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[Antibiotic therapy of infections in patients on dialysis]
Abstract:
The results obtained in treating infections in 53 patients involved in a chronic dialysis-transplantation program are reported. Higher susceptibility to infections and reduced immune functions were observed in dialyzed patients. The problem of the occurrence rate of individual infections was analyzed and infections of the respiratory system, particularly bronchopneumonia, were found to be predominant. No patient died of infection; in two patients the prescribed antibiotic of first choice had to be changed; positive clinical and laboratory effect was recorded in 51 of the 53 patients treated, and after change of the antibiotic in all the patients. Particular regimens of individual antibiotics in dialyzed patients are given along with the dialyzability of the drugs. The best results were obtained with ofloxacin and doxycycline of Czecho-Slovak make in monotherapy, in combined treatment gentamycin an amikacin with cefamezin or with cefotaxim proved to be most effective. Of the 45 pathogenic agents isolated, Staphylococcus aureus, Klebsiella spp, and Acinetobacter lwoffi, which have a good sensitivity to antibiotics, had the highest occurrence rates. (Tab. 4, Ref. 6.).
Insights
Patients undergoing chronic dialysis and transplantation face increased infection risks, primarily respiratory infections like bronchopneumonia. Effective antibiotic treatments, including ofloxacin and doxycycline, showed high success rates in this vulnerable population.
Area of Science:
- Infectious Diseases
- Nephrology
- Immunology
Context:
- Patients in chronic dialysis-transplantation programs exhibit heightened susceptibility to infections.
- Immune function is significantly reduced in patients undergoing dialysis.
- Respiratory infections, particularly bronchopneumonia, are the most prevalent in this cohort.
Purpose:
- To analyze infection occurrence rates in patients undergoing chronic dialysis-transplantation.
- To evaluate the efficacy of various antibiotic regimens in treating infections in this patient group.
- To identify predominant pathogens and their antibiotic sensitivities.
Summary:
- A study of 53 patients in a chronic dialysis-transplantation program reported high rates of infection, predominantly respiratory. Most patients responded well to antibiotic treatment, with ofloxacin and doxycycline showing efficacy in monotherapy. Combined treatments with gentamicin, amikacin, cefamezin, or cefotaxim were also effective.
- Key pathogens identified included Staphylococcus aureus, Klebsiella spp., and Acinetobacter lwoffi, all demonstrating good antibiotic sensitivity.
- No patient mortality was attributed to infection, and treatment was successful in 51 out of 53 patients, with full recovery after antibiotic adjustment in all cases.
Impact:
- Provides crucial data on infection management in immunocompromised patients undergoing dialysis and transplantation.
- Highlights effective antibiotic strategies, including specific drug choices and regimens, for this population.
- Informs clinical practice regarding the prevention and treatment of infections in renal replacement therapy patients.