tetracycline and Emergencies

Topics: Actinomycetales Infections; Anti-Bacterial Agents; Aortic Valve Stenosis; Bacteremia; Brevibacterium; Ceftriaxone; Disease Susceptibility; Drug Therapy, Combination; Emergencies; Endocarditis, Bacterial; Facial Dermatoses; Gentamicins; Humans; Levofloxacin; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Recurrence; Tetracycline; Vancomycin; Wound Infection

We describe the laboratory-confirmed etiologies of illness among participants in a hospital-based febrile illness cohort study in northern Tanzania who retrospectively met Integrated Management of Adolescent and Adult Illness District Clinician Manual (IMAI) criteria for septic shock, severe respiratory distress without shock, and severe pneumonia, and compare these etiologies against commonly used antimicrobials, including IMAI recommendations for emergency antibacterials (ceftriaxone or ampicillin plus gentamicin) and IMAI first-line recommendations for severe pneumonia (ceftriaxone and a macrolide). Among 423 participants hospitalized with febrile illness, there were 25 septic shock, 37 severe respiratory distress without shock, and 109 severe pneumonia cases. Ceftriaxone had the highest potential utility of all antimicrobials assessed, with responsive etiologies in 12 (48%) septic shock, 5 (14%) severe respiratory distress without shock, and 19 (17%) severe pneumonia illnesses. For each syndrome 17-27% of participants had etiologic diagnoses that would be non-responsive to ceftriaxone, but responsive to other available antimicrobial regimens including amphotericin for cryptococcosis and histoplasmosis; anti-tuberculosis therapy for bacteremic disseminated tuberculosis; or tetracycline therapy for rickettsioses and Q fever. We conclude that although empiric ceftriaxone is appropriate in our setting, etiologies not explicitly addressed in IMAI guidance for these syndromes, such as cryptococcosis, histoplasmosis, and tetracycline-responsive bacterial infections, were common.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Amphotericin B; Ampicillin; Anti-Infective Agents; Bacterial Infections; Ceftriaxone; Child; Cohort Studies; Cryptococcosis; Emergencies; Female; Gentamicins; Histoplasmosis; Humans; Infections; Macrolides; Male; Microbial Sensitivity Tests; Middle Aged; Pneumonia, Bacterial; Respiratory Distress Syndrome; Shock, Septic; Tanzania; Tetracycline; Young Adult

Topics: Breast Neoplasms; Cardiac Tamponade; Drainage; Emergencies; Female; Heart Neoplasms; Humans; Lung Neoplasms; Pericardial Effusion; Pericardium; Tetracycline

Topics: Adolescent; Adult; Aged; Child; Emergencies; Female; Gastrointestinal Diseases; Humans; Male; Middle Aged; Peritonitis; Premedication; Surgical Wound Infection; Tetracycline; Therapeutic Irrigation

Topics: Acute Disease; Adolescent; Adult; Aged; Diverticulitis; Emergencies; Female; Humans; Intraoperative Period; Male; Middle Aged; Peritonitis; Tetracycline; Therapeutic Irrigation

Topics: Adult; Emergencies; Esophagitis; Female; Humans; Tetracycline; Urethritis

Satisfactory experience with single-layer colorectal anastomosis during 1969-74 led to an analysis of the results of single-layer large bowel anastomosis during the subsequent years 1975-79. This technique has continued to be associated with a low incidence of anastomotic failure, but anastomotic integrity also depends on rigorous attitudes to bowel preparation, to bacterial contamination and to the avoidance of anastomosis when the risk of anastomotic failure is high.

Topics: Aged; Emergencies; Humans; Intestine, Large; Male; Methods; Postoperative Complications; Risk; Suture Techniques; Tetracycline; Therapeutic Irrigation

Topics: Animals; Cardiac Catheterization; Coronary Artery Bypass; Coronary Vessels; Dogs; Electrocardiography; Emergencies; Fluoresceins; Injections, Intravenous; Ligation; Myocardial Infarction; Myocardial Revascularization; Tetracycline

Topics: Ampicillin; Angina Pectoris; Anti-Bacterial Agents; Bacteriological Techniques; Diagnosis, Differential; Drug Therapy; Emergencies; Genital Diseases, Female; Humans; Hydrocortisone; Hypoxia; Metaraminol; Sepsis; Shock; Shock, Septic; Surgical Wound Infection; Tetracycline

Bacteremic shock is second in frequency only to myocardial infarction as a cause of hypotension and death in hospitalized medical patients. The clinical course is marked by fever, usually with chills, and hypotension with a full pulse and warm extremities, followed by shock, often resistant to treatment. Anticipation of this complication in patients with certain predisposing diseases or factors facilitates early recognition of the symptoms and signs of bacteremic shock and prompt treatment. Early and effective treatment of the offending infection often prevents progression of hypotension to the stage of frank vascular collapse.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Emergencies; Humans; Hypotension; Metaraminol; Methicillin; Myocardial Infarction; Norepinephrine; Phenoxybenzamine; Sepsis; Shock; Shock, Septic; Streptomycin; Tetracycline