EVALUATION OF ENTEROSORBENT POLYSORB MP CLINICAL EFFECT IN CASES OF ACUTE ENTERIC INFECTIONS OF CHILDREN

EVALUATION OF ENTEROSORBENT POLYSORB MP CLINICAL EFFECT IN CASES OF ACUTE ENTERIC INFECTIONS OF CHILDREN

EVALUATION OF ENTEROSORBENT POLYSORB MP CLINICAL EFFECT IN CASES OF ACUTE ENTERIC INFECTIONS OF CHILDREN

 Acute enteric infections (AEI) take one of the leading places in the range of infectious incidences. 60 — 65% of all the AEI cases are registered among children, at that the incidence rate among young children is particularly high (up to 70%).

  According to literature sources, the whole complex of modern researches helps to define AEI etiology in 56—80% of cases. Such aetiologic agents as Salmonella, Shigella, Vibrio cholerae cause less than 10% of all the intestinal infections cases of children in civilized countries

  The rate of rotavirus infections in the structure of AEI varies from 9 to 73%, and in respect of all the children, hospitalized on the occasion of enteric disorders, it makes 20—60%.

  Change of aetiologic structure and pathogenesis of AEI of children (increase of the number of virus diarrhea), resistance increase of bacteria to antimicrobials, increase of the number of unfavorable outcomes in recent years, connected with burdened preclinical background of patients, dictate terms of search for new etiopathogenesis medicines and development of therapy for patients with acute enteric infections.

  Basic directions of pathogenetic therapy for the treatment of acute enteric infectious diseases accompanied by diarrhea syndrome, are as follows:

deintoxication;

aquatic-electrolytic disorder correction;

motor-secretory disorder correction of gastro-intestinal tract;

correction of gut organisms disorders;

reinforcement of reparative processes in mucous membrane of large bowel;

enterosorption.

   Enterosorption in case of infectious diseases is not just pathogenetic therapy method, but also aetiologic, as sorbing agents can uptake not just endo- and ectotoxind of causative agents, but also detect at its surface causative agents of bacterial and viral nature, thus excluding them from pathologic process. The ability of enterosorbents to bind endo- and ectotoxins of causative agents contributes much to the macroorganism deintoxication.

  At the pharmaceutical market of Russia various groups of enterosorbents are presented by absorbent carbons, lignines, ion exchanger resins, which have quite different clinical effect, sometimes unpleasant organoleptical properties (Polyphepan), different level of solubility, various aromatic flavorings, which are vital in case of children treatment with allergic diseases and, of course, possible traumatic impact on mucous membrane of the intestinal tract. In this respect the problem of use of new medicine – enterosorbents, which meets modern requirements, especially in respect of children, is quite vital.

  One of new medicines is native drug POLYSORB MP, manufactured by Polysorb CJSC, city of Cheliabinsk, produced from fine silicon, meeting all basic requirements in respect of enterosorbents: non toxic, does not traumatize mucous membrane of gastro-intestinal tract, can be easily removed from gastro-intestinal tract, has good sorption and organoleptical properties.

  The results of using enterosorbent POLYSORB MP for the treatment of acute enteric infections of children were included into this work.

Purpose:

  Estimation of clinical efficiency of the medicine-enterosorbent POLYSORB MP, development of pathogenetic therapy of acute enteric infections of children, followed by diarrhea syndrome.

Materials and methods:

  In compliance with the work purpose in 2005-2006 65 children were examined, who underwent hospital treatment at MMPI (Municipal Medical and Preventive Treatment Institution) City Clinical hospital №1, City of Smolensk, department №5 (intestinal infections). Clinical information on intoxication phenomena estimation was used for the medicine efficiency estimation: duration of sickness, vomit, dysorexia; evidence of disease clinical features: feverish period, abdominal syndrome, diarrhea period, presence of abnormal foreign substances in the stool; laboratory evaluation of causative agent release –bacteriological and serologic methods were used.

  2 groups of children were selected, group “А” - 35 children apart from traditional basis therapy (including specific antimicrobial or antiviral) underwent the treatment with the help of the enterosorbent POLYSORB MP and control group “B” - 30 children who underwent the traditional basis (including specific antimicrobial or antiviral) therapy.

  Total absence of intoxication syndromes in the group examined stated at the 4th day with maximum fading at the 1st and the 2nd day, and in the control group – intoxication symptoms preserved to the 7th day with maximum fading at the 2nd and the 4th.

  Abdominal syndrome cut shorted in the research group with the overwhelming majority up to the 3rd day, in the control set in 25% preserved up to the 4th day.

  In the research group with the overwhelming majority up to the 3rd day the stool was formed, in the control group in 3.3% it was preserved to be liquid to the 8th day of disease.

  In the research group abnormal foreign substances disappeared up to the end of the 2-3rd day, in the control group preserved up to 5 days.

 The following dynamics was formed in the process of obtained data analysis:

 DYNAMICSOFclinical symptoms

 

CRITERIA

 

GROUPS

 

Group“А”

 (N-35)

 

Group“B”

(N-30)

 

Fever response duration

 

2.8 days

 

3.2 days

 

Duration of sickness and vomit

 

2.3 days

 

3.6 days

Durationof bellyache

2.5 days

3.8 days

Diarrhea duration

 

 

3.2 days

 

 

4.3 days

 

 

 

Preservation of abnormal foreign substances in stool (intrusive diarrhea)

 

 

3.14 days

 

 

3.8 days

 

 

Average period of hospitalization

 

 

4.3 days

 

 

5.8 days

 

 

According tolaboratory findings:

 

Causative agent

 

Group“А”

 

Group“B”

Release of causative agents before treatment

Release of causative agents after treatment

Release of causative agents before treatment

Release of causative agents after treatment

Shigella

Flexneri 2а

2

0

2

0

Rotavirus

18

0

13

5

Causative agents notreleased

 

15

 

15

laboratory findings dynamics

  In the group “Аout of 2 cases of shigellosis (released Shigella Flexneri 2а), in control inoculations of fecal masses after the therapy held only negative findings were detected.

  Out of 18 cases of rotavirus infection (laboratory certified) in the control studies of fecal masses the rotavirus was not detected.

  In the group “B” out of 2 cases of shigellosis Shigella Flexneri 2а was released, in control inoculations after therapy only negative findings were detected.

  Positive control inoculations of fecal masses for rotaviruses were detected in 5 out of 13 cases of rotavirus infection (laboratory certified).

  In both the groups 15 children were made a diagnosis of acute enteric infection, not certified laboratory.

  Development of adverse reactions and hyperresponsiveness to the enterosorbent used in the range of patients were not detected.

Conclusions:

Therefore, the information received shows that:

1. In the process of using enterosorbent POLYSORB MP by children with acute enteric infection there was determined quick intoxication syndrome reduction dynamics, stool normalization and disappearance of abnormal foreign substances in comparison with the control group.

2.  On the back of therapy held in the examined group, better intestinal tract sanitation from pathogenic causative agents (in case of rotavirus infection) was achieved.

3. Therapeutic action of POLYSORB with reduction of infectious disease duration, terms of hospitalization and lower cost of the medicine (in comparison with analogue) presupposes possible positive benefits.

4. Enterosorption method with the use of POLYSORB MP can be recommended for the treatment of children acute enteric infections with the syndrome of intoxication and diarrhea.