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Infections of skin and soft tissues
In 2004, 1.3 million patients were hospitalized for ICMT in France, Germany, Italy, Spain and the United Kingdom, including cellulite (52.7 percent), local surgical infection (15.8 percent), diabetic foot (15.3 percent), decubitus (12 percent).
Infections of the skin and soft tissues are usually caused by several microbes at the same time, but the most frequent pathogen is S. aureus. Particularly dangerous is the widespread spread of strains resistant to most antimicrobial agents - beta-lactam antibiotics, aminoglycosides, lincosamides, fluoroquinolones.
In addition, Gram-negative bacteria of the Enterobacteriaceae family (Klebsiellaspp., Enterobacterspp., E. Coli), which are usually resistant to cephalosporins, are widespread in medical institutions.
When choosing the means of antibacterial therapy, an extremely important approach to the choice of drugs, which is determined by the level of soft tissue damage, the features of the course of the disease and the presence of drug resistance.
It should be remembered that any wound, regardless of the location of its location and origin, always contains a certain number of microorganisms (primary microbial contamination). The main purpose of any primary dressing is to stop bleeding and prevent infection of the wound, regardless of whether it is placed at home, by ambulance, by doctors from polyclinics or hospitals. In the subsequent treatment is carried out in accordance with the phase of the wound process, the species composition of the microbes caught in the wound.
In the last two decades, new antiseptics (iodopyron, miramistin, dioxidin, lavasept) are widely used in the treatment of purulent-inflammatory processes and purulent wounds. Low-effective ointments on lanolin-vaseline basis (Vishnevsky ointment, ichthyol ointment, streptocid, erythromycin, tetracycline, furacillin, etc.) have been almost completely excluded from the practice of treating patients with skin and soft tissue infection. These preparations were replaced by polyethylene glycol (PEG) based ointments.
Special difficulties always arise in the treatment of patients with skin and soft tissue infection (trophic ulcers, pressure ulcers, thermal skin lesions, postoperative and post-traumatic wounds) against allergies, medicinal and microbial dermatitis, repeated infections of the wound with hospital highly resistant microorganisms (S. aureus, S. Pyogenes, Enterococcus spp., P. aeruginosa, Enterobacteriaceae, Bacteroides sp.). This infection can get into the tissues from the patient's skin if there is insufficient compliance with personal hygiene rules, as well as hygiene of bedding, the hands of medical personnel, etc. Reinfection causes a gross violation of wound healing processes.
In today's world, where strains of microorganisms are resistant to most drugs, drugs of choice in such situations can be considered silver-containing medicines, for example 2% cream of sulfatiazole silver (Argosulfan cream). Cream Argosulfan has a high antimicrobial activity against all potential pathogens of soft tissue infections (including with bedsores and trophic ulcers). The hydrophilic base of Argosulfan protects the young epithelial tissue, activates the growth of the superficial epithelium, thereby the cream allows to quickly restore the integrity of the skin. The base of the cream also provides an analgesic effect and good tolerability. The poor solubility of the silver sulfatiazole salt allows maintaining a constant concentration of the drug in the tissues, and also causes the absence of toxicity. Of particular importance is the fact that long-term observations show the lack of resistance of microbes to this drug.
Thus, today Argosulfan can be considered as a drug of choice for local treatment and prevention of skin and soft tissue infections: trophic ulcers, pressure ulcers, burns, post-traumatic and post-operative long-term non-healing wounds.