PRE-AUTHORIZATION OF ANTIBACTERIAL DRUGS IN THE TREATMENT OF CHILDREN WITH ACUTE PERIANAL ABSCESS
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Keywords

acute perianal abscess, children, antibacterial therapy

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Khaitovych , M., Kysil , N., Temirova О., Holovnia , O., Turchak , D., & Polovynka , V. (2022). PRE-AUTHORIZATION OF ANTIBACTERIAL DRUGS IN THE TREATMENT OF CHILDREN WITH ACUTE PERIANAL ABSCESS. Medical Science of Ukraine (MSU), 18(2), 22-28. https://doi.org/10.32345/2664-4738.2.2022.04

Abstract

Relevance. Acute perianal abscess mainly occurs in boys in the first year of life, but can occur in girls and in older age, often progressing to anal fistula. After surgery and drainage, it is advisable to administer antibiotics because antibiotic therapy reduces the risk of fistula.

Objective is to evaluate the possibility of using antibacterial drugs, mainly Access and Watch groups with a narrow spectrum of action, in the treatment of children with perianal abscess.

Materials and methods. A retrospective analysis of the results of treatment of 26 boys and 4 girls aged 3 months to 17 years. The study of biological material was performed by the culture method. Species identification of microorganisms was performed on automatic microbiological analyzers Vitek2Compact (bioMerieux) and VitekMS (bioMerieux). All children underwent surgical removal of the crypt and drainage of the abscess. Antibacterial therapy was prescribed for a period of 3 to 12 days, depending on the course of the disease and the results of microbiological monitoring.

Results. A total of 48 prescriptions of antibacterial agents were made, of which 33 (68.7%) were antibacterial agents from the Access group. 16 children were treated only with Access group antibacterial drugs. Of these, 14 children, mostly in the first year of life, received only narrow-spectrum antibacterial agents (amikacin in monotherapy or in combination with metronidazole, clindamycin). In the scheme of treatment of children 14 children, mostly older people included a drug from the group of cephalosporins of the third generation. Half of these patients also received amikacin and 3 received metronidazole.

Conclusions. Children with acute perianal abscess in the first year of life should be treated as mono- or combination therapy with narrow-spectrum drugs from the Access group, while older children - with the inclusion of a combination of antimicrobial drugs broad-spectrum drugs Watch group.

https://doi.org/10.32345/2664-4738.2.2022.04
Article PDF (Українська)

References

Stites T, Lund DP. Common anorectal problems. Semin Pediatr Surg. 2007; 16(1):71-78. DOI: 10.1053/j.sempedsurg.2006.10.010.

View at:

Publisher Site: https://www.sciencedirect.com/science/article/abs/pii/S1055858606000850?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/17210486/

Rosen NG. Anorectal Abscess in Children. 2021.

View at:

Publisher Site: https://emedicine.medscape.com/article/935226-overview

Afşarlar CE, Karaman A, Tanır G, Karaman I, Yılmaz E, Erdoğan D, Maden HA, Cavuşoğlu YH, Ozgüner IF. Perianal abscess and fistula-in-ano in children: clinical characteristic, management and outcome. Pediatr Surg Int. 2011; 27(10):1063-8. DOI: 10.1007/s00383-011-2956-7.

View at:

Publisher Site: https://link.springer.com/article/10.1007/s00383-011-2956-7

PubMed: https://pubmed.ncbi.nlm.nih.gov/21785979/

Samuk I, Avinadav E, Barak U, Seguier E, Steiner Z, Freud E. Perianal abscess in infants: Amenable to conservative treatment in selected cases. Pediatr Int. 2019; 61(11):1146-1150. DOI: 10.1111/ped.13996.

View at:

Publisher Site: https://onlinelibrary.wiley.com/doi/10.1111/ped.13996

PubMed: https://pubmed.ncbi.nlm.nih.gov/31469939/

Lohsiriwat V. Anorectal emergencies. World J Gastroenterol. 2016 July 14; 22(26): 5867-5878. DOI: 10.3748/wjg.v22.i26.5867.

View at:

Publisher Site: https://www.wjgnet.com/1007-9327/full/v22/i26/5867.htm

PubMed: https://pubmed.ncbi.nlm.nih.gov/27468181/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948271/

Yamana T. Japanese Practice Guidelines for Anal Disorders II. Anal fistula. J Anus Rectum Colon. 2018; 2(3): 103-109. DOI: 10.23922/jarc.2018-009

View at:

Publisher Site: https://www.jstage.jst.go.jp/article/jarc/2/3/2_2018-009/_article

PubMed: https://pubmed.ncbi.nlm.nih.gov/31559351/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752149/

Bałaż K , Trypens A., Polnik D, Pankowska-Woźniak K, Kaliciński P. Perianal abscess and fistula-in-ano in children - evaluation of treatment efficacy. Is it possible to avoid recurrence? Pol Przegl Chir. 2020; 92(2):29-33. DOI: 10.5604/01.3001.0013.8158.

View at:

Publisher Site: https://ppch.pl/resources/html/article/details?id=198318&language=en

PubMed: https://pubmed.ncbi.nlm.nih.gov/32312918/

Mocanu V, Dang JT, Ladak F, Tian C, Wang H, Birch DW, Karmali S. Antibiotic use in the prevention of anal fistulas following incision and drainage of anorectal abscesses: a systematic review and meta-analysis. Am J Surg. 2019; 217(5):910-917. DOI: 10.1016/j.amjsurg.2019.01.015.

View at:

Publisher Site: https://www.americanjournalofsurgery.com/article/S0002-9610(18)31292-3/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/30773213/

Melander RJ, Zurawski DV, Melander C. Narrow-spectrum antibacterial agents. Medchemcomm. 2018; 9(1):12-21. DOI: 10.1039/C7MD00528H.

View at:

Publisher Site: https://pubs.rsc.org/en/content/articlelanding/2018/MD/C7MD00528H

PubMed: https://pubmed.ncbi.nlm.nih.gov/29527285/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839511/

Alm RA, Lahiri SD. Narrow-Spectrum Antibacterial Agents – Benefits and Challenges. Antibiotics. 2020; 9(7): 418. DOI:10.3390/antibiotics9070418.

View at:

Publisher Site: https://www.mdpi.com/2079-6382/9/7/418

PubMed: https://pubmed.ncbi.nlm.nih.gov/32708925/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400354/

2021 ‎AWaRe classification. WHO

View at:

Publisher Site: https://www.who.int/publications/i/item/2021-aware-classification

Jen S-P, Horng H, Swaminathan S, Cennimo D, Kapila R. Antimicrobial Restriction and Preauthorization: Easier Said Than Done? Open Forum Infectious Diseases. 2015; 2 (1): 1405. DOI: 10.1093/ OFID/OFV133.959

View at:

Publisher Site: https://academic.oup.com/ofid/article/2/suppl_1/1405/2635529

Order of the Ministry of Health of Ukraine dated 3.08.2021 №1614 «On the organization of infection prevention and infection control in health care institutions and institutions of social services / social protection». [in Ukrainian].

View at:

Publisher Site: https://phc.org.ua/sites/default/files/users/user92/%D0%BD%D0%B0%D0%BA%D0%B0%D0%B7.pdf

Nottingham JM, Rentea RM. Anal Fistulotomy. StatPearls [Internet]. 2021.

View at:

PubMed Central: https://www.ncbi.nlm.nih.gov/books/NBK555998/10.1053/j.sempedsurg.2006.10.010

Bohr S., Mammadli T. Perineal Diagnostic Microbial Swabs As A Predictive Parameter In Pediatric Burn Injury. Ann Burns Fire Disasters. 2020; 33(3):224-232.

View at:

PubMed: https://pubmed.ncbi.nlm.nih.gov/33304213/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680194/

Kisil NP et al. Method of surgical treatment and anesthesia of young children with pararectal abscess and chronic paraproctitis. Utility model patent No. 57231; 10.02.2011. [in Ukrainian].

The European Committee on Antimicrobial Susceptibility Testing – EUCAST.

View at:

Publisher Site: https://www.eucast.org/

Spakhi OV, Lyaturinskaya OV, Makarova MA, Dovbysh OV. [Therapy of paraproctitis in newborn and infants]. Neonatolohiia, khirurhiia ta perynatalna medytsyna. 2015; 18(4):65-68. [in Russian]

View at:

Publisher Site: http://dspace.zsmu.edu.ua/handle/123456789/3190

Toyonaga T, Matsushima M, Tanaka Y, Shimojima Y, Matsumura N, Kannyama H, Nozawa M, Hatakeyama T, Suzuki K, Yanagita K, Tanaka M. Microbiological analysis and endoanal ultrasonography for diagnosis of anal fistula in acute anorectal sepsis. Int J Colorectal Dis. 2007 Feb; 22(2):209-13. DOI: 10.1007/s00384-006-0121-x.

View at:

Publisher Site: https://link.springer.com/article/10.1007/s00384-006-0121-x

PubMed: https://pubmed.ncbi.nlm.nih.gov/16601946/

Cheng S-F, Tsai W-S. Microbiological Analysis of Perianal Abscess and Its Treatment. Medicine, Biology. Purpose. 2010. Corpus ID: 85920516. DOI: 10.6312/SCRSTW.2010.21(1).09817

View at:

Semanticscholar: https://www.semanticscholar.org/paper/Microbiological-Analysis-of-Perianal-Abscess-and-Cheng-Tsai/f9c3343d563cef5632b5fb7d9d70f092585c9cdd

Clegg HW, Giftos PM, Anderson WE, Kaplan EL, Johnson DR. Clinical Perineal Streptococcal Infection in Children: Epidemiologic Features, Low Symptomatic Recurrence Rate after Treatment, and Risk Factors for Recurrence. J Pediatr. 2015; 167(3):687-93.e1-2. DOI: 10.1016/j.jpeds.2015.05.034.

View at:

Publisher Site: https://www.jpeds.com/article/S0022-3476(15)00541-7/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/26095284/

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