[The role of cefepime, a 4th-generation cephalosporin, in treating patients with surgical sepsis]. / Rol' tsefalosporina IV pokoleniia tsefepima v lechenii bol'nykh s khirurgicheskim sepsisom.

Cefepime (Maxipime) was used in the management of 22 patients at the age of 18 to 73 years with the surgical sepsis syndrome (SAPS > 15). In 16 patients surgical sepsis was due to pancreatitis, appendititis, abdominal wound or trauma or complications after planned surgical interventions on the organs of the abdominal cavity. In the other 6 patients surgical sepsis was due to inflammatory processes in soft tissues after minor trauma. In 10 patients (group 1) cefepime was used after the pathogen verification and antibioticogram examination. In 12 patients (group 2) the antibiotic was used in the empirical therapy as the first line drug after the patients acceptance from another unit when the pathogen nature was obscure. Cefepime was administered intravenously in a dose of 2.0 g twice daily for 7 to 10 days in combination with metronidazole in a dose of 0.5 g thrice daily. After 5-6 days of the treatment the patients of group 1 were switched to the cefepime intramuscular regimen. The lethality totaled 18 per cent (4 patients). Three of them were from group 2. The patients died of progressive polyorgan insufficiency. It is characteristic that in no cases cefepime induced septic shock due to the endotoxin escape. No septicopyemia was as well observed even in the patients with verified bacteremia due to Staphylococcus aureus.

[Use of antegrade endolymphatic administration of antistaphylococcal and antipseudomonal plasma in the treatment of infectious complications in severe multiple trauma]. / Primenenie antegradnogo éndolimfaticheskogo vvedeniia antistafilokokkovoi i antisinegnoinoi plazmy v lechenii infektsionnykh oslozhnenii pri tiazheloi sochetannoi travme.

The article deals with the treatment of infectious complications in persons with severe concurrent trauma. Microbiological study of the wound discharge and damaged tissues showed staphylococci and blue pus bacillus to be the principal causative agents of infectious complications. In view of the poor response of the immune system to the opportunistic flora, the performance of passive immunization with antistaphylococcal and antipseudomonal plasma is pathogenetically grounded. Taking into account the involvement of the lymphatic system in the infectious process, endolymphatic administration of the immune plasma is suggested.

[Wound infection]. / Ranevaia infektsiia.

A present-day view on the problem of wound infection is analyzed with special reference to recent data. Active surgical approach in combination with many-component antibacterial and correcting treatment still remains important in prevention and treatment of wound infection.