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1.
Drugs ; 69(4): 407-19, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19323585

RESUMEN

Patients with bronchiectasis experience tenacious mucus, recurrent infectious exacerbations, and progressive worsening of symptoms and obstruction over time. Treatment is aimed at trying to break the cycle of infection and progressive airway destruction. Antibacterial treatment is targeted towards likely organisms or tailored to the results of sputum culture. Inhaled antibacterial therapy may offer the advantage of increased local concentration of medication, while minimizing systemic adverse effects; however, to date, studies have been equivocal in this disorder. Macrolides, in addition to their antibacterial properties, have unique anti-inflammatory properties, which may make them useful in this disorder. Other mucoactive and anti-inflammatory agents, such as inhaled corticosteroids, mannitol and hypertonic saline, may also prove useful in this disease, but further studies are needed.


Asunto(s)
Antiinfecciosos/uso terapéutico , Antiinflamatorios/uso terapéutico , Bronquiectasia/tratamiento farmacológico , Administración por Inhalación , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Antiinfecciosos/administración & dosificación , Antiinflamatorios/administración & dosificación , Broncodilatadores/administración & dosificación , Broncodilatadores/uso terapéutico , Expectorantes/administración & dosificación , Expectorantes/uso terapéutico , Humanos , Soluciones Hipertónicas/administración & dosificación , Soluciones Hipertónicas/uso terapéutico , Macrólidos/administración & dosificación , Macrólidos/uso terapéutico , Manitol/administración & dosificación , Manitol/uso terapéutico
2.
Heart Lung ; 34(6): 442-7, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16324966

RESUMEN

Right-sided acute bacterial endocarditis (ABE) is an infrequent complication of central intravenous (IV) lines. We report a case of methicillin-sensitive Staphylococcus aureus tricuspid valve (TV) ABE related to a peripherally inserted central catheter line (PICC). Patients with right-sided ABE present with symptoms of fever and chills, and symptoms and signs of pulmonary emboli. In the patient presented, the PICC line was removed and high-dose cefazolin therapy, 2 g (IV) every 8 hours, was initiated. Although the patient's blood cultures became negative during the third week of cefazolin therapy, her erythrocyte sedimentation rate and teichoic acid antibody titers remained high. Pulmonary emboli developed. A large TV vegetation (1 x 2 cm) remained unchanged after 4 weeks of cefazolin therapy. For these reasons, cefazolin treatment was considered a treatment failure. Therapy with daptomycin was initiated at a dose of 6 mg/kg (IV) every 24 hours. During daptomycin therapy, the patient's erythrocyte sedimentation rate and teichoic acid antibody titers gradually returned to normal. Repeat transthoracic echocardiograph revealed the TV vegetation was gone and the methicillin-sensitive Staphylococcus aureus ABE was cured with daptomycin. We conclude daptomycin is a rapidly bactericidal antistaphylococcal antibiotic reliably effective even when other usually effective antistaphylococcal antibiotics have failed.


Asunto(s)
Cateterismo Venoso Central/efectos adversos , Cefazolina/uso terapéutico , Daptomicina/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus aureus/efectos de los fármacos , Enfermedad Aguda , Adulto , Antibacterianos/uso terapéutico , Endocarditis Bacteriana/etiología , Endocarditis Bacteriana/microbiología , Femenino , Estudios de Seguimiento , Humanos , Resistencia a la Meticilina , Embarazo , Complicaciones Infecciosas del Embarazo/etiología , Complicaciones Infecciosas del Embarazo/microbiología , Tercer Trimestre del Embarazo , Infecciones Estafilocócicas/etiología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Válvula Tricúspide
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