications of mixed infection can lead to severe conditions such as bacteremia and sepsis. In modern imagination, mixed infection is a pathological process caused by two or more microorganisms with unified pathogenesis. Herewith each agent’s infection contributes to the development of mixed infection pathogenesis. In this complex interaction new microbiocenosis is forming, in which the selection of persistent strains presences. The chronic process is a result of this interference. Mixed infection is more difficult in detect and treatment, than monoinfection. The correct choice of antimicrobial agents requires a doctor’s clinical thinking, which caused deep knowledge of microbiology, pharmacology and dentistry. The aim of our study was to investigate the application of modern antimicrobial medicaments in the treatment of mixed autoinfection stomatitis. Clinical-laboratory examination was conducted for 48 patients in the dynamics of treatment. Drugs for antibiotic therapy were elected on the principle of necessity and sufficiency. Ofloxacin is the drug, which has high activity against intracellular microorganisms and low toxicity. It is well tolerated by patients. This medicine belongs to fluoroquinolones group, the main advantage of which is the efficiency of bacterial infections that are resistant to other classes of antimicrobial chemicals. Ofloxacin well penetrate in target organs. There are some defects in the ofloxacin spectrum of activity. Thus, it is ineffective against anaerobes and simple organisms. That’s why we combined ofloxacin with ornidazole, which is nytroimidazols derivative. Combined therapy of this group of patients also includes enterosorbents, probiotics symbiotic, hyposensitization drugs and vitamins. For local therapy we used painkillers, non-steroidal anti-inflammatory and epithelizing medicaments. Treatment of experimental group was considered effective in achieving positive results in a clinical picture of the disease and microbiological examination six days after the start of doctor appointments. The best positive dynamics on the results of microbiological studies registered in 11 patients (78.5%) with acute ulcerative gingivitis/stomatitis and acute aphthous stomatitis. After six days of complex treatment microflora is completely normal. In the control group, we didn’t designate antibiotics per os, for our patients so their oral microflora staied almost the same. In all cases preserved mixed microflora of the oral cavity. Thus, the combined application of ofloxacin and ornidazole is the most optimal for the patients with oral mixed infections. It is necessary to extend the antibiotic therapy in the patients with long-term chronic autoinfection oral lesions. It is important to take consideration of the general state of the patients and the results of microbiological research in the dynamics of treatment.