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https://www.readbyqxmd.com/read/29043422/guidelines-for-the-use-of-chest-radiographs-in-community-acquired-pneumonia-in-children-and-adolescents
#1
REVIEW
Savvas Andronikou, Elena Lambert, Jarred Halton, Lucy Hilder, Iona Crumley, Mark D Lyttle, Cara Kosack
National guidance from the United Kingdom and the United States on community-acquired pneumonia in children states that chest radiographs are not recommended routinely in uncomplicated cases. The main reason in the ambulatory setting is that there is no evidence of a substantial impact on clinical outcomes. However clinical practice and adherence to guidance is multifactorial and includes the clinical context (developed vs. developing world), the confidence of the attending physician, the changing incidence of complications (according to the success of immunisation programs), the availability of alternative imaging (and its relationship to perceived risks of radiation) and the reliability of the interpretation of imaging...
October 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29043420/lung-ultrasound-for-the-diagnosis-of-community-acquired-pneumonia-in-children
#2
REVIEW
Jacob A M Stadler, Savvas Andronikou, Heather J Zar
Ultrasound (US) has been proposed as an alternative first-line imaging modality to diagnose community-acquired pneumonia in children. Lung US has the potential benefits over chest radiography of being radiation free, subject to fewer regulatory requirements, relatively lower cost and with immediate bedside availability of results. However, the uptake of lung US into clinical practice has been slow and it is not yet included in clinical guidelines for community-acquired pneumonia in children. The aim of this review is to give an overview of the equipment and techniques used to perform lung US in children with suspected pneumonia and the interpretation of relevant sonographic findings...
October 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29036540/tackling-anti-microbial-resistance-ethical-framework-for-rational-antibiotic-use
#3
Jasper Littmann, Annette Rid, Alena Buyx
Background: To reduce the effect of antimicrobial resistance and to preserve antibiotic effectiveness, clinical guidelines and health policy documents call for the rational use of antibiotics, which aims to reduce unnecessary or minimally effective antibiotic use. Methods: Through ethical analysis, we show that rational use programmes can lead to ethical conflicts, because they sometimes place patients at risk of harm-for example, a delayed switch to second-line antibiotics for community-acquired pneumonia can lead to substantial increases in mortality...
October 5, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/29034094/antibiotic-therapy-supportive-treatment-and-management-of-immunomodulation-inflammation-response-in-community-acquired-pneumonia-review-of-recommendations
#4
REVIEW
Marco Mantero, Paolo Tarsia, Andrea Gramegna, Sonia Henchi, Nicolò Vanoni, Marta Di Pasquale
Community-acquired pneumonia is a common and serious disease, with high rates of morbidity and mortality. Management and treatment of community-acquired pneumonia are described in three main documents: the 2007 American Thoracic Society guidelines, the 2011 European Respiratory Society guidelines, and the 2009 British Thoracic Society guidelines, updated by the NICE in 2015. Despite the validity of current guidelines in improving prognosis and management of patients with community-acquired pneumonia, not all recommendations have high levels of evidence and there are still some controversial issues...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28970157/initial-empiric-antibiotic-therapy-for-community-acquired-pneumonia-in-chinese-hospitals
#5
Xiaomeng Nie, Yesheng Li, Zhangwei Yang, Hui Wang, Sanyong Jin, Yang Jiao, Mark L Metersky, Yi Huang
OBJECTIVES: Studies on treatment of community-acquired pneumonia (CAP) in China are very scarce. This study was performed to investigate empirical antibiotic practices for patients hospitalized with CAP in China and the risk factors for treatment failure. METHODS: Data was collected from a national Chinese hospitalization database. Adult patients who were diagnosed as CAP between October 1st, 2014, and September 30th, 2015 were identified. We studied initial empiric antibiotic regimens, microbiologic sampling, treatment failure, in hospital mortality, and length of hospital stay (LOS)...
September 29, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28956537/epidemiology-and-treatment-of-the-commonest-form-of-listeriosis-meningitis-and-bacteraemia
#6
Pasquale Pagliano, Ferhat Arslan, Tiziana Ascione
Listeria monocytogenes is a Gram-positive bacillus and facultative intracellular bacterium whose transmission occurs mainly through the consumption of contaminated food. Listeriosis has an incidence estimated at around three-six cases per million per year and the most common forms of the infection are neurolisteriosis, bacteraemia, and maternal-neonatal infection. Those affected by listeriosis are at the extremes age of the life or report specific risk factors, such as malignancies, causing a defect of cellular immunity...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28955497/pneumococcal-vaccination-in-autoimmune-rheumatic-diseases
#7
REVIEW
Éva Rákóczi, Zoltan Szekanecz
Streptococcus pneumoniae is the leading cause of the community-acquired pneumonia. The mortality rate of invasive pneumococcal infections is high. Immunocompromised patients suffering from autoimmune inflammatory rheumatic diseases (AIRD) have a high risk for acquiring these infections. Protection against infection can be improved with vaccination. After using polysaccharide vaccines (PPV-23), in July 2013, a 13-valent conjugate vaccine (PCV-13) was approved for adults. Due to its conjugate form, this vaccine is the recommended choice in pneumococcal vaccine-naive patients...
2017: RMD Open
https://www.readbyqxmd.com/read/28952384/investigational-drugs-in-phase-i-and-phase-ii-clinical-trials-for-the-treatment-of-community-acquired-pneumonia
#8
Adamantia Liapikou, Catia Cillóniz, Antoni Torres
Community acquired pneumonia is one of the main infections, remaining as a global cause of considerable morbidity and mortality. Successful treatment hinges on expedient delivery of appropriate antibiotic therapy tailored to both the likely pathogens and the severity of disease. Although antibiotic resistance is increasing and pharmaceutical companies continue to debate the profitability of introducing new antibacterial agents, an encouraging number of new molecules have recently been unveiled which target multidrug-resistant bacteria...
November 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28914846/-analysis-of-the-efficiency-of-antimicrobial-treatment-for-community-acquired-pneumonia-in-clinical-practice
#9
O V Zhukova, O V Ruina, S V Kononova, T M Konyshkina
AIM: To analyze actual drug consumption based on the defined daily dose (DDD analysis) and to analyze the utilization of drugs based on their proportion of the total defined daily doses (DU90% analysis) for the antimicrobial therapy of community-acquired pneumonia (CAP) in clinical practice at a hospital in Russia. MATERIAL AND METHODS: The investigation materials were the data of 117 case histories of male (51.3%) and female (48.7%) patients hospitalized with CAP at Nizhny Novgorod City Clinical Hospital Five in 2015...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28892896/detection-of-cytomegalovirus-in-bronchoalveolar-lavage-fluid-from-hiv-positive-individuals-with-community-acquired-pneumonia
#10
Arati Mane, Pankaj Gujar, Shraddha Gaikwad, Tilak Dhamgaye, Arun Risbud
INTRODUCTION: Cytomegalovirus (CMV) pneumonia is one of the frequent viral pneumonia reported in persons with HIV infection. Knowledge of pulmonary CMV infection is important for deciding appropriate diagnostic strategies. However, there is scanty literature addressing the role of CMV aetiology among HIV positive individuals presenting with Community Acquired Pneumonia (CAP) using Bronchoalveolar Lavage (BAL) samples from India. AIM: To detect CMV in BAL fluid from HIV-positive individuals presenting with CAP...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890433/evaluation-of-severity-score-guided-approaches-to-macrolide-use-in-community-acquired-pneumonia
#11
Aran Singanayagam, Stefano Aliberti, Catia Cillóniz, Antoni Torres, Francesco Blasi, James D Chalmers
International guidelines including those in the UK, Japan, Australia and South Africa recommend the avoidance of macrolides in patients with low-severity community-acquired pneumonia (CAP). We hypothesised that severity scores are poor predictors of atypical pneumonia and response to macrolide therapy, and thus, inadequate tools for guiding antibiotic prescriptions.Secondary analysis of four independent prospective CAP datasets was conducted. The predictive values of the CURB-65 and pneumonia severity index (PSI) for clinically important groups of causative pathogens were evaluated...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28876159/implementing-a-multidisciplinary-approach-to-enhance-compliance-with-guideline-recommended-prechemotherapy-pneumococcal-vaccination-in-a-military-based-medical-oncology-practice
#12
Wilfred Delacruz, Sandra Terrazzino, Michael Osswald, Casey Payne, Brian Haney
PURPOSE: Patients with cancer are at increased risk for invasive pneumococcal disease, including community-acquired pneumonia. Current Advisory Committee on Immunization Practices and National Cancer Comprehensive Network guidelines recommend pneumococcal vaccination for immunocompromised patients, including patients with cancer. METHODS: We conducted a quality improvement (QI) project to enhance compliance with pneumococcal vaccination in patients before their chemotherapy...
September 6, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28874937/antimicrobial-therapy-for-pneumonia-in-the-emergency-department-the-impact-of-clinical-pharmacists-on-appropriateness
#13
Brett A Faine, Nicholas Mohr, Jenna Dietrich, Laura Meadow, Kari K Harland, Elizabeth Chrischilles
INTRODUCTION: Pneumonia impacts over four million people annually and is the leading cause of infectious disease-related hospitalization and mortality in the United States. Appropriate empiric antimicrobial therapy decreases hospital length of stay and improves mortality. The objective of our study was to test the hypothesis that the presence of an emergency medicine (EM) clinical pharmacist improves the timing and appropriateness of empiric antimicrobial therapy for community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP)...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28837859/systematic-review-of-respiratory-viral-pathogens-identified-in-adults-with-community-acquired-pneumonia-in-europe
#14
REVIEW
Y Alimi, W S Lim, L Lansbury, J Leonardi-Bee, J S Nguyen-Van-Tam
Community-acquired pneumonia (CAP) is an important respiratory disease and the fifth leading cause of mortality in Europe. The development of molecular diagnostic tests has highlighted the contributions of respiratory viruses to the aetiology of CAP, suggesting the incidence of viral pneumonia may have been previously underestimated. We performed a systematic review and meta-analysis to describe the overall identification of respiratory viruses in adult patients with CAP in Europe, following PRISMA guidelines (PROSPERO; CRD42016037233)...
August 5, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28835382/utility-of-blood-culture-among-children-hospitalized-with-community-acquired-pneumonia
#15
MULTICENTER STUDY
Mark I Neuman, Matthew Hall, Susan C Lipsett, Adam L Hersh, Derek J Williams, Jeffrey S Gerber, Thomas V Brogan, Anne J Blaschke, Carlos G Grijalva, Kavita Parikh, Lilliam Ambroggio, Samir S Shah
BACKGROUND AND OBJECTIVES: National guidelines recommend blood cultures for children hospitalized with presumed bacterial community-acquired pneumonia (CAP) that is moderate or severe. We sought to determine the prevalence of bacteremia and characterize the microbiology and penicillin-susceptibility patterns of positive blood culture results among children hospitalized with CAP. METHODS: We conducted a cross-sectional study of children hospitalized with CAP in 6 children's hospitals from 2007 to 2011...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28835381/reliability-of-examination-findings-in-suspected-community-acquired-pneumonia
#16
Todd A Florin, Lilliam Ambroggio, Cole Brokamp, Mantosh S Rattan, Eric J Crotty, Andrea Kachelmeyer, Richard M Ruddy, Samir S Shah
BACKGROUND: The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. METHODS: This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28822165/-methodological-quality-assessment-of-community-acquired-pneumonia-clinical-practice-guidelines-in-china-based-on-agree-%C3%A2-tool
#17
Ying-Jie Zhi, Xing Liao, Yan-Ming Xie, De-Min Li, Wei Chen, Yao-Long Chen, Ren-Bo Chen, Ya Yuwen, Hong-Chun Zhang, Yong-Yan Wang
This study is aimed to identify and assess the methodological quality of community-acquired pneumonia (CAP) clinical practice guidelines (CPG) in China by using AGREE Ⅱ tool. CNKI, SinoMed, Wanfang, and VIP Chinese databases from database establishment to March 2017 were searched by manual retrieval to collect all the clinical practice guidelines prepared by various associations or organizations, then AGREE Ⅱtool was used to assess them. Data in each CPG were analyzed in terms of six domains, including scope and purpose, participants, rigor, clarity and readability, applicability and editorial independence...
June 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#18
Prateek J Shukla, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Geovanny F Perez
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#19
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28813753/pre-guideline-trends-associated-with-chest-radiograph-usage-for-pediatric-community-acquired-pneumonia-in-emergency-department-settings
#20
Eric W Jones, Benjamin Meyer, Aaron M Berg, Benson S Hsu
BACKGROUND: Health care spending in the U.S. totaled $3 trillion in 2014 and continues to increase rapidly. Minimizing waste through clinical guidelines is a promising strategy to reduce spending without compromising patient care. In 2011, clinical guidelines recommended against the use of chest X-ray (CXR) for diagnosis of community-acquired pneumonia (CAP) in pediatric ambulatory settings. However, use of CXR has not changed post-guideline. Thus, understanding the drivers of CXR utilization prior to guideline implementation could improve guideline adherence...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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