Suppurative thrombophlebitis medical therapy: Difference between revisions
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===Septic pelvic vein thrombophlebitis=== | |||
* Based on the [[CT]] and [[MRI]] findings [[septic pelvic vein thrombophlebitis]] is classified into following categories for management.<ref>{{Cite journal | |||
| author = [[Javier Garcia]], [[Ramzi Aboujaoude]], [[Joseph Apuzzio]] & [[Jesus R. Alvarez]] | |||
| title = Septic pelvic thrombophlebitis: diagnosis and management | |||
| journal = [[Infectious diseases in obstetrics and gynecology]] | |||
| volume = 2006 | |||
| pages = 15614 | |||
| year = 2006 | |||
| month = | |||
| doi = 10.1155/IDOG/2006/15614 | |||
| pmid = 17485796 | |||
}}</ref>. | |||
:* 1. '''Right ovarian vein thrombosis''' | |||
::* Preferred regimen (1): [[Ertapenem]] 1 g PO qd for 7 days {{and}} [[Enoxaparin]] (1 mg/Kg) initially {{and}} 3–6 months of [[Warfarin]] (INR 2.5) | |||
::* Preferred regimen (2): [[Gentamicin]] 4 mg/kg {{and}} [[Ampicillin]] 2 g {{and}} [[Clindamycin]] 1200 mg for 7 days {{and}} [[Enoxaparin]] (1 mg/Kg) initially {{and}} 3–6 months [[Warfarin]] (INR 2.5). | |||
::* Note: Repeat [[CT]] scan after 3 months. If negative, stop [[anticoagulation]]. If still positive for [[thrombi]], [[anticoagulate]] for 3 additional months. | |||
:* 2. '''Pelvic branch vein thrombosis''' | |||
::* Preferred regimen (1): [[Ertapenem]] 1 g PO qd for 7 days {{and}} [[Enoxaparin]] (1 mg/Kg) PO for 2 weeks | |||
::* Preferred regimen (2): [[Gentamicin]] (4 mg/kg) PO {{and}} [[Ampicillin]] 2 g PO {{and}} [[Clindamycin]] 1200 mg PO for 7 days {{and}} [[Enoxaparin]] (1 mg/Kg) for 2 weeks. | |||
:* 3. '''Negative for pelvic thrombi''' | |||
::* Preferred regimen (1): [[Ertapenem]] 1 g PO qd for 7 days {{and}} [[Enoxaparin]] (1 mg/Kg) for 1 week | |||
::* Preferred regimen (2): [[Gentamicin]] (4 mg/kg) PO qd {{and}} [[Ampicillin]] 2 g PO qd {{and}} [[Clindamycin]] 1200 mg PO qd for 7 days {{and}} [[Enoxaparin]] (1 mg/Kg) PO qd for 1 weeks | |||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
[[Category: Infectious Disease Project]] | |||
Revision as of 20:35, 12 August 2015
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Suppurative thrombophlebitis Microchapters |
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Differentiating Suppurative thrombophlebitis from other Diseases |
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Diagnosis |
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Treatment |
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Suppurative thrombophlebitis medical therapy On the Web |
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Directions to Hospitals Treating Suppurative thrombophlebitis |
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Risk calculators and risk factors for Suppurative thrombophlebitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
Overview
Medical therapy of Suppurative thrombophlebitis aims to eliminate the source of infection, followed by antibiotic coverage for the detected pathogen. Surgical intervention, anticoagulation is considered after evaluation of the case. Empirical therapy is administered until the blood culture results detect the targeted pathogen.
The role of anticoagulation is uncertain, and should not be routinely used, as there are no controlled studies to determine its role. It is tried when extension of the thrombus is evident even with proper antibiotic use.
Peripheral Vein Suppurative Thrombophlebitis
Till the blood culture results detect the targeted pathogen, empiric antibiotic therapy is given aiming to include an agent with activity against staphylococci plus an agent with activity against enterobacteriaceae.
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Jugular Vein Suppurative Thrombophlebitis
A beta-lactamase resistant beta-lactam antibiotic should be used in cases of jugular vein suppurative thrombophlebitis.
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Vena Cava Suppurative Thrombophlebitis
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Septic pelvic vein thrombophlebitis
- Based on the CT and MRI findings septic pelvic vein thrombophlebitis is classified into following categories for management.[1].
- 1. Right ovarian vein thrombosis
- Preferred regimen (1): Ertapenem 1 g PO qd for 7 days AND Enoxaparin (1 mg/Kg) initially AND 3–6 months of Warfarin (INR 2.5)
- Preferred regimen (2): Gentamicin 4 mg/kg AND Ampicillin 2 g AND Clindamycin 1200 mg for 7 days AND Enoxaparin (1 mg/Kg) initially AND 3–6 months Warfarin (INR 2.5).
- Note: Repeat CT scan after 3 months. If negative, stop anticoagulation. If still positive for thrombi, anticoagulate for 3 additional months.
- 2. Pelvic branch vein thrombosis
- Preferred regimen (1): Ertapenem 1 g PO qd for 7 days AND Enoxaparin (1 mg/Kg) PO for 2 weeks
- Preferred regimen (2): Gentamicin (4 mg/kg) PO AND Ampicillin 2 g PO AND Clindamycin 1200 mg PO for 7 days AND Enoxaparin (1 mg/Kg) for 2 weeks.
- 3. Negative for pelvic thrombi
- Preferred regimen (1): Ertapenem 1 g PO qd for 7 days AND Enoxaparin (1 mg/Kg) for 1 week
- Preferred regimen (2): Gentamicin (4 mg/kg) PO qd AND Ampicillin 2 g PO qd AND Clindamycin 1200 mg PO qd for 7 days AND Enoxaparin (1 mg/Kg) PO qd for 1 weeks
References
- ↑ Javier Garcia, Ramzi Aboujaoude, Joseph Apuzzio & Jesus R. Alvarez (2006). "Septic pelvic thrombophlebitis: diagnosis and management". Infectious diseases in obstetrics and gynecology. 2006: 15614. doi:10.1155/IDOG/2006/15614. PMID 17485796.