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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">riri</journal-id><journal-title-group><journal-title xml:lang="ru">Раны и раневые инфекции. Журнал имени проф. Б.М. Костючёнка</journal-title><trans-title-group xml:lang="en"><trans-title>Wounds and wound infections. The prof. B.M. Kostyuchenok journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2408-9613</issn><issn pub-type="epub">2500-0594</issn><publisher><publisher-name>Regional non-governmental organization “Surgical society - Wounds and wound infections”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25199/2408-9613-2019-6-2-17-23</article-id><article-id custom-type="elpub" pub-id-type="custom">riri-178</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL REPORTS</subject></subj-group></article-categories><title-group><article-title>Эмпирическая антимикробная терапия гнойно-септических осложнений в хирургической колопроктологии</article-title><trans-title-group xml:lang="en"><trans-title>Empirical antimicrobial therapy of purulent-septic complications in surgical coloproctology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стойко</surname><given-names>Ю. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Stoiko</surname><given-names>Yu. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Россия, 105203, Москва, ул. Нижняя Первомайская, д. 70</p></bio><bio xml:lang="en"><p>70, Lower Pervomayskaya Str., Moscow, 105203, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гусаров</surname><given-names>В. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Gusarov</surname><given-names>V. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Россия, 105203, Москва, ул. Нижняя Первомайская, д. 70</p></bio><bio xml:lang="en"><p>70, Lower Pervomayskaya Str., Moscow, 105203, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левчук</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Levchuk</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Россия, 105203, Москва, ул. Нижняя Первомайская, д. 70</p></bio><bio xml:lang="en"><p>70, Lower Pervomayskaya Str., Moscow, 105203, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Максименков</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Maksimenkov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Россия, 105203, Москва, ул. Нижняя Первомайская, д. 70</p></bio><bio xml:lang="en"><p>70, Lower Pervomayskaya Str., Moscow, 105203, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Колозян</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kolozyan</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Россия, 105203, Москва, ул. Нижняя Первомайская, д. 70</p></bio><bio xml:lang="en"><p>70, Lower Pervomayskaya Str., Moscow, 105203, Russia</p></bio><email xlink:type="simple">milanforza@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медико-хирургический Центр им. Н. И. Пирогова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBI «N. I. Pirogov National Medical Surgical Center» Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>28</day><month>11</month><year>2019</year></pub-date><volume>6</volume><issue>2</issue><fpage>17</fpage><lpage>23</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Стойко Ю.М., Гусаров В.Г., Левчук А.Л., Максименков А.В., Колозян Д.А., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Стойко Ю.М., Гусаров В.Г., Левчук А.Л., Максименков А.В., Колозян Д.А.</copyright-holder><copyright-holder xml:lang="en">Stoiko Y.M., Gusarov V.G., Levchuk A.L., Maksimenkov A.V., Kolozyan D.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.riri.su/jour/article/view/178">https://www.riri.su/jour/article/view/178</self-uri><abstract><p>Цель исследования: оптимизировать антибактериальную терапию у больных колопроктологического профиля при гнойно-септических осложнениях.Материалы и методы исследования. Проведено одноцентровое интервенционное исследование с историческим контролем. Началом интервенции стал январь 2017 г., когда в стационаре ФГБУ «НМХЦ им. Н. И. Пирогова» Минздрава России (далее – Пироговский Центр) был введен строгий контроль соблюдения протоколов эмпирической антимикробной терапии. В исследование включены 62 пациента, которым проводили антибактериальную терапию после операций на толстой и прямой кишке в 2016–2017 гг. Больные были разделены на две группы по отношению к началу интервенции: 2016 г. – группа сравнения (А), 2017 г. – основная группа (В).Результаты исследования. Отмечено некоторое снижение общего потребления антибактериальных препаратов у больных колопроктологического профиля с 823,0 до 691,0 Defined Daily Dose (DDD, установленная суточная доза), а также среднего потребления антибиотиков на одного больного с 26,5 до 22,3 DDD. Выявлено увеличение числа случаев соответствия утвержденному протоколу эмпирической антимикробной терапии (АМТ) с 32,3 % в группе А до 67,7 % в группе В, р = 0,01. Частота адекватного эмпирического назначения антибиотиков увеличилась с 71,0 до 93,5 %, р = 0,042. Выявлено значимое увеличение частоты деэскалации АМТ с 3,2 % в группе А до 25,8 % в группе В, р = 0,026.Заключение. Контроль соблюдения протоколов эмпирической АМТ позволил добиться увеличения числа случаев приверженности соблюдению утвержденных протоколов, что положительно сказалось на частоте адекватного назначения эмпирической АМТ, а также привело к увеличению числа случаев деэскалации проводимой АМТ.</p></abstract><trans-abstract xml:lang="en"><sec><title>Object</title><p>Object. to optimize antibacterial therapy in patients with coloproctological profile with purulent-septic complications.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A one-center intervention study with historical control was conducted. The intervention began in January 2017, when in the hospital FSBI «N. I. Pirogov National Medical Surgical Center» Russian Ministry of Health introduced strict monitoring of compliance with the protocols of empirical antimicrobial therapy. The study included 62 patients who underwent antibacterial therapy after operations on the colon and rectum in 2016–2017. Patients were divided into two groups with respect to the beginning of the intervention: 2016 – comparison group (A), 2017 – main group (B).</p></sec><sec><title>Results</title><p>Results. There was a slight decrease in the total consumption of antibacterial drugs in coloproctological patients from 823.0 to 691.0 Defined Daily Dose (DDD, established daily dose), as well as the average consumption of antibiotics per patient from 26.5 to 22.3 DDD. An increase in the number of cases of compliance with the approved protocol of empirical antimicrobial therapy (AMT) was revealed from 32.3 % in group A to 67.7 % in group B, p = 0.01. The frequency of adequate empirical antibiotic prescribing increased from 71.0 to 93.5 %, p = 0.042. A significant increase in the frequency of de-escalation of AMT was revealed from 3.2 % in group A to 25.8 % in group B, p = 0.026.</p></sec><sec><title>Conclusion</title><p>Conclusion. Monitoring compliance with empirical AMT protocols allowed to increase the number of cases of adherence to approved protocols, which positively affected the frequency of adequate appointment of empirical AMT, and also led to increase the number of cases of de-escalation of AMT.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>колоректальная хирургия</kwd><kwd>гнойно-септические осложнения</kwd><kwd>антибиотикотерапия</kwd><kwd>протокол</kwd><kwd>потребление антибиотиков</kwd><kwd>деэскалация</kwd></kwd-group><kwd-group xml:lang="en"><kwd>colorectal surgery</kwd><kwd>purulent-septic complications</kwd><kwd>antibiotic therapy</kwd><kwd>protocol</kwd><kwd>antibiotic consumption</kwd><kwd>de-escalation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Хирургические инфекции кожи и мягких тканей : Российские национальные рекомендации / под ред. Б. Р. Гельфанда, В. А. 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