title: [Anaerobic surgical infection and septic shock].
abstract: In the period 1990 through 1995, one-hundred patients operated for acute abdomen or admitted on a routine basis, presenting evidence of anaerobic infection, undergo treatment in the clinic of emergency surgery. Septic shock develops in 10/100 patients (10 per cent). In six of the latter the outcome is fatal--three with infection caused by spore-forming anaerobes (gas gangrene of the inguinal region--of Fournier, and anterior abdominal wall--anus praeternaturalis--two), and three with infection caused by non-spore-forming anaerobes (mixed anaerobic-aerobic infection). Anaerobic surgical infection and septic shock specificity is discussed, with an algorithm of therapeutic approach, based on clinical experience had with 100 patients, being proposed in either of them. Special emphasis is laid on antibiotic prophylaxis against anaerobic surgical infection. Its implementation in the concrete clinical conditions in this country demands a clearcut hospital drug policy (adoption of the "Drug Formularies" system), and elaboration of a new economical approach to the choice of antibacterial agents (using some of the forms of pharmaco-economical analysis, practicable with a view to the Bulgarian health-care model).
authors.forename: N
authors.initials: N
authors.lastname: Iarŭmov
authors.forename: I
authors.initials: I
authors.lastname: Viiachki
authors.forename: D
authors.initials: D
authors.lastname: Tonev
authors.forename: M
authors.initials: M
authors.lastname: Marina
authors.forename: V
authors.initials: V
authors.lastname: Muĭkov
authors.forename: A
authors.initials: A
authors.lastname: Mitov
authors.forename: B
authors.initials: B
authors.lastname: Korukov
authors.forename: A
authors.initials: A
authors.lastname: Ivanov
authors.forename: M
authors.initials: M
authors.lastname: Miteva
authors.forename: A
authors.initials: A
authors.lastname: Velkov
mesh_terms: D000006:Abdomen, Acute / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001420:Bacteria, Aerobic; D001421:Bacteria, Anaerobic; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D003131:Combined Modality Therapy; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents