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Multidisciplinary,three-dimensional and individualized comprehensive treatment for severe/critical covid-19

Liver Research 2020年第3期4卷 109-117页

作者： Medical Panel of Severe/critical covid-19,The Third Affiliated Hospital of Sun Yat-sen University The Third Affiliated Hospital of Sun Yat-sen University GuangzhouChina

Severe/critical cases account for 18e20% of all novel coronavirus disease 2019(covid-19)patients,but their mortality rate can be up to 61.5%.Furthermore,all deceased patients were severe/critical *** main reasons for the high mortality of severe/critical patients are advanced age(>60 years old)and combined underlying *** patients with comorbidities show decreased organ function and low compensation for damage such as hypoxia and inflammation,which accelerates disease *** lung is the main target organ attacked by severe acute respiratory syndrome coronavirus 2(SARSCoV-2)while immune organs,liver,blood vessels and other organs are damaged to varying *** volume is increased,and mild active inflammation and focal necrosis are observed in the portal *** particles have also been detected in liver ***,multidisciplinary teams(MDTs)and individualized treatment plans,accurate prediction of disease progression and timely interventions are vital to effectively reduce ***,a“multidisciplinary three-dimensional management,individualized comprehensive plan”should be *** treatment plan complies with three principles,namely,multidisciplinary management of patients,individualized diagnosis and treatment plans,and timely monitoring and intervention of *** members are mainly physicians from critical medicine,infection and respiratory disciplines,but also include cardiovascular,kidney,endocrine,digestion,nerve,nutrition,rehabilitation,psychology and specialty *** to a patient's specific disease condition,an individualized diagnosis and treatment plan is formulated(one plan for one patient).While selecting individualized antiviral,anti-inflammatory and immunomodulatory treatment,we also strengthen nutritional support,psychological intervention,comprehensive rehabilitation and timely and full-course intervention to develop overall and special nursing *** response to the rapid

关键词： Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Novel coronavirus disease 2019(covid-19) Severe covid-19 critical covid-19 Treatment Multidisciplinary teams

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Analysis of Antibiotic Usage in critical covid-19 Patients with Secondary Infections

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Journal of Biosciences and Medicines 2022年第12期10卷 122-133页

作者： Widyati Widyati Pandu Harijono Syahrul Tuba Dr. Ramelan Navy Hospital Surabaya Indonesia Faculty of Military Pharmacy The Republic of Indonesia Defense University Sentul Indonesia Medical Faculty of Hang Tuah University Surabaya Indonesia

Background: Infrequent data exist on the frequency of bacterial co-infections and secondary infection among covid-19-infected patients admitted to intensive care units (ICU). Objective: To describe the quantity and the quality of antimicrobial usage in covid-19 with secondary infection, multiple drug resistance organisms and the outcome of antimicrobial treatment. Methods: This study applies observational design with a cross sectional approach. All the patients with laboratory-confirmed severe covid-19 pneumonia who were discharged from the Intensive Care Unit (ICU) Dr. Ramelan Navy Hospital from February 1st to June 30th 2022 included. The quantity of antibiotics usage was assessed by counting the Defined Daily Dose (DDD). Result: During the study period, 126 patients were referred to the ICU for covid-19 with severe pneumonia. There were 70.6% (89 patients) treated with antibiotics and 29.4% (37 patients) untreated with antibiotics. Quantitative analysis of 89 patients revealed that levofloxacin was the most common antibiotic prescribed with 43 DDD, followed by Meropenem and Cefoperazone-Sulbactam, which were 17.76 DDD and 16.87 DDD, respectively. Meanwhile, qualitative analysis resulted in 81 antibiotics (43.55%) being used appropriately. No indications of the use of antibiotics were found in 53 antibiotics (28.49%). Klebsiella pneumonia was the main pathogen identified in the blood, sputum. While E. Coli was found to be the main pathogen in urine. Conclusion: A high death rate in patients treated with antibiotics compared to patients not treated with antibiotics.

关键词： Bacterial Coinfection critical covid-19 Intensive Care Unit Antibiotics Pneumoniae

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