RESUMO
BACKGROUND: Contamination of central catheters is frequent, and biofilm perpetuates infections. Heparin does not protect against infections because it has no antibiotic action. Minocycline and edetic acid (M-EDTA), a potent calcium chelating agent that destroys bacterial and fungal cell membrane and disrupts biofilm, may be an alternative to allow the associated antibiotic to act locally at a high and safe concentration. METHODS: Fifty children with cancer and a port-a-cath were followed up: 26 received heparin (group 1) and 24 M-EDTA (group 2). A total of 762 serial prospective blood cultures were obtained, 387 from group 1 and 375 from group 2. RESULTS: In group 1 (heparin), 19 blood cultures were positive, and infection incidence was 73.1% (19/26 ports). In group 2 (M-EDTA), 5 blood cultures were positive, and the incidence rate was 20.8% (5/24 ports). CONCLUSION: M-EDTA, compared with heparin, prevents and treats catheter infections, and is a promising alternative to decrease sepsis during chemotherapy.
Assuntos
Antibacterianos/uso terapêutico , Infecções Relacionadas a Cateter/tratamento farmacológico , Ácido Edético/uso terapêutico , Minociclina/uso terapêutico , Neoplasias/complicações , Antibacterianos/administração & dosagem , Biofilmes , Sangue/microbiologia , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/microbiologia , Cateterismo Periférico/instrumentação , Cateteres de Demora , Criança , Feminino , Heparina/uso terapêutico , Humanos , Masculino , Minociclina/administração & dosagemRESUMO
BACKGROUND: High-molecular-weight sodium heparin (10,000 IU) has been developed based on studies conducted on burn patients; it has anti-inflammatory, antigenic and anticoagulant properties. OBJECTIVES: The aim of this paper was to evaluate the effects of topical application of sodium heparin spray on two immunosuppressed patients (a child and a young person) with perineal dermatitis and an immunosuppressed child with second-degree burns. METHODS: This is a report of three clinical cases treated in a pediatric hospital. Sodium heparin spray (10,000 IU) was applied at a dose of 4200 IU per percentage of body surface area affected over the hyperemic region. Heparin spray treatment was discontinued after crust formation and wound reepithelialization; essential fatty acid was applied until spontaneous separation of the crust or total wound reepithelialization. RESULTS: Heparin spray had analgesic, angiogenic and anti-inflammatory effects, and did not require secondary wound closure. Pain control was of fundamental importance to the patients; in the three cases, improvement in analgesia was achieved within 24 h of treatment. CONCLUSION: The topical application of heparin spray in patients with perineal dermatitis or superficial second-degree burns demonstrated good tolerability, resulted in good aesthetic outcomes, and reduced pain.