Wound antibiotic treatment

Multiple antibiotic options exist for the treatment of diabetic wound infections. Table 70-6 provides both general treatment strategies and specific, though not all-inclusive, antibiotic recommendations. The duration of therapy correlates with infection severity. Grade 2 infections require 7 to 14 days of therapy, whereas grade 3 to 4 wounds necessitate treatment durations of 14 to 28 days. If osteomyelitis is present, treatment should continue for at least 6 weeks.31... 

Wounds should be irrigated thoroughly with a copious volume (>150 mL) of sterile normal saline. Proper irrigation will reduce the bacterial count in the wound. Antibiotic or iodine solutions do not offer any advantage over saline and actually may increase tissue irritation. Several management techniques used in the treatment of bite wounds remain controversial these include the extent and type of debridement, the use of primary closure within 24 hours of the injury, and indications for the use of antibiotics. 

Chitin, chitosan, and their derivatives have been applied for wound treatment in the veterinary field since 1988, and one of the first cases of chitosan application was reported on a case of canker in a draft horse (Minami et al. 1991). They have also summarized clinical cases using chitin and chitosan to large animals (cows and horses) (Minami et al. 1992), small animals (dogs and cats) (Okamoto et al. 1992), and zoo animals (mammals, reptiles, and birds) (Fukumoto et al. 1995) using the chitin products (Chitipack S and Chitipack P), and a chitosan product (Chitopack C), which are commercialized in Japan. In comparison with conventional therapy with irrigation and antibiotic administration to a wound, new treatments with chitin and chitosan products permitted a substantial decrease in treatment frequency with minimal scar formation. 

Topical antibiotics exert a direct local effect on specific microorganisms and may be bactericidal or bacteriostatic. Bacitracin (Baciguent) inhibits the cell wall synthesis. Bacitracin, gentamicin (G-myticin), erythromycin (Emgel), and neomycin are examples of topical antibiotics. These drugp are used to prevent superficial infections in minor cuts, wounds, skin abrasions, and minor burns. Erythromycin is also indicated for treatment of acne vulgaris. 

The pathogenesis of diabetic foot infection stems from three key factors neuropathy, angiopathy, and immunopathy. Aerobic gram-positive cocci, such as S. aureus and P-hemolytic streptococci, are the predominant pathogens in acutely infected diabetic foot ulcers. However, chronically infected wounds are subject to polymicrobial infection and require treatment with broad-spectrum antibiotics. 

These data, taken together, demonstrate that topical application of rifaximin represents an effective and safe treatment of pyogenic skin infections. An additional application of this dermatological formulation would be infection prophylaxis in superficial skin wounds, particularly when used with a dressing that occludes the wound. Prophylactic topical antibiotic use makes particular sense for wounds in which the risk of infection is high, such as those that are likely to be contaminated (accidental wounds, lacerations, abrasions, and burns). Because all traumatic wounds should be considered contaminated, topical antibiotics are a logical measure to prevent wound... 

The role of antimicrobials for noninfected dog bite wounds remains controversial because only 20% of wounds become infected. Antibiotic recommendations for empiric treatment include a 3- to 5-day course of therapy. Amoxicillin-clavulanic acid is commonly recommended for oral outpatient therapy. Alternative agents include doxycycline, or the combination of penicillin VK and dicloxaciHin. 

If a patient has been exposed to rabies, the treatment objectives consist of thorough irrigation of the wound, tetanus prophylaxis, antibiotic prophylaxis (if indicated), and immunization. Postexposure prophylaxis immunization consists of both passive antibody administration and vaccine administration. 

Although we know less about the other vaccines, the recommendations are the same. You should see a health care provider. A baseline blood sample should be collected for testing for antibodies. We recommend that you take antibiotics (dorycycine and rifampin for strain 19 and REV-1, or doxycydine alone for RB-51) for 3 weeks. At the end of that time you should be rechecked and a second blood sample should be collected. (The sample can also be collected at 2 weeks ) The seme recommendations hold true for spraying vaccine in the eyes (6 weeks of treatment in this case) or spraying onlo open wounds on the skin. 

Tetanus immunoglobulin is an example of an antibody preparation used to induee passive immunization against a mierobial toxin. Tetanus (lockjaw) is an infectious disease caused by the bacterium, Clostridium tetani. Bacterial spores can commonly contaminate surface wounds and the resulting bacterial cells produce a toxin as they multiply. The toxin interferes with normal neurological function, particularly at neuromuscular junctions. The result is spasmodic contraction of muscles and, if untreated, mortality rates are high. Treatment with antibiotics and anti-toxin, however, is highly effective if administered promptly. 

When considering antimicrobial therapy in a patient with fever, one should answer the following questions. First, is the fever caused by an infection If affirmative, data are needed to determine the severity of the infection, the site of infection, and the causal micro-organism(s). Second, when the cause of the fever is infectious, one should ask is treatment with antimicrobial drugs needed Many soft tissue infections including impetigo and decubital ulcers are best treated with local antiseptics and/or wound debridement without the use of antibiotics. If the chance to cure the infection with antimicrobial... 

At one of the hospitals in Moscow the 5% l-(chloromethyl)silatrane ointment was used in treatment of 20 patients. Dressings with the ointment were applied daily or every second day. All the patients were cytologically examined for wound prints, inoculation of microflora, and sensitivity to antibiotics. 

Topical antibiotics are typically available as ointments and are excellent for use on open wounds. Coupled with the antibacterial action of the antibiotic ingredient, topical antibiotic ointments provide a safe and effective option in wound healing. In addition, topical antibiotics are effective for the localized treatment of primary and secondary pyodermas with minimal systemic side effects.14 Prophylactic uses include application for traumatic and surgical wounds, burns, intravascular catheters, and eradication of S. aureus nasal carriage.16 42 The advantage of antibiotic therapy in the treatment of eczematous skin will be discussed in the following article considering AD as an example. 

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