THE EFFECT OF PRE-HOSPITAL ANTIMICROBIAL THERAPY ON GUT MICROBIOTA INDICATORS IN PATIENTS WITH INFECTIOUS COLITIS

Abstract

To evaluate the impact of uncontrolled antimicrobial therapy at the pre-hospital stage on quantitative indicators of intestinal microbiota in patients with colitic forms of salmonellosis, shigellosis, and campylobacteriosis. Materials and methods. A prospective cohort study was conducted (n=68). The main group consisted of patients who had not taken antimicrobial preparations (AMP) within the last 30 days (n=36), while the comparison group consisted of patients who had taken oral AMP for 1-3 days (n=32). The microbiota was assessed using a quantitative culture method (log₁₀ CFU/g) and by its antagonistic activity (%). Statistical analysis included the t-test, point-biserial correlation, and calculation of dysbiosis indices. Results. AMP caused an additional reduction of protective flora by 12-22% and a growth of opportunistic flora by 26-50% (p<0.001-0.05). The overall AMP influence coefficient was 37-40%. Strong correlations were found between AMP intake and a decrease in bifidobacteria (r=-0.779; p<0.0001) and antagonistic activity (r=-0.692; p<0.0001). Conclusion. A short course of uncontrolled AMP intake significantly aggravates the dysbiosis caused by the infection. It is necessary to avoid self-medication and to perform microbiological monitoring before initiating etiotropic therapy.