During lengthy procedures, intraoperative antibiotics may be given every 1 to 2 half-lives of the antibiotic. Typically, postoperative antibiotics are not continued beyond 24 h after surgery. For patients with confirmed allergy or adverse reaction to beta-lactams, one of the following regimens is recommended:.
Clindamycin plus gentamicin , aztreonam , or ciprofloxacin. Metronidazole plus gentamicin or ciprofloxacin. Mixed anaerobic infections occur when the normal commensal relationship among the normal flora of mucosal surfaces eg, skin, mouth, GI tract, vagina is disrupted eg, by surgery, injury, ischemia, or tissue necrosis. Drain and debride the infected area, and give antibiotics selected based on the infection location and thus likely organisms. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
Anaerobic infections of the lung
The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. Common Health Topics. Videos Figures Images Quizzes. Symptoms and Signs. Oropharyngeal anaerobic infections and lung abscesses GI or female pelvic anaerobic infections.
Key Points. Test your knowledge. Add to Any Platform. Bush , MD, Charles E. Click here for Patient Education. The pleural spaces and lungs. Intra-abdominal, gynecologic, CNS, upper respiratory tract, and cutaneous diseases. The principal anaerobic gram-positive cocci involved in mixed anaerobic infections are. The principal anaerobic gram-negative bacilli involved in mixed anaerobic infections include. Bacteroides fragilis. Mixed anaerobic infections can usually be characterized as follows:. They tend to occur as localized collections of pus or abscesses.
Anaerobes are rare in UTI, septic arthritis, and infective endocarditis. Clinical suspicion. Infection adjacent to mucosal surfaces that bear anaerobic flora. Ischemia, tumor, penetrating trauma, foreign body, or perforated viscus.
Spreading gangrene involving skin, subcutaneous tissue, fascia, and muscle. Failure to respond to antibiotics that do not have significant anaerobic activity. Drainage and debridement. Before elective colorectal surgery, patients should have bowel preparation consisting of. Infections tend to occur as localized collections of pus or abscesses.
Bush, MD; Maria T. Was This Page Helpful? Yes No. The infections that frequently involve anaerobic bacteria include superficial infections, including infected paronychia, infected human or animal bites, cutaneous ulcers, cellulitis, pyoderma, and hidradenitis suppurativa. Skin involvement in subcutaneous tissue infections includes: cutaneous and subcutaneous abscesses,  breast abscess, decubitus ulcers, infected pilonidal cyst or sinus, Meleney's ulcer infected diabetic vascular or trophic ulcers, bite wound,  anaerobic cellulitis and gas gangrene, bacterial synergistic gangrene, and burn wound infection.
These can involve the fascia as well as the muscle surrounded by the fascia, and may also induce myositis and myonecrosis. The isolates found in soft-tissue infections can vary depending on the type of infection.
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These bacteria include pigmented Prevotella and Porphyromonas, Fusobacterium and Peptostreptococcus spp. Human bite infections often contain Eikenella spp. Anaerobes infections are often polymicrobial in nature, and sometimes i. Gas in the tissues and putrid-like pus with a gray thin quality are often found in these infections, and they are frequently associated with a bacteremia and high mortality rate.
Treatment of deep-seated soft-tissue infections includes: vigorous surgical management that includes surgical debridement and drainage. Even though there are no controlle studies that support this approach improvement of the involved tissues oxygenation by enhancement of blood supply and administration of hyperbaric oxygen , especially in clostridial infection, may be helpful.
Anaerobic bacteria are often found in oesteomyelitis of the long bones especially after trauma and fracture, osteomyelitis associated with peripheral vascular disease, and decubitus ulcers and osteomyelitis of the facial and cranial bones. Cranial and facial bones anaerobic osteomyelitis often originates by the spread of the infection from a contiguous soft-tissue source or from dental, sinus, or ear infection. The high concentration of anaerobic bacteria in the oral cavity explains their importance in cranial and facial bone infections.
The high number of gut anaerobes in pelvic osteomyelitis is generally caused by their spread from decubitus ulcers sites.
The anaerobic organisms in osteomyelitis associated with peripheral vascular disease generally reach the bone from adjacent soft-tissue ulcers. Long bones osteomyelitis is often caused by trauma, hematogenic spread, or the presence of a prosthetic device. Peptostreptococcus and Bacteroides spp. Pigmented Prevotella and Porphyromonas spp. Clostridium spp. Because Clostridium spp.
Infective endocarditis caused by anaerobic bacteria - EM|consulte
Septic arthritis due to anaerobic bacteria is frequently associated with contiguous or hematogenous infection spread, prosthetic joints and trauma. Most septic arthritis cases caused by anaerobic bacteria are monomicrobial. The predominant anaerobic bacteria isolated are Peptostreptococcus spp. A resurgence in bacteremia due to anaerobic bacteria was observed recently. The commonest isolates are B. The type of bacteria involved in bacteremia is greatly influenced by the infection's portal of entry and the underlying disease. The isolation of B. The main factors which predispose to anaerobic bacteremia are: hematologic disorders; organ transplant; recent gastrointestinal, obstetric, or gynecologic surgery; malignant neoplasms intestinal obstruction; decubitus ulcers; dental extraction ; sickle cell disease; diabetes mellitus; postsplenectomy; the newborn; and the administration of cytotoxic agents or corticosteroids.
The clinical presentations of anaerobic bacteremia are not different from those observed in aerobic bacteremia, except for the infection's signs observed at the portal of entry of the infection. It often includes fever, chills, hypotension, shock, leukocytosis, anemia and disseminated intravascular coagulation.
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Clinical features that are characteristic of anaerobicbacteremia include hyperbilirubinemia, metastatic lesions, and suppurative thrombophlebitis. These infections include cellulitis of the site of fetal monitoring caused by Bacterodes spp. Conditions which can lower the blood supply and can predispose to anaerobic infection are: trauma, foreign body, malignancy, surgery, edema, shock, colitis and vascular disease.
Other predisposing conditions include splenectomy, neutropenia, immunosuppression, hypogammaglobinemia, leukemia, collagen vascular disease and cytotoxic drugs and diabetes mellitus. A preexisting infection caused by aerobic or facultative organisms can alter the local tissue conditions and make them more favorable for the growth of anaerobes.