Question of the Week

Question

Question :

Posted On : 17 Oct 2009

advance tratment for septecemia and how to get and use of rectal arteesunate in rural areas

Expert Answer :

Answer Discussion :

No answer discussion available.

Answer 1

The therapy of sepsis rests on antibiotics, surgical drainage of infected fluid collections, fluid replacement and appropriate support for organ dysfunction along with ionotropes in case of fluid refractory shock. This may include hemodialysis in kidney failure, mechanical ventilation in pulmonary dysfunction, transfusion of blood products, and drug and fluid therapy for circulatory failure. Ensuring adequate nutrition—preferably by enteral feeding, but if necessary by parenteral nutrition—is important during prolonged illness.Most therapies aimed at the inflammation process itself have failed to improve outcome, however Drotrecogin Alfa {activated protein C, one of the coagulation factors} has been shown to decrease mortality from about 31 percent to about 25 percent in severe sepsis. To qualify for drotrecogin alfa, a patient must have severe sepsis or septic shock with an APACHE II score of 25 or greater and a low risk of bleeding. Treatment with corticosteroids might be most beneficial in those with septic shock and early severe acute respiratory distress syndrome {ARDS}, whereas its role in other patients such as those with pancreatitis or severe pneumonia is unclear. Granulocyte-macrophage colony stimulating factor {GM-CSF} is often used in neonatal sepsis, however a recent study found that, while GM-CSF corrects neutropenia if present, it has no effect on reducing sepsis or improving survival.
Rectal Artesunate is currently not available in India. Rectal administration of Artemisinin Derivatives has potential for early treatment for severe malaria in remote settings where injectable antimalarial therapy may not be feasible. It is given as single dose of about 10 mg, kg to decrease the parasite load following which oral drug can be given to complete the course.

Question of the Week

Home

Partner Sites