[Antibacterial treatment of infectious-toxic shock]

The studies enabled one to identify six leading clinicophysiological syndromes developing in patients with infective toxic shock (ITS). They include signs of purulent inflammatory processes, organ disorders and systems disturbances. Despite the clinical picture polymorphism, ITS has a clearly defined stage-by-stage process which makes it possible to determine hyperdynamic and hypodynamic phases of the pathological process within each stage. An absolute condition for antimicrobial drugs includes the following: drainage of the purulent inflammatory focus, arresting of pathogen discharge into the blood flow, recovery of host impaired functions and their maintenance. It was shown that a wrong choice of the drugs and antibacterial therapy regimens resulted in a 2-fold increase in fatal cases with ITS. Disorders in systemic and organ blood flows and microcirculation and coagulation disturbances played a particular role in decreasing antibacterial therapy efficacy. Further ways for optimizing antibacterial therapy are mainly connected with availability of efficient antibacterial drugs for practitioners and introduction of microbiological and pharmacokinetic monitoring of antibacterial therapy providing conditions for their rational and safe use.