Leseva M, Khadzhiĭski O, Grigorov G, Dimitrova A
Khirurgiia (Sofiia). 1995;48(3):8-11.
Proceeding from many years experience with antibiotic treatment of bacterial infections in burnt patients, accumulated in the Section of Burns and Plastic Surgery, and pertinent literature reports, the basic principles of antibacterial therapy in this contingency of patients are set forth. A detailed protocol is presented, based on: 1) presence of clinical and laboratory evidence of infection and its location, and the most likely causing agents involved, 2) bacteriological data on the commonest causing agents of local and systemic infection in burns, and their sensitivity to antibiotics, 3) duration and surface, deepness and location of the burn injury, and 4) spectrum of action, pharmacokinetics, pharmacodynamics and side effects of the various groups of antibiotics, consistent with the age and concomitant diseases of the patients. A number of antibiotic constellations in cases presenting sepsis where resorting to "blind" therapy is necessitated, are recommended. It is underscored that the protocol suggested is open for modifications, and also that antibiotic therapy efficiency may be anticipated only when combined with adequate infusional and operative management.
根据烧伤与整形外科多年来在烧伤患者细菌感染抗生素治疗方面积累的经验以及相关文献报道，阐述了此类患者抗菌治疗的基本原则。基于以下几点提出了详细的方案：1）感染的临床和实验室证据及其部位，以及最可能的致病病原体；2）烧伤局部和全身感染最常见致病病原体的细菌学数据及其对抗生素的敏感性；3）烧伤损伤的持续时间、面积、深度和部位；4）各类抗生素的作用谱、药代动力学、药效学和副作用，同时考虑患者的年龄和伴随疾病。推荐了一些在必须采用“经验性”治疗的脓毒症病例中的抗生素组合。强调所建议的方案可进行修改，并且只有在与充分的输液和手术治疗相结合时，才能预期抗生素治疗的效果。
