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The introduction of local programs for the rational use of antibiotics in a multidisciplinary hospital is aimed at reducing the level of antibiotic resistance and the frequency of healthcare associated infections (HAI). The aim of the study was to analyze the frequency of infectious complications caused by pathogens with multidrug resistance and the level of resistance at the B.V. Petrovsky National Research Center of Surgery based on the implementation of the SCAT program. Material and methods. A retrospective analysis of the SCAT program implementation results on the basis of the B.V. Petrovsky National Research Center of Surgery was carried out. 1850 case histories of the surgical profile for 2018 were analyzed (male —1095, average age 56.2±14.9 years; female — 755, average age 53.7±11.9 years) and 1502 case histories for the January–October period for 2019 (male — 1114, average age 58.3±12.1 years, and female — 388, average age 55.4±12.6 years). Results. The incidence of HAI in 2018 and 2019 was 354 and 159 cases, respectively. Of these, the incidence of nosocomial pneumonia (NP) was 64 cases (61.5%) and 40 cases (38.5%); skin and soft tissue infection (SSTI) — 93 cases (57.4%) and 69 cases (42.6%); surgical site infections (SSI) — 69 cases (82.1%) and 15 cases (17.9%) in 2018 and 2019, respectively. The drug resistance index (DRI) for the most clinically significant strains of the causative agents of HAI was: Klebsiella pneumoniae — 0.14, Acinetobacter baumannii — 0.22, Klebsiella spp. — 0.11, Enterobacter cloacae — 0.15, Enterococcus faecalis — 0.18, Enterococcus faecium — 0.21. Conclusion. The proposed measures for the implementation of the SCAT program at the level of a medical organization reduce the incidence of HAI and the local level of the drug resistance index.

Objective. To evaluate the effectiveness, rationality, and safety of the use of antibacterial medications for the purpose of perioperative prophylaxis (POP) of infectious complications in patients of surgical departments in a multidisciplinary hospital.Materials and methods. A pharmacoepidemiological analysis of 576 case histories of patients aged from 18 to 87 years old (average age was (̱σ) 57.4±14.5), of which 347 (60.2%) were male and 229 (39.8%) — female, after surgical interventions was carried out. The frequency and nature of infectious complications, the rationality of the choice of antibiotic therapy, the incidence of adverse reactions were analyzed. Statistical analysis of the data was carried out using the statistical analysis software package STATISTICA 10.0 (StatSoftInc., USA).Results. The choice of POP schemes corresponded to the recommendations in 207 (35.9%) cases. A high level of non-compliance with the recommendations for perioperative prophylaxis (47.6%) and violations of the POP (76.2%) were revealed. The total number of cases of dosing regimens violation amounted to 225 (39.1%) cases. The frequency of infectious complications in the postoperative period was n=90 (15.6%). The study revealed the interrelationships of non-rational POP schemes with the length of stay in the ICU (p=0.003), violations of the antibiotic dosing regimens with the frequency of repeated surgical interventions associated with infection (p=0.001), the length of stay in the ICU (p=0.005), mortality rate (p=0.002), and isolation of multidrug-resistant strains (p=0.016). Renal impairment is an independent unfavorable predictor of the development of adverse reactions (p