Subject(s)
Cross Infection , Intensive Care Units , Pneumonia , APACHE , Anti-Bacterial Agents/therapeutic use , Cross Infection/diagnosis , Cross Infection/therapy , Diagnosis, Differential , Humans , Pneumonia/diagnosis , Pneumonia/therapy , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/etiology , Pneumonia, Bacterial/therapyABSTRACT
The efficacy of cefepime in the treatment of 46 patients operated for general peritonitis of various genesis and severity (APACHE II not greater than 35) was studied. Cefepime was used in a dose of 2 g administered every 12 hours as slow intravenous infusions in 0.9 per cent sodium chloride solution in combination with metronidazole administered intravenously in a dose of 7.5 mg/kg body weight. The treatment course was 4 to 15 days. 45 patients were given diflucan for the prophylaxis of fungal superinfection, 3 patients were given aminoglycoside antibiotics (netilmicin or amikacin) and 2 patients were given vancomycin per os. The favourable clinical effect of the cefepime therapy was stated in 38 patients (82.6 per cent) including 4 out of 10 patients with initial APACHE II > 15. 101 isolates of aerobic gram-negative and gram-positive microbes from 38 patients treated with cefepime in combination with metronidazole were tested to estimate the bacteriological efficacy of the therapy and it was shown that only 5.9 per cent of them was resistant. The pathogen eradication was stated in 84.2 per cent of the patients.
Subject(s)
Cephalosporins/therapeutic use , Sepsis/drug therapy , Surgical Wound Infection/drug therapy , APACHE , Abdomen , Aged , Anti-Infective Agents/therapeutic use , Cefepime , Drug Therapy, Combination , Female , Humans , Male , Metronidazole/therapeutic use , Middle Aged , Peritonitis/complications , Peritonitis/surgery , Prospective Studies , Sepsis/etiology , Sepsis/microbiology , Surgical Wound Infection/etiology , Surgical Wound Infection/microbiology , Time FactorsABSTRACT
Nosocomial infection remains a pressing problem of surgery and intensive care. The authors analyze the sources of infection, the factors predisposing to it, and the pathogenetic aspects. The strategy of nosocomial infection control is determined by the clinical and nosological structure and severity of patients' status. Microbiological and pharmacological studies helped the authors develop the protocols of the initial and alternative antibiotic therapy of various nosocomial complications of wound infection, abdominal sepsis, nosocomial pneumonia, and infectious toxic shock. Experience gained by the authors permitted them to recommend preventive measures decreasing the risk of exo- and endogenous infection and improving the mechanisms of patients' immunity.
