Use of antibiotics in the management of postirradiation wound infection and sepsis

Journal Article · Fri Jul 01 04:00:00 EDT 1988 · Radiat. Res.; (United States)

DOI:https://doi.org/10.2307/3577052· OSTI ID:6823506

Brook, I

Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references.

• Research Organization: Armed Forces Radiobiology Research Institute, Bethesda, MD (USA)
• OSTI ID: 6823506
• Journal Information: Radiat. Res.; (United States), Journal Name: Radiat. Res.; (United States) Vol. 115:1; ISSN RAREA
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMAL TISSUES
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
BACTERIAL DISEASES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL RECOVERY
BODY
DISEASES
DOCUMENT TYPES
DRUGS
ELECTROMAGNETIC RADIATION
GAMMA RADIATION
HEALING
INFECTIOUS DISEASES
INJURIES
IONIZING RADIATIONS
RADIATION EFFECTS
RADIATION INJURIES
RADIATIONS
RECOVERY
RETICULOENDOTHELIAL SYSTEM
REVIEWS
SEPTICEMIA
SURVIVAL TIME
TISSUES
USES
WOUNDS