ABSTRACT
NSTI is a life-threatening, surgical, and medical emergency. Clinical presentation, at least in the initial phase, can be misleading. Various studies have shown that delay in surgical debridement is associated with increased mortality. A high index of suspicion is important in early recognition and in instituting prompt therapy without delay. Early diagnosis, aggressive surgical debridement, aggressive supportive care, and optimal presumptive antibiotic therapy significantly improve morbidity and mortality associated with NSTIs.
Subject(s)
Soft Tissue Infections/pathology , Soft Tissue Infections/therapy , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Debridement/methods , Early Diagnosis , Humans , Necrosis/drug therapy , Necrosis/surgery , Risk Factors , Soft Tissue Infections/diagnosis , Treatment OutcomeABSTRACT
Biologic response modifiers (BRMs) interact with the host immune system and modify the immune response. BRMs can be therapeutically used to restore, augment, or dampen the host immune response. Although they have been used for decades, their clinical applications have been expanded in the past decade for diagnosis and treatment of many diseases including cancers, immunologic disorders, and infections. This article discusses endogenous biological response modifiers (ie, naturally occurring immunomodulators as a part of the host immune system), which play vital roles as regulators of both innate and adaptive immune responses.
Subject(s)
Communicable Diseases/immunology , Interferons/immunology , Interleukins/immunology , Adaptive Immunity/physiology , Antigen-Presenting Cells/immunology , B-Lymphocytes/immunology , Host-Pathogen Interactions/immunology , Humans , Immunity, Innate/physiology , T-Lymphocytes/immunologyABSTRACT
The emergence and spread of multidrug resistance in many pathogenic bacterial species is increasing at an alarming rate, especially with hospital-acquired infections in the critical care setting. Deaths associated with hospital-acquired infections have exceeded the number attributable to several of the top 10 leading causes of death reported in the United States. The emerging resistance limits the use of older antibiotics. Tigecycline is a new agent, and this article explores its role in the treatment of adults in the critical care setting.
