Mishchenko D. Optimisation of diagnosis of septic complication and antibiotic administration in intensive therapy of acute pancreatitis

The thesis is devoted to improving of diagnostic methods for septic complications and optimization of antibiotic administration for the prevention of infectious complications in patients with severe acute pancreatitis. The thesis is based on analysis of treatment 74 patients with severe acute pancreatitis. The optimal semiquantitative concentrations of procalcitonin (PCT ®-Q test) for diagnosis of infected pancreatic necrosis and sepsis were defined. At threshold of PCTmore than 10 ng/ml the sensitivity and specificity for severe infection complications were 88% and 94%, accordingly. It was shown, that early massive infusion therapy, as a part of infection prevention measures, allows in 8% of cases to refuse antibiotic administration. It was shown that the administration of carbapenems for starting antibacterial therapy reduces the rate of septic complication and as a result, improves late survival.