Mediastinitis medical therapy
Mediastinitis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Mediastinitis medical therapy On the Web |
American Roentgen Ray Society Images of Mediastinitis medical therapy |
Risk calculators and risk factors for Mediastinitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Overview
Treatment for chronic fibrosing mediastinitis is somewhat controversial, and may include steroids or surgical decompression of affected vessels.
Medical Therapy
- Acute mediastinitis treatment
- Treatment secondary to cardiac infection and surgery[1].
- Preferred regimen: Clindamycin 450 mg IV q6h AND Ceftriaxone 2 g IV q24h, for at least 2 weeks
- Prophylaxis
- Methicillin susceptible staphylococcus aureus infection
- Preferred regimen: Second generation cephalosporin.
- Methicillin susceptible staphylococcus aureus infection
- Preferred regimen: Vancomycin
- Note (1): Preoperative antibiotics should be administered to all patients to reduce the risk of mediastinitis in cardiac surgery.
- Note (2): A deep sternal wound infection should be treated with aggressive surgical debridement in the absence of complicating circumstances.
- Note (3): Primary or secondary closure with muscle or omental flap is recommended. Vacuum therapy in conjunction with early and aggressive debridement is an effective adjunctive therapy.
- Note (4): Use of a continuous intravenous insulin protocol to achieve and maintain an early postoperative blood glucose concentration less than or equal to 180 mg/dL while avoiding hypoglycemia is indicated to reduce the risk of deep sternal wound infection.
- Note (5): The use of intranasal mupirocin is reasonable in nasal carriers of S. aureus.
References
- ↑ Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons". J Am Coll Cardiol. 58 (24): e123–210. doi:10.1016/j.jacc.2011.08.009. PMID 22070836.