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Use of 'Synercid'™ (Aventis) in 132 polytrauma patients with Gram-positive nosocomial infection

The purpose of this study was to evaluate the effectiveness of a new powerful antibiotic 'Synercid'™ (Aventis) in the treatment of ICU patients with nosocomial infection. During 2002 (January-September) we prospectively followed 132 patients with polytrauma (two body cavities and/or pelvic bones and/or extremities injured) requiring mechanical ventilation for more than 72 hours. These patients suffered Gram-positive nosocomial infection and were treated with new for Bulgaria antibiotic agent 'Synercid'™ (Aventis) after microbiological confirmation. Eighty-two patients (62%) were treated for nosocomial pneumonia, which was diagnosed clinically (fever, leucosytosis, purulent tracheal secretions and new infiltrate on chest X-ray) and by positive culture (transtracheal aspirate). Forty-three patients (32.6%) were treated for bacteriaemias (fever, leucosytosis, positive blood culture). The rest of the patients were with surgical wound infections (local signs of infection and systemic inflammatory response syndrome). The main causative pathogen was methicillin-resistant S. α-haemolyticus (59 patients with pneumonia [72%]; 34 patients with bacteriaemias [79%]). In patients with surgical wound infections (17 patients), the leading role belonged to methicillin-resistant S. epidermidis (11 patients, or 64.7%) and to MRSA (four patients, or 23.5%). The treatment lasted between 8 and 16 days (mean 11 ± 2 days). The rate of success for pneumonia was 96.3% (79 patients). Three patients developed Gram-negative infection. The rate of success for bacteriaemias was 100%. The rate of success for surgical infection was 82% (14 patients) and the reason was some delayed surgical debridement of the wound. In conclusion, we appreciate the power of this new, for our country, antibiotic agent and added it to group 3 (Hospital Antibiotic Management Policy Protocol) for use only after microbiological confirmation.

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Gyurov, E., Milanov, S., Milanov, M. et al. Use of 'Synercid'™ (Aventis) in 132 polytrauma patients with Gram-positive nosocomial infection. Crit Care 7, P129 (2003). https://doi.org/10.1186/cc2018

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  • DOI: https://doi.org/10.1186/cc2018

Keywords

  • Systemic Inflammatory Response Syndrome
  • Positive Blood Culture
  • Nosocomial Pneumonia
  • Causative Pathogen
  • Pelvic Bone