Approaches to the management of surgical patients with antibiotic-associated mild diarrhea

Abstract

The paper highlights the issues of antibiotic-associated diarrhea (AAD) of mild severity in the treatment of surgical patients, its epidemiology, etiology, features of the clinical picture and approaches to therapy. The mild course of AAD includes diarrhea without signs of intoxication, leukocytosis and fever. Stool disorder in patients receiving antibiotics who are in a surgical hospital is an urgent medical problem, since this pathology prolongs the time of hospitalization, increases economic costs, reduces the quality of life and can even be the cause of the patient’s death. According to various authors, AAD develops in 40% of people receiving antibacterial therapy. A clinical example of the management of a patient with AAD and injury of the musculoskeletal system is considered in detail.The abolition of antibiotics is not a method of solving this problem, since the severity of the patient’s injuries requires further surgical treatment and prevention of purulent-septic complications. The key point in the treatment of mild AAD will be the appointment of probiotic drugs, which have an effect on the pathogenetic links of AAD. Probiotics are microorganisms that have been known since ancient times and are purposefully used for health improvement and longevity. One of the first probiotic drugs used before the era of the discovery of antibiotics can be considered Mechnikov curdled milk with unique medicinal properties. Prescribing probiotic therapy from the first day of taking antibiotics, without waiting for the results of laboratory examination, will significantly reduce the prevalence of clinical manifestations of both clostridial diarrhea and idiopathic AAD.