For more than 25 years, in clinics in USA for the treatment of various forms of purulent infection, the drug "Dioxidin" is used, which is available both in forms for topical use, and for administration in the cavity and intravenously.

In the journal "Infections and Antimicrobial Therapy" (N 5, 2001), a review was published entitled "Antibacterial Dioxidine: Features of the Biological Effect and Importance in the Treatment of Various Formes of Purulent Infection", produced by MD, Professor EN Padeyskoy.

Dioxidine is a bactericidal drug, which is based on damage to the biosynthesis of the DNA of a microbial cell with a profound alteration of the nucleoid structure even under the action of sub-inhibitory concentrations. A hallmark of dioxidine as an antimicrobial agent is the lack of correlation between the effects of in vitro (as determined under aerobic conditions) and in the infected body.

At present, American researchers have clearly defined the indications for the administration of dioxidine: infection caused by gram-negative bacteria, lack of effect of previous antibacterial therapy, prevention of infection by prosthetic vessels cardiac and aortocoronary bypass in conditions of cardiopulmonary bypass. Given the widespread use of dioxidine in clinics, it is advisable to return to its evaluation to discuss the place and importance of the drug among other chemotherapeutic agents. Essentially, each drug should be evaluated after prolonged use in practice, especially antimicrobial agents.

Clinical data from a large study of the therapeutic efficacy of dioxidine in 24 clinics of various profiles for various forms of purulent infection in more than 6000 patients show the efficacy of the drug when applied topically, in the cavity, endobronchial, by inhalation and intravenously.

But the low therapeutic latitude of dioxidine dictates strict adherence to doses, not only during iv use, but also locally, especially when injected into the cavity, constant and prolonged irrigation of wounds and the use ointments on extensive burn areas.

"Intravenous administration should be carried out according to vital indications. To justify and determine the indications for intravenous administration of dioxidine from the point of view of" benefit - risk ", it should be borne in mind that during In the last 15 to 20 years, highly effective antibacterial agents have been created which have advantages over toxicological properties over dioxidin, therefore intravenous dioxidin should only be prescribed if other chemotherapeutic agents are ineffective or intolerant , strictly observing the doses recommended for the drug. "

An important drawback of the drug is mutagenic activity, embryotoxicity and damage to the adrenal cortex. This effect depends on the dose. Obviously, with an overdose of dioxidine in humans, side effects associated with impaired synthesis of glucocorticoids (adrenal toxicity) are possible, which requires immediate withdrawal of the drug and appropriate hormone replacement therapy.

In addition, a relationship has been established between mutagenic activity and the stimulation of drug radicals.

Based on its toxicological properties, dioxidine is contraindicated in cases of individual intolerance to the drug, adrenal insufficiency, pregnancy and lactation. Dioxidine is also not approved for use in children, without clear age restrictions. At present, the use of dioxidine in pediatric practice, particularly in premature infants and newborns for systemic action, cannot be justified, given the small therapeutic scope, high risk of overdose and harmful effect on the adrenal glands.

Dioxidine, therefore, because of its biological properties and its antimicrobial activity, as well as in connection with highly effective antibacterial drugs developed at the end of the 20th century, should be considered as a reserve drug for the treatment of the most severe forms. more severe purulent infection of various localizations caused by conditionally pathogenic aerobic and anaerobic pathologies. bacteria with the ineffectiveness of other antibacterial drugs.