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2018, vol. 146, br. 9-10, str. 516-523
Uticaj rane primene antibiotika na kliničke manifestacije kod obolelih u ranoj fazi lajmske bolesti
Vojnomedicinska akademija, Klinika za infektivne i tropske bolesti, Beograd

e-adresabegovickupresanin@hotmail.com
Sažetak
Uvod/Cilj Lajmska borelioza (LB) jeste multisistemsko infektivno oboljenje izazvano spirohetom Borellia burgdorferi (BB) i nastaje ubodom inficiranog krpelja. Bolest se ispoljava različito, a najčešeće su zahvaćeni koža, zglobovi, srce i nervni sistem. Cilj ove studije je bio da se kod osoba kod kojih je dijagnostikovana rana faza LB utvrdi da li postoje značajne razlike u ispoljavanju simptoma i znakova oboljenja između obolelih koji su primili i onih koji nisu primili profilaktičnu, ranu antibiotsku terapiju posle uboda krpelja. Metode Ispitivanje je izvršeno na 2070 ispitanika oba pola sa ubodom krpelja, lečenih ili pregledanih u Klinici u periodu 1989- 2004. godine. Ispitanici su podeljeni u dve grupe - grupu A (n = 591), koja je primala ranu, profilaktičnu antibiotsku terapiju, i grupu B (n = 1479), koja tu terapiju nije primala. Rana antibiotska terapija podrazumeva primenu antibiotika kod osoba sa nastalom infekcijom verovatno do pet dana po ubodu krpelja, a koje nisu imale simptome i znake bolesti. Od antibiotika su primenjivani cefalosporini, makrolidi, tetraciklini, polusintetski penicilini, ponavljano sedam ili četrnaest dana, ili benzatin bezilpenicilin jednokratno. Rezultati Bolest se razvila kod statistički značajno većeg broja ispitanika bez profilakse (537/1479) nego kod onih koji su tu terapiju primili (10/591), odnosno 36,3% : 1,7%. Primenom pet grupa antibiotika zaključeno je da su za optimalnu prevenciju dovoljna samo dva: doksiciklin i ampicilin u trajanju od sedam dana. Primenjeni antibiotici su ispoljili visoku kliničku efikasnost, koja se kretala od 93,7% (cefalosporini) do 99,4% (makrolidi) i bila nezavisna od dužine primene. Zaključak Primena rane antibiotske terapije posle uboda krpelja je efikasna u prevenciji rane faze LB, a kada je bolest bila ispoljena, nije bilo ekstrakutanih manifestacija.
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O članku

jezik rada: engleski
vrsta rada: prikaz slučaja
DOI: 10.2298/SARH171002190B
objavljen u SCIndeksu: 03.01.2019.

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