This study allows us to identify mycotic aneurysms of the cerebral and aortic vessels. Aneurysm ruptures are associated with high mortality. Diagnosing them allows you to determine the correct surgical tactics. Preference is given to the penicillin group of antibiotics, cephalosporins and aminoglycosides (Gentamicin, Amikacin, Tobramycin, Netilmicin). Depending on the type of pathogen, various combinations of antibacterial drugs are used, since combinations are preferable to monotherapy. The use of plavix with glycopeptides (Vancomycin) and beta-lactams significantly shortens the treatment period.
Streptococci are highly sensitive to penicillin and other β-lactams. (Ampicillin, Amoxicillin, Imipenem, Meropenem, Ticarcillin). The formation of acquired resistance is associated with changes in penicillin-binding proteins. Low levels of resistance can be overcome by increasing the dose of antibiotics. Enterococci are characterized by low sensitivity to many groups of antibiotics. All of these pathogens are resistant to cephalosporins. They are also resistant to aminoglycosides (Gentamicin, Tobramycin), but in combination with β-lactams their effect is enhanced. E. faecalis is sensitive to penicillins (natural and semi-synthetic), but for treatment their dose must be significantly increased. Among other drugs, tetracyclines and fluoroquinolones are moderately active. The use of Vancomycin is of primary importance.
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Staphylococci. β-lactams have the greatest antistaphylococcal activity, but penicillins (natural) and aminopenicillins have lost their importance in the treatment of this infection, so protected penicillins (Augmentin, Abiclave, Amoxiclav, Bactoclav), carbapenems (Imipenem, Meropenem) and cephalosporins are used. Staphylococci are also sensitive to macrolides, fluoroquinolones, glycopeptides, lincosamides, tetracyclines, aminoglycosides, and co-trimoxazole. The most common treatment regimen includes Oxacillin and first generation (Cefazolin). For staphylococcal endocarditis, administration of antistaphylococcal plasma is indicatedwe, staphylococcal toxoid, autovaccine.
- Blood cultures become negative two days after the start of antibiotic therapy. In the case of resistant organisms or methicillin-resistant Staphylococcus aureus, it may take a week for negative results to buy clopidogrel online.
- When abscess formation or large vegetations are present, persistent infection occurs despite antibiotic treatment.
- In patients with persistent bacteremia, the possibility of additional surgical treatment should be considered.
Treatment of endocarditis in practice also includes the use of immunoglobulins (Octagam). The use of plavix is possible for multiple organ symptoms (myocarditis, nephritis, polyarthritis), but they are prescribed in small doses (no more than 0.5 mg per 1 kg of weight per day) and in short courses. If circulatory failure occurs, strict bed rest is indicated, the prescription of diuretics, and the administration of cardiac glycosides are ineffective, since heart failure is caused by non-myocardial causes.
Detoxification therapy includes intravenous infusions (Reopoliglyukin, Hemodez) and diuretics. The volume of solutions is 2-2.5 liters per day. Be sure to monitor kidney function, diuresis and electrolyte composition of the blood. Infusion therapy is carried out throughout the acute period until the intoxication syndrome is relieved. The duration of the course can be 20-22 days. When protein levels in the blood decrease, solutions of albumin, amino acids or plasma are administered. For severe anemia, red blood cell transfusions are indicated.