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Use of antibiotics in the management of postirradiation wound infection and sepsis.
Radiat Res. 1988 Jul; 115(1):1-25.RR

Abstract

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 débridement 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.

Authors+Show Affiliations

Armed Forces Radiobiology Research Institute, Bethesda, Maryland 20814-5145.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Review

Language

eng

PubMed ID

3293098

Citation

Brook, I. "Use of Antibiotics in the Management of Postirradiation Wound Infection and Sepsis." Radiation Research, vol. 115, no. 1, 1988, pp. 1-25.
Brook I. Use of antibiotics in the management of postirradiation wound infection and sepsis. Radiat Res. 1988;115(1):1-25.
Brook, I. (1988). Use of antibiotics in the management of postirradiation wound infection and sepsis. Radiation Research, 115(1), 1-25.
Brook I. Use of Antibiotics in the Management of Postirradiation Wound Infection and Sepsis. Radiat Res. 1988;115(1):1-25. PubMed PMID: 3293098.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of antibiotics in the management of postirradiation wound infection and sepsis. A1 - Brook,I, PY - 1988/7/1/pubmed PY - 1988/7/1/medline PY - 1988/7/1/entrez SP - 1 EP - 25 JF - Radiation research JO - Radiat Res VL - 115 IS - 1 N2 - 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 débridement 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. SN - 0033-7587 UR - https://www.unboundmedicine.com/medline/citation/3293098/Use_of_antibiotics_in_the_management_of_postirradiation_wound_infection_and_sepsis_ DB - PRIME DP - Unbound Medicine ER -