Uso de antimicrobianos na sepse em cães
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Data
2022-01-18
Autores
Melo, Jéssica Cardia de
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Universidade Estadual Paulista (Unesp)
Resumo
Sepse é definida como inflamação sistêmica exacerbada frente a microrganismos, sendo uma das afecções mais graves que culmina em óbito no mundo, tanto em medicina, quanto em veterinária. O desafio em relação a sua resolução está associado ao complexo diagnóstico, condição clínica do paciente, além da escolha empírica dos antimicrobianos, principal pilar no tratamento. Dessa forma, o objetivo deste estudo foi realizar uma revisão de literatura a respeito da terapia antimicrobiana em cães sépticos. Quanto a isto, inúmeras considerações são adotadas para que o clínico seja eficiente em escolher a melhor combinação de antimicrobianos, avaliando características do fármaco, local do foco infeccioso, possíveis microrganismos envolvidos e hemodinâmica do paciente. As classes de antimicrobianos são extensas, porém, alguns grupos se destacam no tocante a característica de possuírem amplo espectro de ação e serem opções para sepse, tais como aminoglicosídeos, cloranfenicol, quinolonas, cefalosporinas de terceira geração e alguns betalactâmicos. Recomenda-se que a escolha seja feita de forma precoce e que as associações de fármacos, caso haja necessidade, respeitem suas particularidades. Apesar da importância dos antibióticos para pacientes sépticos, seu uso deve ser minuciosamente avaliado, visto a vasta quantidade de bactérias selecionadas como multirresistentes em hospitais pelo mundo, sendo uma ameaça à saúde pública. Embora existam inúmeros estudos associados à sepse, faz-se necessárias novas pesquisas, principalmente em medicina veterinária, que abranja os principais microrganismos associados a afecção, principais focos de infecção, fármacos resistentes, bem como doses apropriadas para pacientes com graves alterações sistêmicas.
Sepsis is defined as overreacted sistemic inflammation against microorganisms, being one of the most serious conditions that lead to death in the world, both in human and veterinary medicine. The challenge in this resolution is associated with the complex diagnosis, the patient's clinical condition and the empirical choice of antimicrobials, the main pillar of treatment. Thus, the aim of this study was to carry out review of the literature about antimicrobial therapy in septic dogs. In this regard, numerous considerations are necessary to chose the best antimicrobial combination, evaluating the characteristics of the drug, the locus of the infectious focus, possible microorganisms involved and the patient's hemodynamics. The classes of antimicrobials are extensive, however, some groups are better required to this situation, because of their broad spectrum of action. The representants are aminoglycosides, chloramphenicol, quinolones, third-generation cephalosporins and some beta-lactams. The choice should be agile and, if necessary the use of more de one drug, they need to respect their particularities. Despite the importance of antibiotics for septic patients, their use should be carefully evaluated, given the vast amount of bacteria selected as multiresistant in hospitals around the world, posing a threat to public health. Although there are numerous studies associated with sepsis, further research is needed, especially in veterinary medicine, covering the main microorganisms associated with the disease, main infection foci, resistant drugs, as well as appropriate doses for patients with severe systemic changes.
Sepsis is defined as overreacted sistemic inflammation against microorganisms, being one of the most serious conditions that lead to death in the world, both in human and veterinary medicine. The challenge in this resolution is associated with the complex diagnosis, the patient's clinical condition and the empirical choice of antimicrobials, the main pillar of treatment. Thus, the aim of this study was to carry out review of the literature about antimicrobial therapy in septic dogs. In this regard, numerous considerations are necessary to chose the best antimicrobial combination, evaluating the characteristics of the drug, the locus of the infectious focus, possible microorganisms involved and the patient's hemodynamics. The classes of antimicrobials are extensive, however, some groups are better required to this situation, because of their broad spectrum of action. The representants are aminoglycosides, chloramphenicol, quinolones, third-generation cephalosporins and some beta-lactams. The choice should be agile and, if necessary the use of more de one drug, they need to respect their particularities. Despite the importance of antibiotics for septic patients, their use should be carefully evaluated, given the vast amount of bacteria selected as multiresistant in hospitals around the world, posing a threat to public health. Although there are numerous studies associated with sepsis, further research is needed, especially in veterinary medicine, covering the main microorganisms associated with the disease, main infection foci, resistant drugs, as well as appropriate doses for patients with severe systemic changes.
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Palavras-chave
Sepse, Antimicrobianos, Resistência bacteriana, Sepsis, Antimicrobials, Bacterial resistance