ANALYSIS OF THE TREATMENT OF PATIENTS WITH ABSCESSES AND PHLEGMONS OF THE MAXILLOFACIAL REGION

The study aimed to determine the composition and sensitivity of microorganisms to antibiotics isolated from pathological foci for further use of the most effective antibacterial drugs.From January 2019 to December 2024, 192 case histories of patients aged 18 to 82 with MFA abscesses and phlegmon of various localization, prevalence, and severity of the course who were treated at the Department of Oral and Maxillofacial Surgery of the ME "Poltava Regional Clinical Hospital, named after M.V. Sklifosovsky of the Poltava Regional Council" were analyzed.The analysis of variance (ANOVA) method was used to process the results.Abscesses and phlegmon occurred more often in the working-age population -80.7% (155 out of 192 cases), of which 65.2% among men and 34.8% among women, with a ratio of 2:1.The ratio of abscesses to phlegmon was 3.5:1.Odontogenic abscesses prevailed (47.2%), while non-odontogenic abscesses accounted for 38.5%.Phlegmons of odontogenic etiology accounted for 6.25%, non-odontogenic -7.8%.Among non-odontogenic abscesses, abscessing furuncles and carbuncles were most often diagnosed (63.5%).Suppuration of atheroma and complicated mandibular fractures accounted for 9.4% each, purulent lymphadenitis -5.4%, suppuration of the median neck cyst -4.1%, and sublingual salivary gland -1.4% abscess.Among the odontogenic abscesses, subperiosteal (63%), buccal (15%), maxillary-lingual groove (6%), infratemporal fossa and odontogenic sinusitis (3% each), submandibular, submaxillary and palatal (1% each) dominated.Among the non-odontogenic phlegmon, adenophlegmon (40%) and phlegmon due to infected mandibular fractures (20%) prevailed.Others -phlegmons due to infected wounds, phlegmons of the lower lip, parotid and masticatory area and tonsillogenic phlegmons -6.6% each.In 100% of cases with phlegmon, monocultures were isolated: Staphylococcus aureus -40.3%, Staphylococcus saprophyticus -4%, Klebsiella pneumonia -3.7%, Pseudomonas aeruginosa -3%, others -4.8%.In 11.9% of cases, the bacterial culture failed to grow, indicating the possible presence of anaerobes.An important aspect is determining antibiotic sensitivity.St. epidermidis was sensitive to ceftriaxone, azithromycin, clindamycin, vancomycin, and meropenem.St. aureus was sensitive to ceftriaxone, clindamycin, vancomycin, levofloxacin, and meropenem, but 100% of strains were resistant to penicillin G. Str.pyogenes and Str.viridans are 100% susceptible to ceftriaxone, cefotaxime, and amoxicillin.Escherichia coli and Pseudomonas aeruginosa demonstrated high sensitivity to ceftazidime, amikacin, and mepenam.