Estudo bacteriológico de abscessos causados por picada de serpentes do genero bothrops

Andrade, João Guimarães de; Pinto, Raimundo Nonato Leite; Andrade, Ana Lúcia; Martelli, Celina Maria Turchi; Zicker, Fábio

doi:10.1590/s0036-46651989000600001

Cited by 22 publications

(15 citation statements)

References 6 publications

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“…Cellulitis was defined by the presence of local inflammation signs (erythema, edema, bruising and pain) with association to fever, leukocytosis, lymphangitis and/or lymphadenitis [46]. An abscess was characterized by individual injuries, floating, presenting purulent secretion or serous-purulent secretion [46,47]. Two independent observers evaluated all the patients and came to a final agreement.…”

Section: Methodsmentioning

confidence: 99%

Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial

et al. 2017

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BackgroundSecondary bacterial infections from snakebites contribute to the high complication rates that can lead to permanent function loss and disabilities. Although common in endemic areas, routine empirical prophylactic use of antibiotics aiming to prevent secondary infection lacks a clearly defined policy. The aim of this work was to estimate the efficacy of amoxicillin clavulanate for reducing the secondary infection incidence in patients bitten by Bothrops snakes, and, secondarily, identify risk factors for secondary infections from snakebites in the Western Brazilian Amazon.Methods and findingsThis was an open-label, two-arm individually randomized superiority trial to prevent secondary infection from Bothrops snakebites. The antibiotic chosen for this clinical trial was oral amoxicillin clavulanate per seven days compared to no intervention. A total of 345 patients were assessed for eligibility in the study period. From this total, 187 accomplished the inclusion criteria and were randomized, 93 in the interventional group and 94 in the untreated control group. All randomized participants completed the 7 days follow-up period. Enzyme immunoassay confirmed Bothrops envenoming diagnosis in all participants. Primary outcome was defined as secondary infection (abscess and/or cellulitis) until day 7 after admission. Secondary infection incidence until 7 days after admission was 35.5% in the intervention group and 44.1% in the control group [RR = 0.80 (95%CI = 0.56 to 1.15; p = 0.235)]. Survival analysis demonstrated that the time from patient admission to the onset of secondary infection was not different between amoxicillin clavulanate treated and control group (Log-rank = 2.23; p = 0.789).Secondary infections incidence in 7 days of follow-up was independently associated to fibrinogen >400 mg/dL [AOR = 4.78 (95%CI = 2.17 to 10.55; p<0.001)], alanine transaminase >44 IU/L [AOR = 2.52 (95%CI = 1.06 to 5.98; p = 0.037)], C-reactive protein >6.5 mg/L [AOR = 2.98 (95%CI = 1.40 to 6.35; p = 0.005)], moderate pain [AOR = 24.30 (95%CI = 4.69 to 125.84; p<0.001)] and moderate snakebites [AOR = 2.43 (95%CI = 1.07 to 5.50; p = 0.034)].Conclusions/SignificancePreemptive amoxicillin clavulanate was not effective for preventing secondary infections from Bothrops snakebites. Laboratorial markers, such as high fibrinogen, alanine transaminase and C-reactive protein levels, and severity clinical grading of snakebites, may help to accurately diagnose secondary infections.Trial registrationBrazilian Clinical Trials Registry (ReBec): RBR-3h33wy; UTN Number: U1111-1169-1005.

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Section: Methodsmentioning

confidence: 99%

Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial

et al. 2017

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“…O veneno botrópico pode também levar a alterações da função plaquetária bem como plaquetopenia. Essas alterações na coagulação sanguínea são as principais características dos envenenamentos por serpentes da família Viperidae 2,17,18,19 .…”

Section: Descrição Do Casounclassified

Envenenamento por serpente Bothrops no município de Afuá, Ilha de Marajó, estado do Pará, Brasil

Silva

Pardal

2018

Revista Pan-Amazônica de Saúde

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“…Although the incidence of abscesses on the bite wound area is approximately 12% for accidents involving South American Bothrops spp. (Ribeiro & Jorge, 1990, the specific involvement of Salmonella is clearly not a problem (Andrade et al, 1989;. This also applies to large constrictor snakes and small colubrids.…”

Section: It Is Not Possible To Eliminate Salmonella From the Digestivmentioning

confidence: 97%

Salmonella Associated with Snakes (Suborder Serpentes)

Bastos¹

2012

Salmonella - Distribution, Adaptation, Control Measures and Molecular Technologies

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Estudo bacteriológico de abscessos causados por picada de serpentes do genero bothrops

Abstract: RESUMO

Cited by 22 publications

References 6 publications

Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial

Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial

Envenenamento por serpente Bothrops no município de Afuá, Ilha de Marajó, estado do Pará, Brasil

Salmonella Associated with Snakes (Suborder Serpentes)

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