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Community Acquired Pneumonia Treatment

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https://www.readbyqxmd.com/read/29158922/hypoxemic-respiratory-failure-from-acute-respiratory-distress-syndrome-secondary-to-leptospirosis
#1
Shannon M Fernando, Pierre Cardinal, Peter G Brindley
Acute respiratory distress syndrome (ARDS), characterized by hypoxemic respiratory failure, is associated with a mortality of 30-50% and is precipitated by both direct and indirect pulmonary insults. Treatment is largely supportive, consisting of lung protective ventilation and thereby necessitating Intensive Care Unit (ICU) admission. The most common precipitant is community-acquired bacterial pneumonia, but other putative pathogens include viruses and fungi. On rare occasions, ARDS can be secondary to tropical disease...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29153959/after-hours-respiratory-physiotherapy-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-an-australian-perspective
#2
Lisa van der Lee, Anne-Marie Hill, Shane Patman
INTRODUCTION: Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals. MATERIALS AND METHODS: A cross-sectional, mixed methods online survey was conducted...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153553/effectiveness-of-an-early-switch-from-intravenous-to-oral-antimicrobial-therapy-for-lower-respiratory-tract-infection-in-patients-with-severe-motor-intellectual-disabilities
#3
Masaru Kawamura, Takayuki Hoshina, Masato Ogawa, Takato Nakamoto, Koichi Kusuhara
An early switch from intravenous to oral antimicrobial therapy is useful for reducing the duration of the hospitalization in adult patients with community acquired-pneumonia, whereas the efficacy of switch therapy for pediatric patients with community acquired (CA)-lower respiratory tract infection (LRTI) is uncertain. The aim of this study is to investigate the efficacy of switch therapy for LRTI in patients with severe motor intellectual disabilities (SMID). This retrospective study was performed on 92 patients with SMID who were admitted to the Department of Pediatrics at the Hospital of University of Occupational and Environmental Health, Japan from April 1, 2010 to March 31, 2017 for the suspicion of bacterial LRTI and were initially treated with an intravenous antimicrobial agent...
November 16, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#4
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29138583/efficacy-of-intravenous-tigecycline-in-patients-with-acinetobacter-complex-infections-results-from-14-phase-iii-and-phase-iv-clinical-trials
#5
Hal Tucker, Michele Wible, Ashesh Gandhi, Alvaro Quintana
Background: Acinetobacter infections, especially multidrug-resistant (MDR) Acinetobacter infections, are a global health problem. This study aimed to describe clinical outcomes in patients with confirmed Acinetobacter spp. isolates who were treated with tigecycline in randomized clinical trials. Materials and methods: Data from 14 multinational, randomized (open-label or double-blind), and active-controlled (except one) Phase III and IV studies were analyzed using descriptive statistics...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29132435/vasculotide-reduces-pulmonary-hyperpermeability-in-experimental-pneumococcal-pneumonia
#6
Birgitt Gutbier, Xiaohui Jiang, Kristina Dietert, Carolin Ehrler, Jasmin Lienau, Paul Van Slyke, Harold Kim, Van C Hoang, Jason T Maynes, Daniel J Dumont, Achim D Gruber, Norbert Weissmann, Timothy J Mitchell, Norbert Suttorp, Martin Witzenrath
BACKGROUND: Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality worldwide. Despite effective antimicrobial therapy, CAP can induce pulmonary endothelial hyperpermeability resulting in life-threatening lung failure due to an exaggerated host-pathogen interaction. Treatment of acute lung injury is mainly supportive because key elements of inflammation-induced barrier disruption remain undetermined. Angiopoietin-1 (Ang-1)-mediated Tie2 activation reduces, and the Ang-1 antagonist Ang-2 increases, inflammation and endothelial permeability in sepsis...
November 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29126268/duration-of-antibiotic-use-among-adults-with-uncomplicated-community-acquired-pneumonia-requiring-hospitalization-in-the-united-states
#7
Sarah H Yi, Kelly M Hatfield, James Baggs, Lauri A Hicks, Arjun Srinivasan, Sujan Reddy, John A Jernigan
Background: Previous studies suggest duration of antibiotic therapy for community-acquired pneumonia (CAP) often exceeds national recommendations and might represent an important opportunity to improve antibiotic stewardship nationally. The objective of this study was to determine average length of antibiotic therapy (LOT) for patients treated for uncomplicated CAP in US hospitals and proportion of patients with excessive durations. Methods: Records of retrospective cohorts of patients 18-64 years with private insurance and ≥65 years with Medicare hospitalized for CAP in 2012-13 were utilized...
November 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29123431/comparative-quality-measures-of-emergency-care-an-outcome-cockpit-proposal-to-survey-clinical-processes-in-real-life
#8
Susanne Burgemeister, Alexander Kutz, Antoinette Conca, Thomas Holler, Sebastian Haubitz, Andreas Huber, Ulrich Buergi, Beat Mueller, Philipp Schuetz
Background: Benchmarking of real-life quality of care may improve evaluation and comparability of emergency department (ED) care. We investigated process management variables for important medical diagnoses in a large, well-defined cohort of ED patients and studied predictors for low quality of care. Methods: We prospectively included consecutive medical patients with main diagnoses of community-acquired pneumonia, urinary tract infection (UTI), myocardial infarction (MI), acute heart failure, deep vein thrombosis, and COPD exacerbation and followed them for 30 days...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29119848/management-of-community-acquired-pneumonia-in-immunocompetent-adults-updated-swedish-guidelines-2017
#9
Simon Athlin, Christer Lidman, Anders Lundqvist, Pontus Naucler, Anna C Nilsson, Carl Spindler, Kristoffer Strålin, Jonas Hedlund
Based on expert group work, Swedish recommendations for the management of community-acquired pneumonia in adults are here updated. The management of sepsis-induced hypotension is addressed in detail, including monitoring and parenteral therapy. The importance of respiratory support in cases of acute respiratory failure is emphasized. Treatment with high-flow oxygen and non-invasive ventilation is recommended. The use of statins or steroids in general therapy is not found to be fully supported by evidence. In the management of pleural infection, new data show favourable effects of tissue plasminogen activator and deoxyribonuclease installation...
November 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29117671/changing-trends-in-clinical-characteristics-and-antibiotic-susceptibility-of-klebsiella-pneumoniae-bacteremia
#10
Miri Hyun, Chang In Noh, Seong Yeol Ryu, Hyun Ah Kim
Background/Aims: Klebsiella pneumoniae is second most common organism of gram-negative bacteremia in Korea and one of the most common cause of urinary tract infection, and intra-abdominal infection. Methods: We compared clinical and microbiological characteristics about K. pneumoniae bacteremia in a tertiary hospital between 10 years. Group A is who had K. pneumoniae bacteremia at least one time from January 2004 to December 2005. Group B is from January 2012 to December 2013...
November 10, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29107789/overcoming-the-challenges-of-low-drug-solubility-in-the-intravenous-formulation-of-solithromycin
#11
Daniel Evans, Samuel Yalkowsky, Sara Wu, David Pereira, Prabha Fernandes
Solithromycin is a fluoro-ketolide (a fourth-generation macrolide) antibiotic that has been undergoing clinical trials for the treatment of community acquired bacterial pneumonia. In this study, development of the tri-amino acid buffered solithromycin intravenous (IV) formulation was performed to minimize the occurrence of infusion associated local adverse events (infusion site pain or phlebitis) observed in patients who received the tartaric acid buffered IV formulation with a lower buffered capacity during Phase I clinical trials...
October 28, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29096171/considerations-for-effect-site-pharmacokinetics-to-estimate-drug-exposure-concentrations-of-antibiotics-in-the-lung
#12
REVIEW
Keith A Rodvold, William W Hope, Sara E Boyd
Bronchoalveolar lavage (BAL) and microdialysis have become the most reliable and relevant methods for measuring lung concentrations of antibiotics, with the majority of BAL studies involving either healthy adult subjects or patients undergoing diagnostic bronchoscopy. Emphasis on the amount of drug that reaches the site of infection is increasingly recognized as necessary to determine whether a dose selection will translate to good clinical outcomes in the treatment of patients with pneumonia. Observed concentrations and/or parameters of exposure (e...
October 30, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29094629/infectious-diseases-and-immunological-markers-associated-with-patients-with-non-hodgkin-lymphoma-treated-with-rituximab
#13
Kleber Jordão de Souza, Rodrigo Sala Ferro, Luiz Euribel Prestes-Carneiro, Paula Andreia Martins Carrilho, Dewton de Moraes Vasconcelos
BACKGROUND: The use of rituximab (RTX) is increasing, even in developing countries. It has become the first-line therapy or adjuvant to chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone) for various diseases, including B cell lymphoma and autoimmune diseases. AIM: We describe the infectious diseases and immunological markers associated with RTX treatment of patients with non-Hodgkin lymphoma (NHL). METHODS: Serum immunoglobulins were determined before and after intravenous immunoglobulin (IVIg) administration...
November 2, 2017: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/29091975/treatment-trends-and-outcomes-in-healthcare-associated-pneumonia
#14
Sarah Haessler, Tara Lagu, Peter K Lindenauer, Daniel J Skiest, Aruna Priya, Penelope S Pekow, Marya D Zilberberg, Thomas L Higgins, Michael B Rothberg
BACKGROUND: The American Thoracic Society and Infectious Diseases Society of America guidelines for management of healthcare-associated pneumonia (HCAP), first published in 2005, have been controversial regarding the selection of empiric broad-spectrum antibiotics, whether the criteria for HCAP predicts the likelihood of infection with multidrug resistant organisms, and whether HCAP patients have improved outcomes when treated with empiric broad-spectrum antibiotics. METHODS: A retrospective cohort study at 488 US hospitals from July 2007 to November 2011...
November 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29084336/effectiveness-of-%C3%AE-lactam-monotherapy-vs-macrolide-combination-therapy-for-children-hospitalized-with-pneumonia
#15
Derek J Williams, Kathryn M Edwards, Wesley H Self, Yuwei Zhu, Sandra R Arnold, Jonathan A McCullers, Krow Ampofo, Andrew T Pavia, Evan J Anderson, Lauri A Hicks, Anna M Bramley, Seema Jain, Carlos G Grijalva
Importance: β-Lactam monotherapy and β-lactam plus macrolide combination therapy are both common empirical treatment strategies for children hospitalized with pneumonia, but few studies have evaluated the effectiveness of these 2 treatment approaches. Objective: To compare the effectiveness of β-lactam monotherapy vs β-lactam plus macrolide combination therapy among a cohort of children hospitalized with pneumonia. Design, Setting, and Participants: We analyzed data from the Etiology of Pneumonia in the Community Study, a multicenter, prospective, population-based study of community-acquired pneumonia hospitalizations conducted from January 1, 2010, to June 30, 2012, in 3 children's hospitals in Nashville, Tennessee; Memphis, Tennessee; and Salt Lake City, Utah...
October 30, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29071842/-literature-study-on-prevention-and-treatment-of-community-acquired-pneumonia-by-traditional-chinese-medicine
#16
De-Min Li, Shi-Huan Tang, Qiang Liao, Wei Chen, Hong-Chun Zhang
Among the literatures of the prevention and treatment of community-acquired pneumonia (CAP) published in recent years, there were 16 kinds of classic prescription, including 52 RCTs about Maxingshigan Decoction, 21Chinese patent medicines. There are eight kinds of indications for the drug specification, among which the literatures of Tan Reqing injection accounted for the most about 136 RCTs; There were literatures about non-drug treatment, including: acupuncture, Chinese medicine paste, enema, Chinese medicine ionization, Chinese medicine fumigation, bamboo cans and so on...
April 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29067039/management-of-community-acquired-pneumonia-by-family-physicians
#17
Saima Akhter, Nadeem Rizvi, Sajeer Bhura, Usman Ali Warraich
BACKGROUND AND OBJECTIVE: Community Acquired Pneumonia (CAP)is a major burden on health systemwith significant mortality and morbidity. Family Physicians(FPs)can play important role. To determine management strategies and prescription of FPs regarding CAP. METHODS: A multicenter cross sectional survey was done in 10 cities of Pakistan from November 2014 to January 2015. Self-administered questionnaire was filled by 110 Family Physicians. RESULTS: Of total 71% of FPs reported to work in high prevalence areas for respiratory ailments...
July 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29061311/efficacy-of-high-doses-of-penicillin-versus-amoxicillin-in-the-treatment-of-uncomplicated-community-acquired-pneumonia-in-adults-a-non-inferiority-controlled-clinical-trial
#18
Carl Llor, Almudena Pérez, Eugenia Carandell, Anna García-Sangenís, Javier Rezola, Marian Llorente, Salvador Gestoso, Francesc Bobé, Miguel Román-Rodríguez, Josep M Cots, Silvia Hernández, Jordi Cortés, Marc Miravitlles, Rosa Morros
INTRODUCTION: Community-acquired pneumonia (CAP) is treated with penicillin in some northern European countries. OBJECTIVES: To evaluate whether high-dose penicillin V is as effective as high-dose amoxicillin for the treatment of non-severe CAP. DESIGN: Multicentre, parallel, double-blind, controlled, randomized clinical trial. SETTING: 31 primary care centers in Spain. PARTICIPANTS: Patients from 18 to 75 years of age with no significant associated comorbidity and with symptoms of lower respiratory tract infection and radiological confirmation of CAP were randomized to receive either penicillin V 1...
October 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29050134/-the-role-of-nemonoxacin-in-the-treatment-of-community-acquired-pneumonia
#19
W P Hu, J Zhang, J M Qu
No abstract text is available yet for this article.
October 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29046011/-biomarkers-in-diagnosis-treatment-and-prognosis-of-infectious-lung-diseases
#20
M Unnewehr, M Kolditz, W Windisch, B Schaaf
Biomarkers play an important role in the management of infectious pulmonary diseases, even though there is only limited evidence that biomarker-guided therapies are superior to clinical strategies.Well-established indications for the use of biomarkers are the guidance of the duration of antibiotic therapy in community-acquired pneumonia (CAP) by PCT, the decision against the use of antibiotics by CRP or PCT in ambulatory settings, and the evaluation of CAP treatment by CRP or PCT kinetics.In the prognostic assessment of CAP, the standard biomarkers of acute organ dysfunction should be given priority, e...
October 18, 2017: Pneumologie
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