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Colite pseudomembranosa associada aos antibacterianos

Authors: Ferreira, Sandra Cristina da Silva;

Colite pseudomembranosa associada aos antibacterianos

Abstract

Os antibióticos antibacterianos têm um tropismo para as células procariotas, exercendo a sua ação bactericida ou bacteriostática sobre estas. No entanto, apesar da sua especificidade, os antibióticos podem ter efeitos tóxicos nas células humanas, dando origem às reações adversas. A colite pseudomembranosa foi descrita pela primeira vez em 1893 por Finney, sendo uma doença infeciosa que surge geralmente na sequência de antibioterapia prévia, tendo como principal agente etiológico o Clostridium difficile. Esta trata-se de uma entidade com taxa de mortalidade elevada, rondando os 20 a 30% e onde as recorrências são comuns. A infeção por C.difficile é das mais incidentes adquiridas em indivíduos hospitalizados. Os antibióticos provocam a alteração da flora intestinal normal permitindo a colonização pelo C.difficile, que em condições apropriadas leva à ocorrência de sintomatologia. Os antibióticos mais implicados são os de largo espetro, tendo-se como exemplo as penicilinas associadas a beta lactamases e a clindamicina, possuindo estes um largo impacto na microbiota intestinal. Existem vários métodos de diagnóstico laboratorial para testar amostras fecais à procura dos bacilos e/ou suas toxinas para confirmação deste tipo de infeção, bem como métodos de visualização direta e estudos de imagem abdominal (diagnóstico clínico). No que respeita ao tratamento, a vancomicina e o metronidazol são os fármacos mais utilizados na infeção por C.difficile, havendo variações conforme a gravidade da doença. Embora a maioria das infeções respondam à terapêutica disponível, a infeção pode aumentar a morbilidade, prolongar a hospitalização, e mesmo colocar a vida do doente em risco, pelo que o uso racional dos antibacterianos é de extrema importância, bem como as restantes medidas de prevenção. Antibacterial antibiotics have a tropism for prokaryotic cells, exerting its bactericidal or bacteriostatic on these. However, despite of their specificity, antibiotics can have toxic effects on human cells, giving rise to adverse reactions. Pseudomembranous colitis was described in 1893 by Finney, being an infectious disease that usually appears as a result of antibiotic treatment, the main etiological agent Clostridium difficile. This is an illness with a high mortality rate, around 20-30% and where recurrences are common. Infection with C. difficile is the most incident acquired in hospitalized individuals. Antibiotics cause alteration of the normal intestinal flora allowing colonization by C. difficile, which under appropriate conditions leads to the occurrence of symptoms. The antibiotics most commonly involved are broad spectrum, for example penicillins associated with beta lactamases and clindamycin, possessing such a large impact on the intestinal microbiota. There are several methods of laboratory diagnosis to test fecal samples in search of bacilli and / or their toxins to confirm this type of infection, as well as methods of direct visualization and abdominal imaging studies (clinical diagnosis). With regard to treatment, vancomycin and metronidazole are the most commonly drugs used for the C. difficile infection, with variations depending on the severity of the disease. Although the majority of infections respond to therapy available, the infection can increase morbidity, prolonged hospitalization, and even life-threatening patient, whereby the rational use of antibacterial agents is extremely important as well as preventive measures remaining.

Country
Portugal
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Keywords

Treatment, Tratamento, Antibacterial antibiotics, Colite pseudomembranosa, Métodos de diagnóstico, Clostridium difficile, Diagnostic methods, Pseudomembranous colitis, Antibiótico antibacteriano

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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