Respiratory system >>>> Legionellosis - treatment and prevention
Legionellosis - treatment and prevention.
Treatment
Since the diagnosis of a disease is a difficult task, the choice of drugs is a great responsibility. Many groups of antibiotics are not effective. But the lack of effect of treatment can serve as an indirect diagnostic element for the presence of legionella bacteria .
The tactics of treating legionellosis is divided into two approaches: etiotropic and pathogenetic.
Etiotropic treatment is aimed at combating the pathogen and involves the use of antibiotics and immune - corrective therapy.
In cases with Pontiac fever, antibiotic therapy is not indicated, and treatment is carried out according to the symptoms.
The results of etiotropic therapy are assessed according to several criteria:
- decrease in temperature in the first two days from the start of taking drugs,
- positive dynamics in the lungs (reduction of wheezing, crepitus, no shortness of breath),
- no negative dynamics in chest x-ray in two projections,
- absence of tachycardia,
- decrease in leukocytes and an increase in the relative number of blood lymphocytes,
- lack of hypotension.
If there is no tendency to a decrease in temperature, a decrease in intoxication, then antibiotic therapy is revised.
The pathogenetic approach is aimed at monitoring symptoms and treating disorders of the functioning of organs and systems.
- Carrying out measures to detoxify the body through drugs and procedures (oxygenation).
- The development of necrotic processes can be stopped using protease inhibitors, but this process should be carried out under constant monitoring of the dynamics of the coagulogram.
- With progressive respiratory failure (especially in the case of legionella alveolitis ), the use of corticosteroids is indicated, except in cases of complications (parapneumonic pleurisy).
- With obstructive pulmonary disorders , the use of bronchodilators, oxygen inhalation is indicated.
- According to indications, they are transferred to artificial ventilation.
- Decrease in the aggregation of erythrocytes in the blood.
Prevention
Prevention of legionellosis is control over the state of ventilation, air conditioning, steam generation systems, showers and bathrooms, swimming pools, fountains and other possible places of settlement of legionella. Regular cleaning and disinfection of the above objects will help to reduce the concentration and eliminate bacterial colonies. Disinfection is carried out by treating hazardous areas with chlorine-containing chemicals, or by heating water to 80-100 in Celsius.
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