Romanian Society of Pharmaceutical Sciences
 

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ETIOLOGICAL DIAGNOSIS AND PHARMACOTHERAPEUTIC MANAGEMENT OF PARAPNEUMONIC PLEURISY

DANIELA CĂLINA 1#, LUCICA ROȘU 2#, ALEXANDRA FLORIANA ROȘU 3#, GABRIEL IANOŞI 4#, SIMONA IANOŞI 5#, OVIDIU ZLATIAN 2#, RADU MITRUȚ 6#, ANCA OANA DOCEA 7#*, OTILIA ROGOVEANU 8#, PAUL MITRUȚ 9#, ALINA CRENGUȚA NICOLAE 10#, CRISTINA MANUELA DRĂGOI 10#, ELIZA GOFIȚĂ 7#

1.Clinical Pharmacy Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
2.Microbiology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
3.Internal Medicine Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
4.Surgery Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
5.Dermatology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
6.Pathology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
7.Toxicology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
8.Physiotherapy Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
9.Internal Medicine Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
10.Biochemistry Department, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

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Pleurisy is an inflammatory process characterized by the accumulation of fluid in the pleural cavity. The most frequent complication of pneumonia is the pleural effusion that can become infected and that needs microbiological analysis of the pleural fluid for an individualized treatment. The aim of this study was to identify the cases of infectious pleurisy by isolating and identifying pathogens in the pleural fluid and determining their antimicrobial susceptibility for a targeted and effective therapy and also to establish antimicrobial resistance phenotypes of the isolated germs. The study was conducted between 04.05.2014 - 01.12.2015 on 150 patients, diagnosed with pleurisy hospitalized in Craiova Emergency County Hospital in in surgical wards: thoracic surgery, general surgery and intensive care. Pathogens were isolated in 43.33% of the pleural fluids. Etiological infective agents palette was diverse, represented by Staphylococcus aureus, methicillin resistant Staphylococcus aureus (MRSA), Streptococcus pyogenes, Enterococcus, Escherichia coli, Klebsiella spp., Pseudomonas spp., nonfermenters Gram negative rods, anaerobic bacteria and Candida albicans. A high proportion of isolated strains showed resistance to chemotherapeutic agents with broad spectrum, which indicates their nosocomial potential. Antimicrobial susceptibility testing is absolutely necessary, in order to choose the most effective therapy.