Sepsis drug therapy

Electrolytes Daily doses based on daily maintenance requirements, renal function, gastrointestinal losses, acid-base status, concomitant drug therapy, nutritional and anabolic status Pa lion I has hyponatremia, hypokalemia, hypomagnesemia, and hypophosphatemia, also has low serum bicarbonate concentration, could be component of metabolic acidosis due to sepsis... 

Patients with abdominal sepsis received usual drug therapy combined with biospecific hemosorption with Lyposorb. All patients were urgently operated. After operative procedure patients were transferred to intensive care unit for recovery, where all the necessary treatment and observations were carried out during critical postoperative period. 

Appropriate empiric anti-infective therapy decreases 28-day mortality compared to inappropriate empiric therapy (24% versus 39%).22 23,30 Additionally, appropriate therapy administered within 1 hour of sepsis recognition also decreases complications and mortality.22-23,30 Empiric anti-infective therapy should include one, two, or three drugs, depending on the site of infection and causative pathogens (Table 79-3). Anti-infective clinical trials in sepsis and septic shock patients are scarce and have not demonstrated differences among agents therefore, factors that determine selection are ... 

Etanercept therapy should not be initiated in patients with active infection. If an infection develops in a person taking etanercept, he or she should be closely monitored. If a serious infection or sepsis occurs, the drug should be discontinued. Etanercept should be used with caution in individuals who have conditions predisposing them to serious infection (e.g., uncontrolled diabetes, hematological abnormalities). Data on drug interactions are limited. Live virus vaccines are contraindicated because of the potential for secondary transmission of the infection by the vaccine. Myelo-suppressive antirheumatic agents have been associated with pancytopenia in some patients treated with etanercept. 

Amphotericin B remains the drug of choice in the treatment of invasive aspergillosis, locally invasive mucormycosis, and many disseminated fungal infections occurring in immunocompromised hosts (the patient population most at risk for serious fungal infections). For example, the febrile neutropenic oncology patient with persistent fever despite empirical antibacterial therapy is best treated with amphotericin B for possible Candida spp. sepsis. 

Serious adverse events occur in up to 6% of patients with anti-TNF therapy. The most important adverse effect of these drugs is infection due to suppression of the ThI inflammatory response. This may lead to serious infections such as bacterial sepsis, tuberculosis, invasive fungal organisms, reactivation of hepatitis B, listeriosis, and other opportunistic infections. Reactivation of latent tuberculosis, with dissemination, has occurred. Before administering anti-TNF therapy, all patients must undergo purified protein derivative (PPD) testing prophylactic therapy for tuberculosis is warranted for patients with positive test results. More common but usually less serious infections include upper respiratory infections (sinusitis, bronchitis, and pneumonia) and cellulitis. The risk of serious infections is increased markedly in patients taking concomitant corticosteroids. 

AZATHIOPRINE LEFLUNOMIDE T risk of serious infections (sepsis) and of opportunistic infections (Pneumocystis jiroveci pneumonia, tuberculosis, aspergillosis) Additive immunosuppression Monitor platelets, white bloods cell, haemoglobin and haematocrit at baseline and regularly - weekly, during concomitant therapy. With evidence of bone marrow suppression, discontinue leflunomide and administer colestyramine or charcoal to T elimination of leflunomide - For signs and symptoms of immunosuppression, see Qinical Features of Some Adverse Drug Interactions, Immunosuppression and blood dyscrasias... 

During a cesarean section, unlike other surgical procedures, antibiotics should be administered after the initial incision is made and after the umbilical cord is clamped. This will minimize infant drug exposure and thus potentially decrease the incidence of neonatal sepsis. Longer durations of prophylactic therapy have not been shown to result in lower infection rates. " ... 

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