[Effect of clarithromycin on the systemic inflammatory response syndrome severity in patients after myocardial...

The aim is to investigate the effectiveness of SIRS pharmacological correction in patients after CABG when adding clarithromycin to the standard antibacterial therapy. Patients of the 1st group (n=25) received Klacid- CP ("Abbott") in perioperative period plus to standard antibacterial therapy (3rd generation cephalosporins), patients of 2nd group received standard therapy. At 1st screening stage, as well as on the 2-nd and 4-th day after operation were recorded data of an anamnesis, concomitant pathology, examination, were measured the level of white blood cells, LII, biochemical blood analysis (CRP), defined the concentration of interleukins (IL-1, 6, 8,10,12) and TNF - a. In all studied patients, laboratory' and physical data did not go beyond the reference values, intraoperation data, blood loss and ALV duration did not statistically differ. According to the results of research in patients of both groups there were manifestations of SIRS in the form of reliable significant increase in body temperature, as well as the level of Il-6, IL-8, CRP, LII, TNF - a, leukocytosis. While in the clarithromycin group body temperature was significantly lower in all time points. The level of CRP for the 4th day in 1.5 times, and TNF in 4 times less than in the control group, and the values of anti-inflammatory IL-10 to the 2nd day, on the contrary almost in 2 times higher than those in the control group. Thus, the obtained data confirmed that the CABG is accompanied by non-inflammatory SIRS development. At the same time clarithromycin gives an independent proven anti-inflammatory effect and can be recommended for application in the schemes of prophylactic antimicrobial therapy during perioperative period in this category of patients.