[Long-term antibiotic suppressive therapy for an infected thoracic aorta graft].

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  • Author(s): Berdal JE;Berdal JE; Steinbakk M
  • Source:
    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke [Tidsskr Nor Laegeforen] 2003 Aug 28; Vol. 123 (16), pp. 2260-2.
  • Publication Type:
    Case Reports; English Abstract; Journal Article
  • Language:
    Norwegian
  • Additional Information
    • Transliterated Title:
      Langtids suppresjonsbehandling med antibiotika av infisert torakal aortaprotese.
    • Source:
      Publisher: Norske Laegeforening Country of Publication: Norway NLM ID: 0413423 Publication Model: Print Cited Medium: Internet ISSN: 0807-7096 (Electronic) Linking ISSN: 00292001 NLM ISO Abbreviation: Tidsskr Nor Laegeforen Subsets: MEDLINE
    • Publication Information:
      Publication: Oslo : Norske Laegeforening
      Original Publication: Chistiania : Alb. Cammermeyer, 1880-
    • Subject Terms:
      Aorta, Thoracic/*surgery ; Aortitis/*drug therapy ; Blood Vessel Prosthesis/*adverse effects ; Clindamycin/*administration & dosage ; Dicloxacillin/*administration & dosage ; Drug Therapy, Combination/*administration & dosage ; Postoperative Complications/*drug therapy ; Prosthesis-Related Infections/*drug therapy ; Sepsis/*drug therapy ; Staphylococcal Infections/*drug therapy; Administration, Oral ; Aged ; Aorta, Thoracic/microbiology ; Aortitis/microbiology ; Aortitis/surgery ; Humans ; Male ; Postoperative Complications/microbiology ; Prosthesis-Related Infections/microbiology ; Recurrence ; Sepsis/microbiology ; Time Factors
    • Abstract:
      Background: Infections of arterial vascular grafts are among the most dreaded complications in vascular surgery. Infection in a thoracic aorta graft poses particular challenges. Depending on the local anatomy, extraanatomic bypass, otherwise the cornerstone in the management of infected vascular grafts, is usually impossible.
      Material and Methods: We present a case report on a patient with an infected thoracic aorta graft and discuss the choice of antibiotics for long-term suppressive therapy.
      Results: In the course of the 52 months since the insertion of the aortic graft, the patient experienced eight serious episodes of staphylococcal septicaemia, with Staphylococcus aureus in blood culture on each occasion. A combination therapy of three orally administered anti-staphylococcal antibiotics has kept him free from recurrent septic episodes over the last 25 months, with a good quality of life and without signs of systemic infection.
      Interpretation: Life-long antibiotic suppressive therapy for infected thoracic aorta graft offers the prospect of long-term survival with a good quality of life, even when there are recurrent serious septic complications. The choice of antibiotics should take into account the feasibility of the proposed treatment; parenteral antibiotics are not a realistic option in the long run. The antibiotics should be well absorbed after oral administration, have a high intrinsic activity against the offending pathogen, and be given at intervals leading to inhibitory blood concentrations throughout most of the day. In our patient, a triple combination therapy was necessary.
    • Accession Number:
      3U02EL437C (Clindamycin)
      COF19H7WBK (Dicloxacillin)
    • Publication Date:
      Date Created: 20030926 Date Completed: 20031027 Latest Revision: 20131121
    • Publication Date:
      20240829
    • Accession Number:
      14508548