Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2002
Review[Therapeutic principles of staphylococcal infections--Role and limitations of standard compounds].
Antibiotic therapy plays an important (but not exclusive) role in the treatment of staphylococcal infections. Measures aimed at reducing the bacterial inoculum through local procedures must be envisaged as often as possible. The removal of any foreign, infected materials is essential to success. ⋯ In the light of these data, we propose a therapeutic approach to severe bacterial infection caused by a cluster of Gram-positive cocci. Staphylococcal infections pose daily therapeutic problems, whether in open-care practice or intensive care units. The specificity of staphylococcal infections encountered in an intensive care setting require a therapeutic approach which takes account of the context, and particularly of the incidence of resistant staphylococcal infections.
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Ann Fr Anesth Reanim · May 2002
Review[Antibiotic combinations in Staphylococcus aureus infections: arguments against].
In a case of severe infection due to Staphylococcus aureus, generally accepted practice involves the use of a combination of antibiotics. This article examines the type and quality of the experimental and clinical data which has been collected in this context. Published findings suggest that the arguments in favour of combinations are usually theoretical, and that a demonstration of the superiority of combinations has never been made by comparative, randomised studies.
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Research efforts to discover new compounds active against staphylococci are more than ever justified today. The incidence of methicillin-resistant staphylococci remains very high in hospitals, and the solution provided by glycopeptides is far from being satisfactory. ⋯ Finally, strains with diminished sensitivity to these antibiotics are beginning to appear. This article examines the opportunities offered by two new anti-staphylococcal agents: quinupristine-dalfopristine (Synercid) and linezolide (not marketed in France).
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Ann Fr Anesth Reanim · May 2002
Review[The epidemiology of toxemic infections caused by Staphylococcus aureus in an intensive care setting].
The mission of the National Reference Centre for Staphylococcal Toxemia (CNRTS) is to participate in the epidemiological surveillance of staphylococcal toxemia in France. As these syndromes do not have to be declared, the data collected remain incomplete. Comparison of the clinical data with the results of molecular analysis of the causal strains has nonetheless enabled advances in our understanding of the present-day epidemiology of these syndromes, a clearer knowledge of their pathophysiology and isolation of a hitherto unknown entity, staphylococcal necrotizing pneumonia.