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Macau Periodical Index (澳門期刊論文索引)

Author
Raineri, SM; Stabile, A; Giarratano, A
Title
Linezolid in bolus vs linezolid in continuous infusion -- The host response in patients with severs sepsis
Journal Name
澳門醫學雜誌
Pub. Info
2005年6月26日, Vol.5, No.2, pp. 87-91
Keyword
Severe sepsis;Host response;Linezolid
Abstract
Objective: Severe sepsis by gram positive pathogens is commonly associated with high morbidity and mortality in every ICU. During the sepsis the coagulation cascade, the complement system and the actication system are activated, in different moments, and this contributes to the development of multiple organ failure. This activaion involves all system specially in late sepsis and contributes to the development of multiple organ failure associated with high mortality rate. Linezolid is a new class of antimicrobials (oxazolidinones) for the treatment of gram positive infection such as nosocomial pneumonia (including MRSA), community acquired pneumonia, complicate and umcomplicated skin infection and vancomycin resistant Enterococcus Faecium infection. In the study we propose to compare the clinical efficacy of Linezolid in bolus vs Linezolid in continuous infusion in patients with severe sepsis and septic shock (outcome) and to analyse whether significant differences are registered in the coagulation, inflammatory and complement response between the two groups of patients. Methods: A prospective, randomized comparative trial incolved not neutropenic patients admitted in ICU form January until March 2004. The 15 patients involved were those with severe sepsis or septic shock with a positive colture for gram positive and/or nosocomial pneumonia and/or complicated infection. 8 patients received iv Linezolid 600mg q 12 h for 14 days. We monitored AT III, PC, via functional (activity), immunological (antigen) and ELISA. The C1-inhibitor was measured by a chromogenic functional assay. Discussion: There is not difference significant, about mortality, between the patients of Group A and Group B. The Markers levels show the same trend in each group. It's to notice the different response registered in Survivors and No Survivors group. Conclusions: This preliminary data confirm the important role of coagulation and complement inhibitor in the modulation of host response in septic patients. (Pls separate the discussion and conclusion for two parts) Paragraph Headings: 1. Introduction 2. Methods 3. Results 4. Discussion & Conclusions Tables: 1. Population Data 2. Scores and Markers in Group A (±DS) 3. Scores and Markers in Group B (±DS) 4. Scores and Markers in Group NO Survivors (±DS) 5. Scores and Markers in Group Survivors (±DS) 6. Trend of inflammatory and complement markers in No Survivors Group (±DS) 7. Trend of inflammatory and complement markers in Survivors Group (±DS)