Hospital therapy. Treatment and prevention of infective endocarditis (IE) (most important)

Lecture notes, cheat sheets
Free library / Directory / Lecture notes, cheat sheets

Hospital therapy. Treatment and prevention of infective endocarditis (IE) (most important)

Lecture notes, cheat sheets

Table of contents (expand)

20. Treatment and prevention of infective endocarditis (IE)

Treatment. Treatment of IE should be as early and etiotropic as possible, taking into account bacteriological data. A combination of conservative and surgical treatment is advisable.

For the treatment of IE in all age groups, antibiotics are primarily used, which have a bactericidal effect on microorganisms. The drug of first choice is still penicillin. The daily dose - up to 20 IU is administered intravenously and intramuscularly. However, one should not exclude the fact that in patients of elderly and senile age, when treated with penicillin and other antibiotics in high doses, a cardiotoxic effect is often observed.

With an unknown etiology, treatment begins with high doses of benzylpenicillin intramuscularly or intravenously up to 18-000 units or more, a combination with streptomycin up to 000 g / m per day or aminoglycosides (gentamicin, tobramycin at a rate of 20-000 mg / day) is used. kg per day). Cephalosporins are also basic drugs used for the treatment of IE: the most commonly used are claforan, cefamisin (000-1 g/day, intramuscularly and intravenously), as well as zeporin (4-6 g/day) and kefzol (up to 4-10 g intravenously). and etc.). Fusidin has a good anti-staphylococcal effect, in some cases it is effective in the resistance of microorganisms to other antibiotics (10-16 g / day).

Treatment with antibiotics is prescribed for a long time in a course of 1,5-2 months, until the infection is completely eliminated.

With reduced immunoreactivity of the body, antibacterial agents are combined with passive immunotherapy using immunomodulators (thymalin, T-activin, etc.). To prevent thrombosis, for example, in case of endocarditis that has developed against the background of angiogenic sepsis, controlled hypocoagulation is created using heparin (20-000 units intravenously or subcutaneously). To inhibit proteolytic enzymes, contrical is used (up to 25-000 units intravenously).

When valvular IE contributed to the formation of valvular heart disease or the manifestations of the disease do not disappear despite massive antibiotic therapy, it is advisable to perform surgical treatment. The main goal of the operation is to preserve the patient's own valve. Sometimes they are limited to removing vegetations, suturing ruptures of the valves, etc. If the valve is almost completely destroyed under the influence of infection, it is replaced with an artificial one (prosthesis) using mechanical and biological prostheses.

Prevention. Prevention of IE consists in the timely sanitation of chronic foci of infection in the oral cavity, tonsils, nasopharynx, paranasal sinuses, the use of active antibiotic therapy for acute streptococcal and staphylococcal diseases (tonsillitis, etc.). Hardening of the body is recommended.

<< Back: Clinical presentation and diagnosis of infective endocarditis (IE)

>> Forward: Etiology of bronchial asthma (BA)

We recommend interesting articles Section Lecture notes, cheat sheets:

▪ General and clinical immunology. Crib

▪ Social statistics. Lecture notes

▪ History of world and domestic culture. Crib

See other articles Section Lecture notes, cheat sheets.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

The existence of an entropy rule for quantum entanglement has been proven 09.05.2024

Quantum mechanics continues to amaze us with its mysterious phenomena and unexpected discoveries. Recently, Bartosz Regula from the RIKEN Center for Quantum Computing and Ludovico Lamy from the University of Amsterdam presented a new discovery that concerns quantum entanglement and its relation to entropy. Quantum entanglement plays an important role in modern quantum information science and technology. However, the complexity of its structure makes understanding and managing it challenging. Regulus and Lamy's discovery shows that quantum entanglement follows an entropy rule similar to that for classical systems. This discovery opens new perspectives in the field of quantum information science and technology, deepening our understanding of quantum entanglement and its connection to thermodynamics. The results of the study indicate the possibility of reversibility of entanglement transformations, which could greatly simplify their use in various quantum technologies. Opening a new rule ... >>

Mini air conditioner Sony Reon Pocket 5 09.05.2024

Summer is a time for relaxation and travel, but often the heat can turn this time into an unbearable torment. Meet a new product from Sony - the Reon Pocket 5 mini-air conditioner, which promises to make summer more comfortable for its users. Sony has introduced a unique device - the Reon Pocket 5 mini-conditioner, which provides body cooling on hot days. With it, users can enjoy coolness anytime, anywhere by simply wearing it around their neck. This mini air conditioner is equipped with automatic adjustment of operating modes, as well as temperature and humidity sensors. Thanks to innovative technologies, Reon Pocket 5 adjusts its operation depending on the user's activity and environmental conditions. Users can easily adjust the temperature using a dedicated mobile app connected via Bluetooth. Additionally, specially designed T-shirts and shorts are available for convenience, to which a mini air conditioner can be attached. The device can oh ... >>

Energy from space for Starship 08.05.2024

Producing solar energy in space is becoming more feasible with the advent of new technologies and the development of space programs. The head of the startup Virtus Solis shared his vision of using SpaceX's Starship to create orbital power plants capable of powering the Earth. Startup Virtus Solis has unveiled an ambitious project to create orbital power plants using SpaceX's Starship. This idea could significantly change the field of solar energy production, making it more accessible and cheaper. The core of the startup's plan is to reduce the cost of launching satellites into space using Starship. This technological breakthrough is expected to make solar energy production in space more competitive with traditional energy sources. Virtual Solis plans to build large photovoltaic panels in orbit, using Starship to deliver the necessary equipment. However, one of the key challenges ... >>

Random news from the Archive

Northern hemisphere gets more rainfall 24.10.2013

A quick look at the precipitation map of the world shows that most tropical rain falls in the Northern Hemisphere. So, on Palmyra Atoll (6 degrees north latitude), 444 cm of precipitation falls per year, while at an equal distance from the equator on the opposite side, only 114 cm.

For a long time, scientists believed that the reason for this phenomenon is the bizarre geometry of the Earth - ocean basins tilt diagonally, and the rotation of the planet pushes tropical rains north of the equator. But a new study from the University of Washington shows that such a phenomenon occurs for a different reason: because of ocean currents that originate from the poles thousands of kilometers from the equator.

Scientists in their report explained the reasons for this unusual phenomenon, and also proved that cold waters affect seasonal rains. And seasonal rains are crucial for agriculture in the African Sahel and in southern India. These regions are extremely uncomfortable, because large volumes of moist warm air rise up and return to the earth in the form of heavy precipitation. And since it is warmer in the Northern Hemisphere, more precipitation falls. Only one question remained unresolved: why is it warmer in the Northern Hemisphere?

Dargan Frierson Frierson and his colleagues made the first measurements using NASA's CERES satellite. It turned out that, in theory, the Southern Hemisphere receives more light, therefore, it should be warmer and more rainy. But after a number of other studies and the creation of computer models, scientists saw that a key role in shaping the climate is played by a water stream that curls in the Greenland region and goes along the ocean floor to Antarctica itself. The stream then rises and flows north over the surface. If this water current does not exist, then tropical rains will turn towards the south. The fact is that when water moves north for a long time, it gradually heats up. Thus, the current carries about 400 trillion watts of power across the equator.

The importance of ocean currents in shaping the climate was learned from the 2004 film The Day After Tomorrow, in which the circulation of the ocean's waters changes and New York freezes over. Scientists say that there will be no such sudden change, but gradual ones are quite real, for example, by 2100, UN experts say. At the same time, perhaps, the line of tropical rains will shift to the south, as it has probably already been in the past.

The slowing of the ocean current may be due to increased precipitation, and the fresher water of the North Atlantic will make the ocean water less dense.

According to scientists, their study is another proof of how important northern latitudes are for the entire climate of the Earth. Early work has already demonstrated how changing temperature balance between hemispheres affects the amount of tropical rainfall. A recent study showed how air pollution from industrial activities blocked light from reaching the Northern Hemisphere in the 1970s and 80s, and this process shifted the tropical rain line south. Experts believe that many climate changes are caused by climate change, and the future will depend on global warming and the circulation of water flows in the ocean. At this stage, the lack of knowledge about the impact of air pollution makes it difficult to predict the future shift of tropical rainfall.

Other interesting news:

▪ The new USB connector will not be incompatible with the current one.

▪ Signal circuit boards found inside human cells

▪ masked camera

▪ Artificial intelligence has learned to clone higher organisms

▪ Robot neurosurgeon

News feed of science and technology, new electronics

Interesting materials of the Free Technical Library:

▪ section of the site Biographies of great scientists. Article selection

▪ article Mars pathfinder space laboratory. History of invention and production

▪ article What flowers in Sarajevo remind of the war many years after it ended? Detailed answer

▪ article Automatic machine operator on knotting and winding machines and machine tools, engaged in the manufacture of corner springs. Standard instruction on labor protection

▪ article Making a scale of homemade pointer devices. Encyclopedia of radio electronics and electrical engineering

▪ article Converting a potentiometer angle to a digital code. Encyclopedia of radio electronics and electrical engineering

Leave your comment on this article:

All languages of this page

Home page | Library | Articles | Website map | Site Reviews