Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife)
Abstract INTRODUCTION: Rabies is a major and seriously neglected public health problem worldwide. A treatment consisting of supportive therapy with the use of drugs that show antiviral activity is called the Milwaukee Protocol. In Brazil, this protocol was adapted to the national reality and called...
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ftdoajarticles:oai:doaj.org/article:bcbb68c798f74e7181072282253cf6b7 2023-05-15T15:10:59+02:00 Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) Leandro Augusto Ledesma Elba Regina Sampaio Lemos Marco Aurélio Horta 2020-11-01T00:00:00Z https://doi.org/10.1590/0037-8682-0352-2020 https://doaj.org/article/bcbb68c798f74e7181072282253cf6b7 EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100375&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0352-2020 https://doaj.org/article/bcbb68c798f74e7181072282253cf6b7 Revista da Sociedade Brasileira de Medicina Tropical, Vol 53 (2020) Rabies Milwaukee Protocol Recife Protocol Arctic medicine. Tropical medicine RC955-962 article 2020 ftdoajarticles https://doi.org/10.1590/0037-8682-0352-2020 2022-12-31T02:47:39Z Abstract INTRODUCTION: Rabies is a major and seriously neglected public health problem worldwide. A treatment consisting of supportive therapy with the use of drugs that show antiviral activity is called the Milwaukee Protocol. In Brazil, this protocol was adapted to the national reality and called the Recife Protocol. In this study, we compared the Milwaukee Protocol with the Recife Protocol, assessing the differences and how these differences may change the course of clinical management. METHODS We searched electronic databases for the use of anti-rabies treatments. A total of 65 articles were published between 2004 and 2019. RESULTS: The protocols have similarities in care related to rabies patients and are important for the treatment of patients in intensive care units. Both protocols indicate deep sedation, antiviral use, constant concern with electrolyte balance, and vasoconstriction related to the condition. Many differences were observed in this study. For the Milwaukee Protocol, sedation should be gradually removed after the eighth day, and on the twelfth day, the patient should be without sedation. In the Recife Protocol, in order to avoid immunomodulation, it is recommended to remove sedation according to the titers of neutralizing antibodies to the rabies virus in the cerebral spinal fluid. CONCLUSIONS: In addition to the differences and similarities raised, our findings indicate that these protocols require a large center for rabies treatment, but the disease most often occurs in places where resources and hospital infrastructure are scarce. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 53 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
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Rabies Milwaukee Protocol Recife Protocol Arctic medicine. Tropical medicine RC955-962 |
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Rabies Milwaukee Protocol Recife Protocol Arctic medicine. Tropical medicine RC955-962 Leandro Augusto Ledesma Elba Regina Sampaio Lemos Marco Aurélio Horta Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |
topic_facet |
Rabies Milwaukee Protocol Recife Protocol Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract INTRODUCTION: Rabies is a major and seriously neglected public health problem worldwide. A treatment consisting of supportive therapy with the use of drugs that show antiviral activity is called the Milwaukee Protocol. In Brazil, this protocol was adapted to the national reality and called the Recife Protocol. In this study, we compared the Milwaukee Protocol with the Recife Protocol, assessing the differences and how these differences may change the course of clinical management. METHODS We searched electronic databases for the use of anti-rabies treatments. A total of 65 articles were published between 2004 and 2019. RESULTS: The protocols have similarities in care related to rabies patients and are important for the treatment of patients in intensive care units. Both protocols indicate deep sedation, antiviral use, constant concern with electrolyte balance, and vasoconstriction related to the condition. Many differences were observed in this study. For the Milwaukee Protocol, sedation should be gradually removed after the eighth day, and on the twelfth day, the patient should be without sedation. In the Recife Protocol, in order to avoid immunomodulation, it is recommended to remove sedation according to the titers of neutralizing antibodies to the rabies virus in the cerebral spinal fluid. CONCLUSIONS: In addition to the differences and similarities raised, our findings indicate that these protocols require a large center for rabies treatment, but the disease most often occurs in places where resources and hospital infrastructure are scarce. |
format |
Article in Journal/Newspaper |
author |
Leandro Augusto Ledesma Elba Regina Sampaio Lemos Marco Aurélio Horta |
author_facet |
Leandro Augusto Ledesma Elba Regina Sampaio Lemos Marco Aurélio Horta |
author_sort |
Leandro Augusto Ledesma |
title |
Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |
title_short |
Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |
title_full |
Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |
title_fullStr |
Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |
title_full_unstemmed |
Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |
title_sort |
comparing clinical protocols for the treatment of human rabies: the milwaukee protocol and the brazilian protocol (recife) |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2020 |
url |
https://doi.org/10.1590/0037-8682-0352-2020 https://doaj.org/article/bcbb68c798f74e7181072282253cf6b7 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 53 (2020) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100375&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0352-2020 https://doaj.org/article/bcbb68c798f74e7181072282253cf6b7 |
op_doi |
https://doi.org/10.1590/0037-8682-0352-2020 |
container_title |
Revista da Sociedade Brasileira de Medicina Tropical |
container_volume |
53 |
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