ABSTRACT
Topical agents are widely used in the care of burn patients; however the efficacy to prevent local infections and/or sepsis has not been clearly established in studies with a high level of evidence. This systematic review was conducted to assess the comparative efficacy among different topical agents. Material and Methods. The literature search was performed using the Medline database. Key MESH terms were: (burn* or scald*) AND (antibacterial or antibiotic*) AND (topic*) AND (therap* or prophylax*). Only randomized or quasi-randomized clinical trials, with a primary endpoint of local infection and/or sepsis were included. Studies were scored and classified regarding methodological key issues according to their level of evidence. Results. The initial search identified 457 studies of which 14 were eligible for final evaluation, and full text was available for 11 of them. Conclusions. The evidence found in our review does not support differences in efficacy of topical agents to reduce sepsis and/or local infections in burn patients.
Los agentes tópicos son ampliamente utilizados en el cuidado de los pacientes quemados. Con el objetivo de evaluar la eficacia comparativa entre diferentes agentes tópicos habitualmente utilizados para la prevención de infecciones, llevamos a cabo una revisión sistemática. Material y métodos. La búsqueda bibliográfica se realizó en la base Medline. Las palabras clave utilizadas, fueron: burn* or scald* AND antibacterial or antibiotic* AND topic* AND therap* or prophylax*. Solamente se incluyeron estudios con asignación aleatorizada o cuasi-aleatorizada de las intervenciones y cuya variable principal fuera la presencia de infección local y/o sepsis. Resultados. La búsqueda inicial detectó 457 artículos, de los cuales se seleccionaron 14 para su evaluación final, disponiendo del texto de 11 de ellos. Conclusiones. Las evidencias halladas sobre el tema fueron de calidad científica moderada. No se identificaron evidencias que demostraran la superioridad de alguno de los agentes tópicos sobre otros para reducir la infección o la sepsis en el paciente quemado.
Subject(s)
Humans , Anti-Bacterial Agents/administration & dosage , Burns/complications , Skin Diseases, Bacterial/prevention & control , Administration, Topical , Silver Compounds/administration & dosageABSTRACT
A estruturação do Sistema Nacional de Vigilância Epidemiológica do Brasil, em 1975, tornou obrigatória a notificação de algumas doenças transmissíveis com o objetivo de reduzir a carga destes eventos no país. Entretanto, as alterações no perfil epidemiológico destas doenças, associadas a características da sociedade contemporânea, determinam a constante adequação das atividades de vigilância a este cenário. Neste manuscrito, são descritos epidemiologia, tendências e diagnóstico diferencial das seguintes doenças dermatológicas de notificação compulsória no Brasil: aids, dengue, hanseníase, leishmaniose tegumentar americana, sarampo, rubéola e síndrome da rubéola congênita e sífilis. Também são apresentados os principais desafios atuais para o controle e prevenção para cada uma dessas doenças no Brasil.
The development of a Brazilian National Surveillance System in 1975 led to a compulsory reporting of selected infectious diseases aiming to reduce the burden of these events in the country. However, shifts in the epidemiology of these diseases associated with modern life style, demand constant revision of surveillance activities. In this manuscript we present the epidemiology, trends and differential diagnosis of the following compulsory notifiable diseases in Brazil: Aids, dengue fever, hanseniasis, American tegumentary leishmaniasis, measles, rubella and congenital rubella syndrome and syphilis. Additionally, the current challenges for control and prevention of each disease are presented.