Ebola medical therapy
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Ebola medical therapy On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
No specific antiviral drug has demonstrated effectiveness against Ebola infection. Management is primarily supportive and symptomatic. The following basic interventions, when used early, may improve the chances of survival: administration of intravenous fluids and correction of electrolyte abnormalities, maintenance of stable vital signs, and treatment against other co-infections or super-infections by antimicrobial agents. It is common practice to administer prophylactic broad-spectum antimicrobial agents, such as antibiotics and antimalarial agents, due to the high risk of co-infection or super-infection.
Medical Therapy
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- Preferred regimen: supportive therapy. There is no specific antiviral drug available for Ebola thus far. For information of investigational therapies including Favipiravir, Brincidofovir, ZMapp, TKM-Ebola, AVI-6002, and BCX4430, see here.
- Isolate patient
- Provide intravenous fluids (IV) (patients need large volumes in some cases) and maintain electrolytes at normal levels
- Maintain oxygen saturation and blood pressure
- Administer blood products if coagulopathy or bleeding, antiemetics if vomiting , antipyretics if fever, analgesics, anti-motility if severe diarrhea, total parenteral nutrition if patient has poor oral intake and dialysis if there's renal failure
Prophylaxis Against Co-infections or Super-infections
Overwhelming sepsis is associated with the majority of deaths due to Ebola virus disease.[3] Thus, it is common practice to administer antibiotics and antimalarial agents for patients with Ebola virus disease due to the high risk of co-infection or super-infection with Malaria and bacterial organisms.[4] In contrast, the administration of antiviral agents, such as acyclovir or ribavirin, has not demonstrated efficacy.[3]
Nutritional Support
- Although preferred, enteral nutrition may not be tolerated due to vomiting or paralytic ileus.
- Parental nutrition should be administered to patients who cannot tolerate oral food intake.
- Enteral nutrition should be resumed as soon as it is tolerated.
References
- ↑ "Ebola virus treatment".
- ↑ Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.
- ↑ 3.0 3.1 Parkes-Ratanshi R, Ssekabira U, Crozier I (2014). "Ebola in West Africa: be aware and prepare". Intensive Care Med. 40 (11): 1742–5. doi:10.1007/s00134-014-3497-z. PMID 25253023.
- ↑ Kreuels B, Wichmann D, Emmerich P, Schmidt-Chanasit J, de Heer G, Kluge S; et al. (2014). "A Case of Severe Ebola Virus Infection Complicated by Gram-Negative Septicemia". N Engl J Med. doi:10.1056/NEJMoa1411677. PMID 25337633.