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1.
Rev. Soc. Bras. Med. Trop ; 49(6): 796-798, Dec. 2016. graf
Article Dans Anglais | LILACS | ID: biblio-829674

Résumé

Abstract A 2-year-old Brazilian female child from the countryside in Bahia State presented with pain in the right flank of the abdomen, accompanied by a daily fever for about 2 weeks before admission. A large mass in the abdomen was resected by the surgical team. The biopsies revealed the mass was an intra-abdominal mucormycosis. However, the diagnosis was late, and despite treatment (amphotericin B) initiation, the patient eventually died.


Sujets)
Humains , Femelle , Enfant , Cavité abdominale/microbiologie , Mucormycose/diagnostic , Issue fatale , Retard de diagnostic/effets indésirables , Mucormycose/chirurgie
2.
Braz. j. infect. dis ; 12(3): 198-201, June 2008. tab
Article Dans Anglais | LILACS | ID: lil-493647

Résumé

Tigecycline is the first of a new class of antibiotics named glycylcyclines and it was approved for the treatment of complicated intra-abdominal infections and complicated skin and skin structure infections. Notwithstanding this, tigecycline's pharmacological and microbiological profile which includes multidrug-resistant pathogens encourages physicians' use of the drug in other infections. We analyzed, during the first months after its launch, the tigecycline prescriptions for 113 patients in 12 institutions. Twenty-five patients (22 percent) received tigecycline for approved indications, and 88 (78 percent) for "off label" indications (56 percent with scientific support and 22 percent with limited or without any scientific support). The most frequent "off label" use was ventilator associated pneumonia (VAP) (63 patients). The etiology of infections was established in 105 patients (93 percent). MDR-Acinetobacter spp. was the microorganism most frequently isolated (50 percent of the cases). Overall, attending physicians reported clinical success in 86 of the 113 patients (76 percent). Our study shows that the "off label" use of tigecycline is frequent, especially in VAP. due to MDR-Acinetobacter spp., where the therapeutic options are limited (eg: colistin). Physicians must evaluate the benefits/risks of using this antibiotic for indications that lack rigorous scientific support.


Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Antibactériens/usage thérapeutique , Infections bactériennes/traitement médicamenteux , Minocycline/analogues et dérivés , Cavité abdominale/microbiologie , Infections à Acinetobacter/traitement médicamenteux , Infections bactériennes/microbiologie , Étiquetage de médicament , Multirésistance bactérienne aux médicaments , Infections à Enterobacteriaceae/traitement médicamenteux , Minocycline/usage thérapeutique , Études prospectives , Dermatoses bactériennes/traitement médicamenteux , Infections des tissus mous/traitement médicamenteux , Infections à staphylocoques/traitement médicamenteux , Résultat thérapeutique , Jeune adulte
3.
Arq. gastroenterol ; 44(1): 85-90, jan.-mar. 2007. tab
Article Dans Portugais | LILACS | ID: lil-455968

Résumé

RACIONAL: Infecções intra-abdominais são comuns e apresentam elevada morbidade e mortalidade e os agentes infecciosos responsáveis por tais afecções são geralmente os da flora gastrointestinal, em especial a E. coli e Bacteroides fragilis. OBJETIVO: Apresentar uma revisão da seleção e uso de antibióticos em infecções intra-abdominais. CONCLUSÕES: O uso adequado de antibióticos é fundamental para o controle mais rápido da infecção e reduzir a possibilidade de falha no tratamento. A terapia antimicrobiana é iniciada na suspeita de infecção intra-abdominal e os agentes antibióticos selecionados são utilizados de acordo com os germes mais prováveis de serem encontrados no local da infecção. Além disso, eficácia, custo, segurança e comodidade posológica são considerados para uma seleção mais apropriada. Diferentes esquemas são utilizados em infecções intra-abdominais comunitárias e hospitalares devido à flora mais resistente destas últimas.


BACKGROUND: Intra-abdominal infections are common and are associated with elevated morbidity and mortality. The microorganisms that cause intra-abdominal infections are usually from the gastrointestinal flora, mainly E. coli and Bacteroides fragilis. AIM: To present a review of the selection and use of antibiotics in intra-abdominal infections. CONCLUSIONS: Appropriate use of antibiotics is essential to control infection and to reduce treatment failure. Antibiotics are initiated whenever intra-abdominal infection is suspected and the antimicrobial agents are selected based on the most common microorganisms involved. In addition, efficacy, cost, safety, and posologic regimen are considered for an appropriated selection. Antibiotic regimen is different whether the infection is acquired in the community or at hospital due to the more resistant flora in the latter.


Sujets)
Humains , Antibactériens/usage thérapeutique , Infections bactériennes/traitement médicamenteux , Infection croisée/traitement médicamenteux , Maladies de l'appareil digestif/traitement médicamenteux , Infection de plaie opératoire/traitement médicamenteux , Cavité abdominale/microbiologie , Infections bactériennes/microbiologie , Infection croisée/microbiologie , Maladies de l'appareil digestif/microbiologie , Indice de gravité de la maladie , Infection de plaie opératoire/microbiologie
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