Anaerobic infections are the more common clinical types of infection, but there are many errors in their treatment, which can lead to treatment failures, delays and even serious complications. Common errors in the treatment of anaerobic infections are detailed below.
i. Misdiagnosis leads to blindness and error in the use of medicines: anaerobic infections are diagnosed only on the basis of clinical performance and no microbial examination is carried out. Many clinicians can easily diagnose anaerobic infections and use antiaerobic drugs empirically when they encounter specific clinical manifestations such as local swollen formation, tissue decomposition accompanied by deodorant and gas-induced infections. In practice, however, these manifestations are not specific to anaerobic infections and other bacterial infections or mixed infections may have similar symptoms.
Correct practice: Where anaerobic infections are suspected, appropriate specimens should be collected as far as possible for anaerobic culture and drug sensitivity testing. Although the conditions for anaerobic culture are more stringent, it has an irreplaceable effect on the identification of pathogen types and on the understanding of their drug-sensitive properties, so that antibacterial drugs are selected with precision. At the same time, a combination of clinical symptoms, areas of infection and medical history can be made, but it cannot rely solely on clinical performance.
ii. Mis-selection of drugs, (i) abuse of broad spectrum antibiotics, error zones: over-reliance on wide spectrum antibiotics treatment and neglect of targeted anti-aerobic drugs. Some doctors are accustomed to using broad spectrum antibiotics for the treatment of infections, which they believe can cover a variety of pathogens, including anaerobic bacteria. However, antibacterial activity for anaerobics is limited in some broad spectrum antibiotics, such as some antibacterial strains, which have a poor effect on common anaerobics, such as fragile bacterium. Prolonged and irrational use of broad-spectral antibiotics can also lead to strains of the fungus, causing double infections and further complications.
The right choice: In cases of explicit or highly suspected anaerobic infections, drugs with a good antiaerobic activity, such as americium, nitrazine and clinicin, should be preferred. These drugs are relatively antibacterial for most anaerobics and have relatively few adverse effects. In the case of mixed infections, other suitable antibiotics may be used in combination on the basis of drug sensitivity or experience, but can not be used blindly to replace specialized antiaerobic drugs.
(ii) Ignorance of drug resistance, error zone: Ignorance of drug resistance in local anaerobics and choice of drug-resistant. With the widespread use of antibiotics, the problem of resistance to anaerobics is increasing. There may be differences in the anaerobic resistance spectrum between different regions and health-care settings, but some doctors, when choosing antiaerobic drugs, do not take fully into account the local drug resistance situation and still opt for some drugs that are already generally resistant, resulting in treatment failure.
Correct response: Aerobic resistance monitoring should be carried out on a regular basis in medical institutions to keep abreast of the drug resistance dynamics in the region. Doctors, when choosing drugs, give priority to sensitive antiaerobic drugs, taking into account local resistance data. For drug-resistant strain infections, second-line or combined-use options may be selected on the basis of the results of drug-sensitive tests, such as anaerobic infections of mitazine-resistant drugs, the use of a combination of anaeroacin antibiotics (e.g., aminophyllene) or β-actamide/beta-animide inhibitors (e.g., amoxilin/clavic acid) may be considered.
iii. Drug dose and treatment error zone, (i) insufficient dose and error zone: use of antiaerobic drugs below effective treatment dose to reduce adverse drug response. Some doctors are concerned about the adverse effects of anti-aerobic drugs, such as nitraz, which may cause gastrointestinal reactions, neurosystem symptoms, etc., and deliberately reduce the dose. However, effective antibacterial concentrations cannot be achieved with insufficient doses, not only to eliminate anaerobics completely, but to induce bacteria to produce resistance.
Correct dose: The appropriate dose should be determined on the basis of the description of the drug, the patient ‘ s severity, age, weight, liver and kidney function, etc. In general, for most anaerobic infections, sufficient quantities of drugs should be used to ensure effective fungicide or antibacterial concentrations in the affected areas. For example, anaerobic infections are treated with a high dose of 0.5 g per adult per day, three times a day, with an appropriate increase for severe infections. (ii) Unreasonable course of treatment, error zone: premature withdrawal after symptoms have been mitigated. When some patients are treated with anaerobic drugs, the symptoms, such as fever, pain, local edema, etc., are reduced, and the doctor immediately ceases to use them. However, anaerobic bacteria in the body may not have been completely eliminated at this time and may easily lead to re-emergence.
Reasonable course of treatment: The treatment for anaerobic infections depends on the type, location, severity of the infection and the individual differences of the patient. In general, the treatment for shallow anaerobic infections is relatively short, for about 7 – 10 days, while for severe infections such as deep tissue infections, sepsis formations and bacterial haemorrhages, the treatment may take 2 – 4 weeks or even longer. In the course of treatment, a combination of clinical symptoms, signs and laboratory tests (e.g., blood protocol, C reaction protein, video-testing, etc.) should be used to determine whether or not to stop the drug, to ensure a complete cure and to prevent recurrence.
IV. Partially mistreated and mistreated: focusing only on the whole body of medicine, ignoring the importance of partial treatment. In the treatment of anaerobic infections, the full-body use of antiaerobic drugs is necessary, especially for some local infections such as soft skin tissue swollen swollenness and tooth swollenness, but it is often difficult to achieve good treatment if local treatments, such as swollen swollen swollen swollen swollen, local sprawl etc., are neglected. If not dealt with in a timely manner, local health stoves become “hotbeds” for the continuous growth of bacteria, and even full-body medicine is difficult to completely remove.
Correct strategy: For anaerobic infections with a visible abscess, a timely diversion should be carried out, a sepsis should be discharged and a deviant tissue removed. At the same time, local application of some antibacterial drugs, such as rinsing wounds with mitraz solutions, may be used to enhance local antibacterial effects and to promote healing. Combining local treatment with the treatment of whole-body antiaerobic drugs can significantly improve treatment success.
In general, in the treatment of anaerobic infections, clinical doctors are required to make an accurate diagnosis, to make reasonable choices, to regulate the dose and course of treatment, and to focus on local treatments so as to avoid being caught in the error of treatment, in order to increase the level of treatment for anaerobic infections and to improve patient prognosis.
