Lijec̆nic̆ki vjesnik
-
Lijec̆nic̆ki vjesnik · Jan 2010
Review[Lipopeptides and oxazolidinones--novel antibiotics in MRSA infection treatment].
Last few years vancomycin-intermediate S. aureus and vancomycin-resistent S. aureus have emerged, giving us a task to reevaluate susceptiblity to vancomycin in treatment of methicillin-resistent S. aureus (MRSA) infections. It is also oportunity to review necessity for new generation of antibiotics in treatment of MRSA infections. Efficacy of vancomycin treatment in MRSA bacteriemia is associated with minimal inhibitory concentration (MIC) and speed of killing colonies. ⋯ That's one of the reasons why there is novel antibiotic therapy for MRSA investigated, especially daptomycin and linezolid. Daptomycin is lipopeptide and an important optional antibiotic in MRSA infections treatment: bacteremia and endocarditis, even the tricuspidal valve endocarditis. Linezolid, as novel oxazolidinon, has shown good activity against gram-positive bacteria, especially in treatment of nosocomial pneumonia and complicated skin and soft tissue infections caused by MRSA.
-
Careful assessment of fluid balance is required in the perioperative period since appropriate fluid therapy is essential for successful patient outcomes. Volume status is frequently assessed by different hemodynamic variables that could be targeted as endpoints for fluid therapy and resuscitation. Goal directed fluid therapy is a method for correction of fluid status in individual patients that includes invasive hemodynamic monitoring and aggressive perioperative correction of hemodynamics. ⋯ It is associated with a variety of patophysiological disturbances, hydro-electrolyte balance disorders and compensatory mechanisms. Heart failure indicates careful assessment of fluid balance in perioperative period. The aim of this article is to describe actual techniques of hemodynamic measurements as well as main principles of fluid therapy to maintain hydro-electrolyte balance in patients with heart failure.