RESUMO
Streptococcus pneumoniae is a major cause of severe disease worldwide, particularly in the risk population. Two pneumococcal vaccines are currently available for specific prevention of pneumococcal infections among adults in Russia: a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and a 13-valent pneumococcal conjugate vaccine (PCV13). The article describes modern views on the effectiveness and safety of two pneumococcal vaccines in adults with underlying medical conditions and adults aged ≥ 65 years and provides current recommendations for routine use of PPSV23 and PCV13 among persons included in the risk group.
Assuntos
Vacinas Pneumocócicas/uso terapêutico , Pneumonia Pneumocócica , Streptococcus pneumoniae/efeitos dos fármacos , Adulto , Idoso , Humanos , Imunização/métodos , Pneumonia Pneumocócica/microbiologia , Pneumonia Pneumocócica/prevenção & controle , Medicina Preventiva/métodos , Resultado do TratamentoRESUMO
Septic encephalopathy is a form of general cerebral dysfunction caused by a systemic inflammatory reaction. Its investigation encounters enormous difficulties for the lack of reliable biological markers of neuronal lesions and methods for the evaluation of consciousness in severely ill patients. Hence, the importance of correct clinical interpretation of the character and magnitude of CNS activity. Examples are presented demonstrating the difficulty of interpreting disorders in CNS activity associated with evere community-acquired pneumonia.
Assuntos
Antibacterianos/administração & dosagem , Pneumonia , Encefalopatia Associada a Sepse , Encéfalo/patologia , Encéfalo/fisiopatologia , Diagnóstico Diferencial , Gerenciamento Clínico , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Pneumonia/complicações , Pneumonia/diagnóstico , Pneumonia/tratamento farmacológico , Pneumonia/fisiopatologia , Encefalopatia Associada a Sepse/diagnóstico , Encefalopatia Associada a Sepse/etiologia , Encefalopatia Associada a Sepse/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Inconsciência/etiologia , Adulto JovemRESUMO
Conmnnity-acquired pneumonia in pregnancy.
Assuntos
Anti-Infecciosos/uso terapêutico , Infecções Comunitárias Adquiridas , Pneumonia , Complicações Infecciosas na Gravidez , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/etiologia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pneumonia/diagnóstico , Pneumonia/tratamento farmacológico , Pneumonia/etiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/etiologia , Resultado da Gravidez , PrognósticoRESUMO
This open comparative randomized study of efficacy, safety, and pharmacoeconomic characteristics of hilifox-750 (750 mg daily for 5 days) and amoxiclav 2X (875/125 mg twice daily for 10 days) included 60 patients with chronic obstructive pulmonary disease (COPD). Duration of the study was 6 months. Medians of age and smoking index in the group treated with hilifox-750 were 63.5 yr (59, 67) and 30 packs/yr (15, 60) respectively. The treatment reduced cough, apnea, sputum volume and pyoptysis with comparative rates of normalization of body temperature and peripheral leukocyte counts in both groups. Helifox-750 promoted decrease in coughing and apnea within the first three days of therapy. 28 (93%) and 26 (87%) patients recovered by day 4 of helifox and amoxiclav therapy (F-test p = 0.67). Both drugs showed comparable bacteriological efficacy. They were not different in terms of side effect frequency that were mild, resolved spontaneously and did not require withdrawal of therapy. Helifox had advantages over amoxiclav in that it reduced duration of antibacterial therapy to 5 days and of temporary incapacity to 12 days (vs 14); moreover, it needs to be taken only once daily.
Assuntos
Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Antibacterianos/administração & dosagem , Levofloxacino , Ofloxacino/administração & dosagem , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Idoso , Combinação Amoxicilina e Clavulanato de Potássio/efeitos adversos , Combinação Amoxicilina e Clavulanato de Potássio/economia , Combinação Amoxicilina e Clavulanato de Potássio/farmacologia , Antibacterianos/efeitos adversos , Antibacterianos/economia , Antibacterianos/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ofloxacino/efeitos adversos , Ofloxacino/economia , Ofloxacino/farmacologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Resultado do TratamentoRESUMO
The aim of the study was to analyse results of antibiotic treatment of community-acquired pneumonia in the pulmonological department of a multidisciplinary hospital and to estimate its conformity with the national guidelines. We undertook retrospective analysis of 110 case histories and prescriptions to patients with pneumonia (age median 58.5 yr, men 58%). Severe community-acquired occurred in 9% of the cases. Antibacterial therapy at the pre-hospitalization stage was given to 1/3 patients. After hospitalization, the starting therapy most frequently included cefazoline (32.7%), ampicillin (21.8%) or cefotaxim (14.5%). Combinations of cefazoline + ciprofloxacin was used in 7.3%, ampicillin + ciprofloxacin in 4.5%, cefotaxim + ciprofloxacin in 2.7% of the cases. Correction of first-line therapy was needed in 55.4% of the cases because of its inefficiency. Median of duration of antibiotic therapy was 17 days, 2.7% of the cases were switched from intravenous to oral treatment.