RESUMO
An antibiotic policy should aim for the safe, effective and economical use of antimicrobial drugs, and to prevent their indiscriminate use and development of resistant bacterial strains. The term 'antibiotic' is used as a general term for all antimicrobial drugs. Antibiotics prescriptions should be based on clinical evidence of bacterial infection, preferably substantiated by appropriate laboratory culture and sensitivity tests. Viral infections are not an indication for antibiotic prescriptions. Patient factors to be considered for choice and dose of an antibiotic are age, pregnancy, lactation, renal and hepatic impairment. Immunodeficient patients should receive only bactericidal drugs. Severity of infection determines the route of administration. Duration of therapy should not exceed five days, unless specifically prescribed by the physician. An antibiotic should, if started as an empirical therapy not be changed before a minimum of three days trial. Prescriptions of drugs such as aztreonam, imipenem, vancomycin, piperacillin and amphotericin are to be restricted due to cost and toxicity and should be reviewed by the microbiologist (AU)
Assuntos
Antibacterianos , Prática Profissional , Dermatopatias Virais , Prescrições de Medicamentos , Fatores Etários , Gravidez , Lactação , Insuficiência Renal , Imipenem , Piperacilina , Infecções/tratamento farmacológico , Antibacterianos/economia , Antibacterianos/uso terapêutico , Formulação de Políticas , Economia Hospitalar , Resistência Microbiana a Medicamentos , Streptococcus pneumoniae , Infecções por Haemophilus , Sepse , Endocardite , Bronquiectasia , Cloranfenicol , Tetraciclinas , Quinolonas , Sulfonamidas , Bronquite , Sinusite , Tonsilite , Faringite , Sífilis , Hipersensibilidade , Síndrome de Imunodeficiência Adquirida , Aztreonam , Vancomicina , Aciclovir , Anfotericina B , Monitoramento de Medicamentos , Aminoglicosídeos , beta-Lactamases , Região do CaribeRESUMO
A case is described of a three year old boy with acute lymphoblastic leukaemia (ALL) who presented initially with aspergillosis of the nasophgillosis of the nasopharynx. Fungal infection with Aspergillus species is not uncommon in immunosuppressed children, but this case is noteworthy in that the disease presented at the onset of therapy rather than during the phase of treatment with maximum immunosuppression following chemotherapy. This type of infection is usually associated with the treatment of acute non-lymphoblastic leukaemais (AMS) rather than ALL, and prolonged periods of neutropenia which results from aggressive treatment. This patient responded rapidly to treatment with amphotericin B, coincident with resolution of his neutropenia as the underlying disease was treated, eventually eradicating the fungus (AU)
Assuntos
Humanos , Pré-Escolar , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Aspergilose/tratamento farmacológico , Aspergilose/tratamento farmacológico , Aspergilose/microbiologia , Anfotericina B/uso terapêuticoRESUMO
Three cases are reported of patients with the acquired immune deficiency syndrome (AIDS) and cutaneous histoplasmosis. Their initial presentation was that of a generalised malculopapular rash. Two patients were bisexual males and the third was an unmarried female. The range of opportunistic infections seen in AIDS patients in Trinidad is mentioned and clinicians are alerted to the fact that in areas endemic for histoplasma capsulatum maculopapular rash in patients with AIDS may suggest disseminated histoplasmosis. The value of skin biopsy is mentioned. (AU)
