The effectiveness of enterosorbents when treating acute intestinal infections
Comprehensive preventive measures contributed to the significant decrease of diseased diagnosed with acute intestinal infections (AII). However, intensification of migrating processes, spreading of public catering services, poor quality of water in many regions of Russia and other countries lead to AIIs that still constitute a large part of infectious pathologies. One of measures designed to reduce the number of AII cases is a balanced and effective therapy for all patients.
The main area of focus of pathogenetic therapy for AII is detoxification. Enterosorption is a non-specific detoxification method that binds and removes toxins from the gastrointestinal tract. Polisorb MP is a new generation enterosorbent created on the basis of highly dispersed silica; it has polyfunctional non-selective sorption properties; is available in the form of a powder with a particle size of 5 to 20 nm. The modern pharmaceutical market has a wide variety of enterosorbent preparations.
We have carried out a comparative study of the effectiveness of different enterosorbents when treating AII. The study included 88 patients with the cases of bacterial food poisoning and salmonella (40 women and 48 men) aged 17 to 70 years.
Depending on the treatment method the patients were divided into 4 groups: in the 1st patients (n = 50) received Polisorb MP as an enterosorbent at a dose of 9 g/day, in the 2nd (n = 14) - activated carbon - 6 g/day, in the 3rd (n = 13) – the "Filtrum" medicine - 3.2 g/day, for the 4th group (n = 11) enterosorbents were not prescribed. The groups were matched by gender, age of patients and the presence of concomitant diseases (patients with concomitant gastrointestinal diseases and immunodeficiency states were excluded from the study). All patients received rehydration therapy (infusion or oral) and polyenzymes. The effectiveness of treatment was assessed by the rate of disappearance of the main symptoms of the disease (fever, diarrhea, vomiting).
The 1st group (25 men and 25 women aged 17 to 67 years) included 40 patients with the cases of bacterial food poisoning and 10 patients with salmonellosis. The diagnosis of bacterial food poisoning in 16 cases was verified by isolating St. aureus from gastric lavage; in other cases, it was determined by clinical means. Patients had a past history of eating expired salads, mushrooms, and cooked sausages. The diagnosis of salmonellosis in all cases was confirmed bacteriologically (isolation of S. enteritidis). Bacterial food poisoning in 32 cases progressed in a moderate form, in 5 patients there was a mild progression, in 3 patients - severe with pronounced dehydration. The course of salmonellosis in all cases was moderate with grade II dehydration. In the first 24 hours after the onset of the disease, 30 (60%) patients were admitted to the hospital, another 10 (20%) patients - on the 2nd day and the rest were hospitalized on the 3-4th day of the disease.
Polisorb MP at a dose of 3g 3 times a day was prescribed from the 1st day of hospitalization; the duration of treatment was 2–5 days (depending on the duration of diarrhea; on average 3.8 days). Diarrheal syndrome persisted on average 3.6 days (from 1 to 7 days), fever lasted from 1 to 6 days (average 2.1 days) and vomiting in all patients stopped on the day of hospitalization. The duration of hospital stay was 6.0 days.
In the 2nd group (10 men and 4 women aged 20 to 68 years) all patients were diagnosed with the moderate case of bacterial food poisoning. The diagnosis was verified by isolating the St. aureus culture in 3 patients. Patients of the 2nd group were hospitalized on the 1st – 3rd day of the disease; on the day of admission to the hospital, they were prescribed activated carbon as an enterosorbent in a daily dose of 6g.
The duration of diarrhea in patients of this group ranged from 1 to 5 days (on average 3.9 days), the duration of fever - from 1 to 4 days (on average 2.2 days) and the duration of hospital stay - on average 6.3 days.
In the 3rd group (7 women and 6 men aged 18 to 60 years), the patients were diagnosed with mild and moderate cases of bacterial food poisoning, and they received Filtrum as an enterosorbent at a dose of 0.8g 4 times a day for 4-5 days from the moment of admission to the hospital (1-3rd day of the disease). The duration of diarrhea in these patients was 4.6 days, the duration of the fever was 3.5 days, and the hospital stay was 8.3 days.
Patients of the 4th group (4 women and 7 men, aged 25 to 58), who did not receive enterosorbents, constituted the control group. All patients in this group were diagnosed with moderate bacterial food poisoning.
Diarrheal syndrome persisted in this group from 1 to 7 days (on average 4.0 days), fever - 2.5 days (from 2 to 3 days; in 2 patients, the body temperature did not increase) and the duration of hospital stay was 6.9 days (from 3 to 13 days).
Thus, the results of the study showed that enterosorption is an effective and necessary method of treating AII. When Polisorb MP was included in the treatment regimen, the duration of hospital stay, the duration of fever and diarrhea were significantly shorter than in the control group. The lack of significant differences in the timing of the recovery of patients in this and the 2nd group possibly appeared due to the earlier hospitalization of the latter. With the prescription of Polisorb MP, the duration of fever, vomiting and hospital stay was significantly shorter than in patients of group 3; in our study, Filtrum had no effect on the course of the infectious process.
The Polisorb MP medicine can be recommended for inclusion in the standards of medical care for bacterial food poisonings and salmonellosis.
POLISORB MP – EFFECTIVE MULTIPURPOSE ENTEROSORBENT
Polisorb MP (medical, oral) is an inorganic, non-selective enterosorbent based on highly dispersed silica. Due to its non-porous surface Polisorb MP has a high adsorption rate (1–4 min). With prompt initiation of treatment in infection practice (bacterial food poisonings and AIIs) the duration of treatment is significantly reduced. Due to the adaptogenic action of the medicine the organism's resistance to adverse environmental conditions and infections increases. Polisorb MP is used as a radioprotective agent in low radiation conditions.
Specifics of use of Polisorb MP when treating various diseases:
Polisorb MP is non-toxic, has no age restrictions and is thermal and lightproof. In 2005 Polisorb MP was patented for the use as a means with a membrane-stabilizing effect, which makes it possible to use it as a monotherapy in the treatment of a large number of diseases.
CJSC Polisorb www.polisorb.ru Registration certificate of the Ministry of Health of the Russian Federation P No. 001140/01 – 2002. Patent No. 2253459