pulsed or tapered dosage
Spanish translation: pauta / dosis en pulsos o descendente (tapering)
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| 23:54 Feb 11, 2020 |
| English to Spanish translations [PRO] Medical - Medical: Health Care / medical article | |||||||
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|  Selected response from: Neil Ashby Spain Local time: 10:37 | ||||||
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| 4 +1 | pauta / dosis en pulsos or descendente (tapering) |
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| 5 | administración (de antibiótico) espaciada/a intervalos o gradual |
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| Summary of reference entries provided | |||
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| Taper and pulse dosing |
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| Discussion entries: 2 | |
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Answers
10 hrs confidence: 
peer agreement (net): +1
peer agreement (net): +1pauta / dosis en pulsos or descendente (tapering) Explanation: See the English refs I posted, which explain what pulse and tapering are. Vancomicina en tapering prolongado o en pulsos (ejemplo: 125 mg v.o. cada 6 horas por 14 días; luego 125 mg v.o. cada 8 horas por 7 días; luego 125 mg v.o. cada 12 horas por 7 días; 125 mg v.o. una vez al día por 7 días, y luego cada 2 o 3 días por 2 a 8 semanas) https://www.proa.hc.edu.uy/images/Clostridium_Set2018.pdf Guía de diagnóstico y tratamiento de la infección por Clostridium difficile La guía recomienda terapias iniciales más efectivas (vancomicina o fidaxomicina sobre el metronidazol) para reducir el fracaso y la recurrencia del tratamiento Use vancomicina de pulso gradual (recomendación débil, evidencia de baja calidad) o fidaxomicina (recomendación débil, evidencia de calidad moderada) si se usó inicialmente vancomicina. https://www.intramed.net/contenidover.asp?contenidoid=92999 Segunda recaida y posteriores No metronidazol por riesgo de neurotoxicidad Vancomicina en pulsos / pauta descendente 125 mg/6 h x 14 d 125 mg/12 h x 7 d 125 mg/d x 7 d 125 mg/48 h x 7 d 125 mg/72 h x 5 d https://seimc.org/contenidos/gruposdeestudio/geipc/dcientifi... www.slideshare.net › lapedrera › clostridium-diffici... Clostridium difficile. Actualización - Slideshare Translate this page Feb 27, 2015 - Tto complicada: Vancomicina 500 mg/oral/6 horas + vancomicina 500 ... una pauta descendente de vancomicina o pulsos de vancomicina. -------------------------------------------------- Note added at 10 hrs (2020-02-12 10:47:49 GMT) -------------------------------------------------- By the way, all of these references, plus the English ones, are about recurrent Clostridium difficile infections, which is the topic of the question at hand. |
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7 hrs confidence:
administración (de antibiótico) espaciada/a intervalos o gradual Explanation: Hola. Es común que la administración de antibióticos para Clostridium se haga así por ser un organismo formador de esporas. "pulsed"=con un intervalo/a intervalos, "tapered"=gradual o progresiva. Y "dosage" aquí es administración, no "dosificación" (2 conceptos distintos). Aunque podrías decir "las dosis de antibiótico se administran a intervalos o de forma gradual" Mira: https://www.pediatriaintegral.es/numeros-anteriores/publicac... Pruebas de exposición controlada (PEC) Consisten en la administración gradual del medicamento bajo estricto control, y se han denominado también pruebas de provocación. https://tinyurl.com/ssgnko3 (Tesis UCM) Esta asociación determina penicilinemias inmediatas y prolongadas que permiten la administración espaciada del medicamento(…) -------------------------------------------------- Note added at 11 horas (2020-02-12 11:10:48 GMT) -------------------------------------------------- por lo que investigó Neil sobre C. difficile, debe ser una "disminución gradual" de la dosis para esta bacteria, en caso de recuurencia. -------------------------------------------------- Note added at 11 horas (2020-02-12 11:47:05 GMT) -------------------------------------------------- tal vez, y afinando entonces: "(…) las directivas de la IDSA recomiendan una disminución gradual o espaciada de la dosis, a lo largo del tiempo." |
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Reference comments
10 hrs |
| Reference: Taper and pulse dosing Reference information: Pulse dosing is a novel approach to dosing that produces escalating antibiotic levels early in the dosing interval followed by a prolonged dose-free period. Antibiotic is frontloaded by means of four sequential bolus injections, after which antibiotic levels are allowed to diminish until the next dose. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC525458/ Tapering is the gradual reduction at the end of the course of antibiotics. Vancomycin taper regimens are commonly used for the treatment of recurrent Clostridium difficile infections. One rationale for tapering and pulsing of the dose at the end of therapy is to reduce the selective pressure of vancomycin on the indigenous intestinal microbiota. https://aac.asm.org/content/62/5/e02237-17 Although there are limited comparative data available, the best way of handling patients with multiple recurrences, in my experience, is to wean patients off treatment. This is typically done with vancomycin after a standard 10-day course of treatment; when the patient’s symptoms resolve, the doctor should taper the dose and then pulse it (ie, administer it every other day and then every third day). Thus, a typical tapered pulse regimen for vancomycin would be twice a day for a week, once a day for a week, every other day for several weeks (up to a month), and then every third day, depending on the patient’s history. This is a slow process, but it works for most patients. https://www.gastroenterologyandhepatology.net/archives/april... |
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