Use of antibiotics in the management of postirradiation wound infection and sepsis
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), Vol. 115:1
- Country of Publication:
- United States
- Language:
- English
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ANTIBIOTICS
USES
RETICULOENDOTHELIAL SYSTEM
BIOLOGICAL RADIATION EFFECTS
WOUNDS
HEALING
BACTERIAL DISEASES
GAMMA RADIATION
RADIATION INJURIES
REVIEWS
SEPTICEMIA
SURVIVAL TIME
ANIMAL TISSUES
ANTI-INFECTIVE AGENTS
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BIOLOGICAL RECOVERY
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DOCUMENT TYPES
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ELECTROMAGNETIC RADIATION
INFECTIOUS DISEASES
INJURIES
IONIZING RADIATIONS
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560151* - Radiation Effects on Animals- Man