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Особенности при лечении обожженных антибиотиками
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Особенности при лечении обожженных антибиотиками

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by admin15.08.2015
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Следует избегать применения одновременно нескольких антибиотиков и лечить ими активную инфекцию дольше, чем это в действительности необходимо. Срочную переоценку показаний к продолжению антибиотикотерапии следует проводить после 5 дней лечения и каждые 3-5 дней в последующем, поскольку в интересах больного прекратить антибиотикотерапию как можно скорее, чтобы предотвратить появление резистентных микроорганизмов и суперинфекции. Первоначальный выбор системных антибиотиков для лечения инвазивного ожогового сепсиса или септицемии необходимо делать так, чтобы при наличии стрептококка можно было применить пенициллин D, при стафилококке — нафциллин или метициллин или цефалоспорин, при синегнойной палочке — гентамицин, тобрамицин, карбенициллин, при другой грамотрицательной микрофлоре — гентамицин.

Для стимуляции иммунной защиты организма обожженных против антибиотико-устойчивых штаммов стафилококков М. Ф. Камаев и А. Л. Федоровский рекомендуют повторно применять гамма-глобулин и плазму крови направленного противо-стафилококкового действия.

Использование эффективных антимикробных препаратов для местного лечения ожогов (типа сульфамилона) значительно снижает число бактерий в некротических тканях, но никогда не стерилизует рану полностью.

Несмотря на имеющиеся колонии бактерий, инвазии в подлежащие жизнеспособные ткани часто не определяется и классический ожоговый сепсис не развивается. Значит, «бактериальная колонизация» снижена до уровня, при котором имеется адекватный локальный баланс хозяина и паразита в пользу хозяина.

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