Mega doses of prophylaxis antibiotic for life and oftentimes the kidney will give up
and sometimes develop resistance to certain antibiotic and when their
immunity is compromised the opportunistic infection could set in.
One thing about these kind of patients kay diri sa U.S. dili pabutangan ug
contact isolation sign outside their door para warning sa mosulod sa
room nga unta mananakod man ni ilang sakit.
Dili sad makita sa ilang chart, so kaming mga staff magbantay lang pirme
and of course cover up morag astronaut hahaha, gowns, gloves,
foot covers and mask.
It reminds of one cardiologist gikan sa Taiwan to siya ug iya gisuwat sa chart
nga may AIDS ang patient kay tungod sa iya lifestyle nga lalaki unta pero benabaye,
nagubot lagi ang mga staff kay ni violate siya sa confidentiality, gipatawag sa admin
siya ug gi lecture, ops!
This is true. However, considering that patients with full blown AIDS (with CD4+ count of <200) are susceptible to a host of opportunistic infections (from giardia lamblia, cryptococcus, alpha/beta hemolytic strep (and group a/b), to susceptibility to MRSA (methicillin resistant staph aureus) and in cases VRSA (vancomycin resistant staph aureus), their choices are low. Some are also ridden with clostridium, as well as infected with molluscum and other hosts of bacterial infections that the average individual (with a CD4+ count of over 1000) would not even succumb to.
In these cases, the physician maintains the patient in precluding antibiotic therapy. What is meant by this is that we initiate them in a combination of 2+1 (HAART) ; meaning we place the platient in 1 nucleoside inhibitors/non-nucleoside inhibitors, then given them fusion inhibitiors (there is no known resistance to this yet) and protease inhibitors. This drug cocktail prevents the further diminishment of the HIV patient's CD4+ count and preventing the disease from becoming full-blown AIDS.
But, however, for those whose CD4+ counts have reached below the 200 level and are suffering from observable lymphadenopathy and bacterial infections; we give the patient first with low-dose abx. Start them off with wide sprectrum + probenicids. And then continue with higher yield abx.
As for the notion of drug resistance; that is true. Any pathogen will be come resistant to man's drugs. However, that is why the medical pharmacology field is a booming field. So long as there is money and capital to be made in treating patients, they will continue to research, research and create more new generation antibiotics.
For MRSA, we give vancomycin, and for VRSA we give them nafcillin, and high dose aminoglycosides, and higher generations cephas.
In cases with HIV/AIDS patients, we have to put priority in the condition. We treat the bacterial infection first, then we deal with the renal considerations.
As you are right, these kinds of patients are placed in highly sterilized conditions. By order of the physician.
We do what we can with what we can.
So far, AIDS can be treated.
We cannot fully cure it. However, with the current medical pharmacology available, AIDS patients can live for years indefinately. We see a life retention of 30-40 years with our current medical regimen. This does not include future drugs that are under research.
Cheers,
Lorenzo
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