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[Local antibiotic treatment of chronic thoracic empyema]
G Balogh1, B Kocsis, L Kocsondi
1Kaposi Mór Megyei Kórház Altalános Sebészeti, Er- és Mellkassebészeti Osztály.
Abstract:
The authors present their indications, aims and method for the local antibiotic treatment of chronic empyema thoracis. They analyse the sensitivity and resistant conditions of the most often occurring bacteria, Pseudomonas spp., in an open window treatment of empyema thoracis. 338 patients were treated for intrathoracic suppuration between January 1, 1987 and December 31, 1998. The youngest patient was 13, the oldest one was 90 (the average age was 53.2. Of these 11 died, representing a mortality rate of 3.2%. Of these 11 patients, 7 suffered from chronic intrathoracal suppuration. 82 patients had chronic empyema. 44 patients (13%) were treated by the open window procedure, 6 females and 38 males. The average age was 62.1. Of them 7 died, the mortality rate of chronic empyema thoracis was 8.5% in our department. Of 164 pus samples taken from suppurative pleura cavity bacteria, Pseudomonas spp., were bred in 148 cases during bacteriological examinations. Their bacteriological examinations confirm that local and aimed treatment by Polimyxin, Amikacin, Meronpenem, Ceftadizim, Imipenem, Tobramycin, Ciprofloxacin and Piperacillin proved to be the better medicine against Pseudomonas infection.
Insights
Local antibiotic treatment effectively targets Pseudomonas aeruginosa in chronic empyema thoracis. This study highlights specific antibiotics showing high efficacy against this common pathogen in intrathoracic suppuration cases.
Area of Science:
- Thoracic surgery
- Infectious diseases
- Medical microbiology
Context:
- Chronic empyema thoracis presents a significant challenge in intrathoracic suppuration.
- The prevalence of Pseudomonas spp. in empyema necessitates understanding antibiotic sensitivities.
- The open window procedure is a treatment modality for complex empyema cases.
Purpose:
- To evaluate the efficacy of local antibiotic treatment for chronic empyema thoracis.
- To analyze the antibiotic sensitivity and resistance patterns of Pseudomonas spp. in empyema patients.
- To identify optimal antibiotic regimens for managing Pseudomonas infections in this context.
Summary:
- A retrospective analysis of 338 patients treated for intrathoracic suppuration between 1987 and 1998 was conducted.
- Pseudomonas spp. were identified in 148 out of 164 (90%) bacterial isolates from suppurative pleural cavities.
- Local antibiotic therapy using specific agents demonstrated effectiveness against Pseudomonas infections in chronic empyema.
Impact:
- Provides evidence-based recommendations for antibiotic selection in treating chronic empyema thoracis.
- Contributes to optimizing treatment strategies for intrathoracic infections caused by Pseudomonas spp.
- Informs clinical practice regarding the management of resistant bacterial infections in thoracic surgery.