title: Septicaemia.
abstract: Septicaemia still presents a major diagnostic and therapeutic challenge to the clinician. Most cases are hospital-acquiredand the reasons for their increasing prevalence are discussed, with reference to predisposing factors and opportunistic infections. The pathology and bacteriology of proven cases (positive blood cultures) in 1974 in a modern children's and maternity hospital complex are presented. Gram-positive and Gram-negative varieties are compared and the molecular biology and mechansims of endo- and exotoxaemia described. Successful therapy demands correct choice of antibiotic and the development of shock requires skilled supportive measures. For the former a rational scheme is outlined and a plea is made for collection of data for this purpose. Polypharmacy is deprecated and either an aminoglycoside or a cephalosporin forms the mainstay of therapy. The emergence of Bacteroids sp. in cases of abdominal and puerperal sepsis necessitates addition of a lincomycin or metronidazole. Superinfection with systemic candidiasis requires 5-fluorocytosine.
mesh_terms: D002437:Cefazolin / Q000627:therapeutic use; D002509:Cephaloridine / Q000627:therapeutic use; D002512:Cephalothin / Q000627:therapeutic use; D002515:Cephradine / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005437:Flucytosine / Q000627:therapeutic use; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008034:Lincomycin / Q000627:therapeutic use; D008795:Metronidazole / Q000627:therapeutic use; D018805:Sepsis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D012772:Shock, Septic / Q000209:etiology; D014031:Tobramycin / Q000627:therapeutic use
chemical_list: D005839:Gentamicins; D008795:Metronidazole; D002981:Clindamycin; D008034:Lincomycin; D005437:Flucytosine; D002515:Cephradine; D002437:Cefazolin; D002509:Cephaloridine; D002512:Cephalothin; D014031:Tobramycin