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https://www.readbyqxmd.com/read/29850828/factors-associated-with-pneumonia-severity-in-children-a-systematic-review
#1
Preston Dean, Todd A Florin
Community-acquired pneumonia in children is associated with significant morbidity and mortality; however, data are limited in predicting which children will have negative outcomes, including clinical deterioration, severe disease, or development of complications. The Pediatric Infectious Diseases Society/Infectious Diseases Society of America (PIDS/IDSA) pediatric pneumonia guideline includes criteria that were modified from adult criteria and define pneumonia severity to assist with resource allocation and site-of-care decision-making...
May 30, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29802178/impact-of-an-antimicrobial-stewardship-program-on-outcomes-in-patients-with-community-acquired-pneumonia-admitted-to-a-tertiary-community-hospital
#2
Katie Gordon, Ryan Stevens, Benjamin Westley, Lisa Bulkow
PURPOSE: Results of a study evaluating the impact of an antimicrobial stewardship program (ASP) on clinical outcomes in patients hospitalized for community-acquired pneumonia (CAP) are reported. METHODS: A retrospective records review was conducted at a 400-bed hospital to identify patients admitted over 3 years with CAP documented as a primary or secondary diagnosis. Clinical and medication-use outcomes during a 1-year baseline period and in the first and second years after ASP implementation (post-ASP years 1 and 2) were analyzed...
June 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29724618/missed-opportunities-in-the-diagnosis-of-human-immunodeficiency-virus-infection-in-the-region-of-aragon-late-diagnosis-importance
#3
César Gargallo-Bernad, Francisco Javier Sangrós-González, Piedad Arazo-Garcés, Rosa Martínez-Álvarez, Carmen Malo-Aznar, Alicia Gargallo-Bernad, Alba Ballester-Luna, Luis Eduardo Cabrero-Pascual, Pablo Gil-Orna, Víctor José Abadía-Gallego, Isabel Torres-Peña, Héctor Ordiz-Suárez
INTRODUCTION: Late Diagnosis (LD) of Human Immunodeficiency Virus (HIV) infection (CD4 lymphocytes <350/μl at diagnosis of the disease), deteriorates the condition of those affected and increases the probability of transmission. The objective of the present study was to analyse the prevalence of LD, to identify missed diagnostic opportunities (MDO) and to find out which level of the health care delivery system they took place. METHODS: Retrospective, observational and descriptive study of the population diagnosed with infection of HIV/AIDS in the period 2011-2015 in Aragon...
April 30, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29699493/effects-of-age-comorbidity-and-adherence-to-current-antimicrobial-guidelines-on-mortality-in-hospitalized-elderly-patients-with-community-acquired-pneumonia
#4
Xiudi Han, Fei Zhou, Hui Li, Xiqian Xing, Liang Chen, Yimin Wang, Chunxiao Zhang, Xuedong Liu, Lijun Suo, Jinxiang Wang, Guohua Yu, Guangqiang Wang, Xuexin Yao, Hongxia Yu, Lei Wang, Meng Liu, Chunxue Xue, Bo Liu, Xiaoli Zhu, Yanli Li, Ying Xiao, Xiaojing Cui, Lijuan Li, Jay E Purdy, Bin Cao
BACKGROUND: Limited information exists on the clinical characteristics predictive of mortality in patients aged ≥65 years in many countries. The impact of adherence to current antimicrobial guidelines on the mortality of hospitalized elderly patients with community-acquired pneumonia (CAP) has never been assessed. METHODS: A total of 3131 patients aged ≥65 years were enrolled from a multi-center, retrospective, observational study initiated by the CAP-China network...
April 24, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29690685/-current-status-of-diagnosis-and-treatment-of-community-acquired-pneumonia-in-shanghai-revealed-by-a-questionnaire-analysis
#5
J Liu, J Zhang, Q J Cheng, J F Xu, Z J Jie, Y Jiao, Y Huang, J M Qu
Objective: To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. Methods: A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Results: A total of 1 254 valid questionnaires were received, 46.1% from tertiary , 26.4% from secondary and 27...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29679383/shortened-courses-of-antibiotics-for-bacterial-infections-a-systematic-review-of-randomized-controlled-trials
#6
REVIEW
Alexandra M Hanretty, Jason C Gallagher
Commonly prescribed durations of therapy for many, if not most, bacterial infections are not evidence-based. Misunderstandings by clinicians and patients alike influence perspectives on antibiotic use, including duration of therapy and its role in antibiotic resistance. To demonstrate that shorter durations of antibiotic therapy are as efficacious as longer durations for many infections, a systematic review was undertaken of English-language articles by using PubMed to identify articles for inclusion. Additionally, infection-specific guidelines were identified for review of recommendations...
April 20, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29619807/-recommendations-for-the-care-of-patients-with-community-acquired-pneumonia-in-the-emergency-department
#7
A Julián-Jiménez, I Adán Valero, A Beteta López, L M Cano Martín, O Fernández Rodríguez, R Rubio Díaz, M A Sepúlveda Berrocal, J González Del Castillo, F J Candel González
The incidence of community-acquired pneumonia (CAP) ranges from 2-15 cases / 1,000 inhabitants / year, being higher in those older than 65 years and in patients with high co-morbidity. Around 75% of all CAP diagnosed are treated in the Emergency Department (ED). The CAP represents the main cause for sepsis and septic shock in ED, and the most frequent cause of death and admission to the Intensive Care Unit (ICU) due to infectious disease. Overall mortality is 10-14% according to age and associated risk factors...
April 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29553440/inpatient-management-of-community-acquired-pneumonia-at-the-european-gaza-hospital-a-clinical-audit
#8
Said Alyacoubi, Yousef Abuowda, Loai Albarqouni, Bettina Böttcher, Khamis Elessi
BACKGROUND: Disease severity scores such as CURB-65 are often used to guide the management of patients with community-acquired pneumonia. Early and adequate empirical antibiotic treatment reduces mortality. The aim of this study was to examine the severity assessment and management of patients presenting with community-acquired pneumonia at the European Gaza Hospital in the Gaza Strip and to compare this to the best available evidence. METHODS: Medical records of all patients admitted to the European Gaza Hospital with a diagnosis of community-acquired pneumonia between Dec 1, 2015, and March 31, 2016, were reviewed retrospectively...
February 21, 2018: Lancet
https://www.readbyqxmd.com/read/29532655/antimicrobial-susceptibility-trends-and-evolution-of-isolates-with-extended-spectrum-%C3%AE-lactamases-among-gram-negative-organisms-recovered-during-the-smart-study-in-spain-2011-2015
#9
R Cantón, E Loza, J Aznar, R Barrón-Adúriz, J Calvo, F J Castillo, E Cercenado, R Cisterna, F González-Romo, J L López-Hontangas, A I Suárez-Barrenechea, F Tubau, B Molloy, D López-Mendoza
OBJECTIVE: The SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study monitors antimicrobial susceptibility and extended spectrum β-lactamases (ESBLs) in Gram-negative bacilli recovered from intra-abdominal infections (IAI). METHODS: Antimicrobial susceptibility of 5,343 isolates from IAI recovered in 11 centres during the 2011-2015 SMART-Spain program was analysed by standard microdilution (EUCAST criteria) and compared with that from 2002-2010...
April 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29528891/complicated-pneumonia-current-concepts-and-state-of-the-art
#10
Michael C Tracy, Roshni Mathew
PURPOSE OF REVIEW: This review aims to provide clinicians engaged in the care of infants and children an update on the current understanding of the epidemiology, etiology, diagnostic evaluation, and clinical management of complicated pneumonia. The review provides timely information surrounding areas of consensus and ongoing research. RECENT FINDINGS: The epidemiology and etiologies of complicated pneumonia continue to evolve over the past several decades in context of the introduction of new vaccines...
June 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29465065/can-ecdc-pps-hai-au-data-on-antimicrobial-use-can-be-used-to-evaluate-adherence-to-national-guidelines-for-antimicrobial-treatment-of-community-acquired-pneumonia
#11
Aleksander Deptuła, Ewa Trejnowska, Grzegorz Dubiel, Maria Deptuła, Marleta Zienkiewicz, Agnieszka Żukowska, Agnieszka Misiewska-Kaczur, Tomasz Ozorowski, Piotr Księżniakiewicz, Joanna Kubiak, Waleria Hryniewicz
INTRODUCTION    Point prevalence surveys are widely described as a useful tool for evaluating antimicrobial policy and adherence to guidelines. OBJECTIVES    We aimed to investigate if data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey of healthcare‑associated infections and antimicrobial use (PPS HAI&AU) canbe used to evaluate adherence to national guidelines for the treatment of community‑acquired pneumonia (CAP) and to analyze the quality of treatment regimens...
April 30, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29462306/a-multicentre-stewardship-initiative-to-decrease-excessive-duration-of-antibiotic-therapy-for-the-treatment-of-community-acquired-pneumonia
#12
Farnaz Foolad, Angela M Huang, Cynthia T Nguyen, Lindsay Colyer, Megan Lim, Jessica Grieger, Julius Li, Sara Revolinski, Megan Mack, Tejal Gandhi, J Njeri Wainaina, Gregory Eschenauer, Twisha S Patel, Vincent D Marshall, Jerod Nagel
Background: The increased emphasis on pneumonia-related performance measures and patient outcomes has led hospitals to implement multifaceted approaches to quickly identify patients with community-acquired pneumonia (CAP), start timely therapy and reduce readmission. However, there has been minimal focus on duration of therapy (DOT) and patients often receive prolonged antibiotic courses. The IDSA and American Thoracic Society (IDSA/ATS) CAP guidelines recommend 5 days of therapy for clinically stable patients that quickly defervesce and stewardship teams are well positioned to influence prescribing practices...
February 16, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29454509/group-c-strep-mediastinitis
#13
Joseph G Kotora, Eric J Schmieler, Christian S McEvoy, Stephen L Noble
This case is significant to the practice of emergency medicine because it represents the development of an uncommon and potentially fatal mediastinal infection from a commonly encountered and appropriately treated community respiratory pathogen. Most published reports on mediastinitis are those that are status-post cardiothoracic surgery. In our report, we discuss a case of a healthy, young individual who developed this morbid entity from extension of a simple respiratory infection where Group C Streptococcus has been isolated as the causative organism, which to our knowledge has not been previously reported...
May 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29440952/antibiotic-treatment-in-childhood-community-acquired-pneumonia-clinical-practice-versus-guidelines-results-from-two-university-hospitals
#14
Sorin Claudiu Man, Valentina Sas, Cristina Schnell, Camelia Florea, Adelina Ţuţu, Ariana Szilágyi, Sergiu Belenes, Amalia Hebriştean, Anca Bonaţ, Claudia Cladovan, Cornel Aldea
Background and aims: Community-acquired pneumonia (CAP) is a both common and serious childhood infection. Antibiotic treatment guidelines help to reduce inadequate antibiotics prescriptions. Methods: We conducted a retrospective study at the Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca and Dr. Gavril Curteanu Clinical City Hospital, in Oradea. All patients discharged with a diagnosis of CAP between December 1, 2014 and February 28, 2015, were included in the study...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29410326/is-gentamicin-safe-and-effective-for-severe-community-acquired-pneumonia-an-8-year-retrospective-cohort-study
#15
Christopher J Brereton, Daniel Lennon, Sarah Browning, Emily Dunn, John K Ferguson, Joshua S Davis
BACKGROUND AND OBJECTIVE: Gram-negative bacilli are the causative organisms for a significant proportion of patients with severe community acquired pneumonia (CAP) admitted to the intensive care unit (ICU). Clinical guidelines recommend broad spectrum antimicrobials for empiric treatment despite alarming global trends in antimicrobial resistance. We aimed to assess the safety and efficacy of gentamicin, an aminoglycoside with potent bactericidal activity, for empiric Gram-negative cover of severe CAP admitted to ICU...
February 2, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29402313/the-improve-gap-trial-aiming-to-improve-evidence-based-management-of-community-acquired-pneumonia-study-protocol-for-a-stepped-wedge-randomised-controlled-trial
#16
Elizabeth H Skinner, Melanie Lloyd, Edward Janus, May Lea Ong, Amalia Karahalios, Terry P Haines, Anne-Maree Kelly, Melina Shackell, Harin Karunajeewa
BACKGROUND: Community-acquired pneumonia is a leading worldwide cause of hospital admissions and healthcare resource consumption. The largest proportion of hospitalisations now occurs in older patients, with high rates of multimorbidity and complex care needs. In Australia, this population is usually managed by hospital inpatient general internal medicine units. Adherence to consensus best-practice guidelines is poor. Ensuring evidence-based care and reducing length of stay may improve patient outcomes and reduce organisational costs...
February 5, 2018: Trials
https://www.readbyqxmd.com/read/29391051/short-course-antimicrobial-therapy-for-paediatric-respiratory-infections-safer-study-protocol-for-a-randomized-controlled-trial
#17
Jeffrey Pernica, Stuart Harman, April Kam, Jacob Bailey, Redjana Carciumaru, Sarah Khan, Martha Fulford, Lehana Thabane, Robert Slinger, Cheryl Main, Marek Smieja, Mark Loeb
BACKGROUND: Community-acquired pneumonia (CAP) is commonly diagnosed in children. The Infectious Disease Society of America guidelines recommend 10 days of high-dose amoxicillin for the treatment of non-severe CAP but 5-day "short course" therapy may be just as effective. Randomized trials in adults have already demonstrated non-inferiority of 5-day short-course treatment for adults hospitalized with severe CAP and for adults with mild CAP treated as outpatients. Minimizing exposure to antimicrobials is desirable to avoid harms including diarrhoea, rashes, severe allergic reactions, increased circulating antimicrobial resistance, and microbiome disruption...
February 1, 2018: Trials
https://www.readbyqxmd.com/read/29390500/development-of-indicators-for-assessing-rational-drug-use-to-treat-community-acquired-pneumonia-in-children-in-hospitals-and-clinics-a-modified-delphi-study
#18
Wenrui Li, Linan Zeng, Jialian Li, Liang Huang, Ge Gui, Jie Song, Lina Chen, Lucan Jiang, Lingli Zhang
Community-acquired pneumonia (CAP) is a common infectious disease in children. Rational drug use (RDU) is an important approach to reducing the disease burden and mortality rate of CAP in children. There are no monitoring indicators for assessing RDU in children. This study aimed to develop a set of indicators to assess RDU to treat CAP in children in hospitals and clinics using a modified Delphi method.Initial indicators were generated based on a systematic review of guidelines and studies investigating CAP in children...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29380739/management-of-community-acquired-pneumonia-in-adults-2016-guideline-update-from-the-dutch-working-party-on-antibiotic-policy-swab-and-dutch-association-of-chest-physicians-nvalt
#19
W J Wiersinga, M J Bonten, W G Boersma, R E Jonkers, R M Aleva, B J Kullberg, J A Schouten, J E Degener, E M W van de Garde, T J Verheij, A P E Sachs, J M Prins
The Dutch Working Party on Antibiotic Policy in collaboration with the Dutch Association of Chest Physicians, the Dutch Society for Intensive Care and the Dutch College of General Practitioners have updated their evidence-based guidelines on the diagnosis and treatment of community-acquired pneumonia (CAP) in adults who present to the hospital. This 2016 update focuses on new data on the aetiological and radiological diagnosis of CAP, severity classification methods, initial antibiotic treatment in patients with severe CAP and the role of adjunctive corticosteroids...
January 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29373381/outpatient-management-of-community-acquired-pneumonia
#20
Filipe Froes, João Gonçalves Pereira, Pedro Póvoa
PURPOSE OF REVIEW: The first guidelines on community-acquired pneumonia (CAP) were published in 1993, but since then many of the challenges regarding the outpatient management of CAP persist. These include the difficulty in establishing the initial clinical diagnosis, its risk stratification, which will dictate the place of treatment, the empirical choice of antibiotics, the relative scarcity of novel antibiotics and the importance of knowing local microbiological susceptibility patterns...
April 2018: Current Opinion in Infectious Diseases
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