Pavliuk S. Microbiological substantiation of expediency of combined use of decamethoxine and fluoroquinolones for prevention of postoperative infectious complications in ophthalmology

The dissertation is devoted to the microbiological substantiation of approaches to increase the effectiveness of prevention and treatment of infectious complications after ophthalmic surgery by meens the combined use of modern antiseptic drugs based on decamethoxine (DCM) and fluoroquinolones. Among the examined 120 patients there was detected the incidence of eye mucosa colonization by opportunistic pathogens (55 %). In the research of antimicrobial susceptibility to antibacterial drugs and antiseptics of clinical and reference strains of staphylococci, the causative agents of infectious and inflammatory complications of ophthalmic surgery there were received the data of rapid development of antibiotic resistance among clinical strains of opportunistic pathogens. High antimicrobial activity of antiseptic drugs based on cationic surfactants decamethoxine (DCM) against opportunistic bacteria was proved. The presence of subbacteriostatic values of DCM to induce 5.7 - 9.2 times higher sensitivity in the resistant and moderately resistant strains of S. aureus to fluoroquinolones has been proved. The slow rate of formation of resistance of Staphylococcus to antiseptics from the group of cationic surfactants was found. The results of the experimental study proved the absence of toxic effects of the antiseptic ophthalmodec on the tissues of the eye and parenchymal organs of animals when applied topically. In the clinical research there was found that in half of the patients the signs of local inflammatory process in the eye after surgery were associated with the presence of staphylococci. Combined use of levofloxacin with DCM-containing antiseptic ophthalmodec by four instillations every 15 - 20 minutes perioperatively contributed to rapid regression of clinical signs of inflammation and duration of treatment. For the first time, the ability of DCM to reduce the negative metabolic effect on the qualitative assay of tears has been proven.