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1.
Artigo em Inglês | MEDLINE | ID: mdl-25212878

RESUMO

OBJECTIVE: The aim of this prospective study was to determine the influence of anti-inflammatory drugs on the severity of odontogenic cellulitis in patients admitted to our hospital emergency unit. STUDY DESIGN: The study was made from April 30 to October 31 2006. The clinical and pharmacological data was prospectively collected at admission, during hospitalization, and during systematic follow-up. We first studied the whole population and then compared the 2 groups: patients having received anti-inflammatory drugs before admission or not. RESULTS: Two hundred and sixty-seven patients were included. The only severity criterion significantly different between the 2 groups was spreading of cervical lymphangitis (P=0.028). None of the 4 studied parameters was identified as a risk factor for spreading of cervical lymphangitis in multivariate analysis: anti-inflammatory use (OR=5.99, 95%CI [0.71-50.88]), alcohol abuse (OR=4.00, 95%CI [0.66-24.12]), dental hygiene (OR=1.53, 95%CI [0.36-6.56]), and tobacco use (OR=0.27, 95%CI [0.57-1.28]). DISCUSSION: The use of anti-inflammatory drugs during the initial phase of an odontogenic infection was not related to the severity of infection.


Assuntos
Anti-Inflamatórios/efeitos adversos , Celulite (Flegmão)/etiologia , Celulite (Flegmão)/patologia , Doenças Estomatognáticas/complicações , Adolescente , Adulto , Antibacterianos/uso terapêutico , Celulite (Flegmão)/tratamento farmacológico , Celulite (Flegmão)/epidemiologia , Progressão da Doença , Face , Feminino , Infecção Focal Dentária/tratamento farmacológico , Infecção Focal Dentária/epidemiologia , Infecção Focal Dentária/patologia , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pescoço , Doenças Estomatognáticas/tratamento farmacológico , Doenças Estomatognáticas/epidemiologia , Doenças Estomatognáticas/patologia , Adulto Jovem
2.
Artigo em Francês | MEDLINE | ID: mdl-23992888

RESUMO

OBJECTIVE: The aim of this prospective study was to determine the influence of anti-inflammatory drugs on the severity of odontogenic cellulitis in patients admitted to our hospital emergency unit. STUDY DESIGN: The study was made from April 30 to October 31 2006. The clinical and pharmacological data was prospectively collected at admission, during hospitalization, and during systematic follow-up. We first studied the whole population and then compared the two groups: patients having received anti-inflammatory drugs before admission or not. RESULTS: Two hundred and sixty-seven patients were included. The only severity criterion significantly different between the two groups was spreading of cervical lymphangitis (P = 0.028). None of the four studied parameters was identified as a risk factor for spreading of cervical lymphangitis in multivariate analysis: anti-inflammatory use (OR = 5.99, 95%CI [0.71-50.88]), alcohol abuse (OR = 4.00, 95%CI [0.66-24.12]), dental hygiene (OR = 1.53, 95%CI [0.36-6.56]), and tobacco use (OR = 0.27, 95%CI [0.57-1.28]). DISCUSSION: The use of anti-inflammatory drugs during the initial phase of an odontogenic infection was not related to the severity of infection.


Assuntos
Anti-Inflamatórios/uso terapêutico , Celulite (Flegmão)/etiologia , Doenças Estomatognáticas/complicações , Adolescente , Adulto , Celulite (Flegmão)/epidemiologia , Celulite (Flegmão)/terapia , Face , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pescoço , Admissão do Paciente/estatística & dados numéricos , Doenças Estomatognáticas/epidemiologia , Doenças Estomatognáticas/terapia , Adulto Jovem
3.
Med Mal Infect ; 41(12): 652-6, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22056376

RESUMO

BACKGROUND: Adult leukemia patients with febrile neutropenia have a higher volume of distribution requiring increased drug doses. We performed a survey of vancomycin use in that population to assess the accuracy of our dosing guidelines. METHODS: We retrospectively reviewed the charts and laboratory results of vancomycin prescription and monitoring in adult acute myeloid leukemia patients with febrile neutropenia in a teaching hospital. RESULTS: Fifty-four patients received 67 vancomycin courses between January 2005 and April 2007. A loading dose was used in 97% of cases dosed at a mean 15.5±3.3mg/kg. It was followed by a continuous infusion of an average 35.4±6.9mg/kg per day maintenance dose. Serum monitoring yielded serum levels above the 20mg/L target in only 12% of cases. Despite higher dose, the target concentration was only reached in 32% of cases, after a mean 1.5 dose adjustment. The mean final maintenance dose was 42.1±9.4mg/kg per day. Vancomycin was well tolerated and induced only two temporary increases in serum creatinine. The treatment was microbiologically justified in only two cases. The mean length of therapy was 7.7±4.4 days and 41 over 65 (63%) non-documented infections were treated for more than five days despite local guidelines recommending a maximum 5-day course without bacterial documentation. Overall, only seven (10%) vancomycin courses complied with all defined criteria. CONCLUSIONS: Vancomycin use was not optimal. We updated our guidelines after the study to dramatically reduce vancomycin indications in leukemia patients. When it is indicated, following the loading dose, we more closely monitor vancomycin serum levels to allow for an earlier dose adjustment when necessary.


Assuntos
Antibacterianos/sangue , Infecções Bacterianas/sangue , Febre/etiologia , Leucemia Mieloide/sangue , Neutropenia/complicações , Vancomicina/sangue , Doença Aguda , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Antibacterianos/farmacocinética , Antibacterianos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/etiologia , Creatinina/sangue , Relação Dose-Resposta a Droga , Monitoramento de Medicamentos , Fidelidade a Diretrizes , Hospitais Universitários/estatística & dados numéricos , Humanos , Prescrição Inadequada , Quimioterapia de Indução/efeitos adversos , Infusões Intravenosas , Nefropatias/sangue , Nefropatias/induzido quimicamente , Leucemia Mieloide/complicações , Leucemia Mieloide/imunologia , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Infecções Estafilocócicas/sangue , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/prevenção & controle , Vancomicina/administração & dosagem , Vancomicina/efeitos adversos , Vancomicina/farmacocinética , Vancomicina/uso terapêutico
4.
Iowa Med ; 83(10): 364-6, 1993 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8244640
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