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When to stop antibiotic

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https://www.readbyqxmd.com/read/30273842/csf-leukocyte-polykaryocyte-protein-and-glucose-their-cut-offs-of-judging-whether-post-neurosurgical-bacterial-meningitis-has-been-cured
#1
Lishan Yin, Yipeng Han, Guozhuan Miao, Lin Jiang, Sen Xie, Baiyun Liu
OBJECT: This paper is aimed to explore a reasonable guideline for distinguishing whether post-neurosurgical bacterial meningitis has completely been cured, so as to avoid the deficient or excessive treatment for post-neurosurgical bacterial meningitis. PATIENTS AND METHODS: We conducted a retrospective analysis of 46 patients who attended General Hospital of Chinese People's Armed Police Force in Beijing, China, from January 1, 2014 to April 30, 2016. The CSF leukocyte, polykaryocyte, protein and glucose had been tested when their antibiotic treatments were empirically stopped...
September 19, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/30174327/agranulocytosis-induced-by-vancomycin-case-report-and-literature-review
#2
Horacio di Fonzo, Melina Villegas Gutsch, Augusto Castroagudin, María Victoria Cabrera, Mariano E Mazzei, Darío Rueda
BACKGROUND Vancomycin has been used for decades to treat infections by Gram-positive bacteria, particularly those caused by methicillin-resistant staphylococci. Agranulocytosis is an infrequent complication of this antibiotic, postulated in its genesis a mechanism immune-mediated by antineutrophil antibodies and antineutrophil cytoplasm antibodies (ANCA). Treatment includes discontinuing vancomycin, and granulocyte colony-stimulating factor administration. CASE REPORT We present the case of a patient who developed agranulocytosis secondary to vancomycin during the treatment of an infectious endocarditis, which was reversed when the antibiotic was stopped...
September 3, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/30086566/-emergency-medicine-in-remote-settings
#3
REVIEW
Andreas Leischker, Fritz Ge Holst
For many acute diseases and injuries, treatment does not differ between industrialised environment and wilderness setting. However, for some emergencies, treatment needs to be adapted if advanced medical care facilities cannot be reached within 4 hours.In these situations, dislocated joints and fractures should be reduced quickly. Contaminated wounds should be cleaned carefully, with drinking water being sufficient when no sterile solution is available. A patient with a contaminated wound should receive a systemic antibiotic coverage within one hour...
August 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/30075548/organizing-pneumonia-resembling-disease-progression-in-a-non-small-cell-lung-cancer-patient-receiving-ceritinib-a-case-report
#4
Sun M Lim, Hee-Jung An, Hyung S Park, Hyeong J Kwon, Eun Y Kim, Jin Hur, Yong W Moon
RATIONALE: Echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK), a distinct molecular entity, is highly sensitive to ALK tyrosine kinase inhibitors (TKIs) such as crizotinib or ceritinib. Interstitial lung disease is a rare (1.2%) pulmonary toxicity that can result from ALK TKIs, however, organizing pneumonia has not been reported to date. PATIENT CONCERNS: A 45-year-old Korean female with ALK-rearranged metastatic lung adenocarcinoma underwent ceritinib treatment and exhibited a partial response, until she developed organizing pneumonia resembling disease progression...
August 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30041221/the-role-of-non-tuberculous-mycobacteria-in-peritoneal-dialysis-related-infections-a-literature-review
#5
Naoki Washida, Hiroshi Itoh
BACKGROUND: Peritonitis is one of the most frequent reasons for withdrawal of peritoneal dialysis (PD). Although most cases of PD-related peritonitis can be treated with antibiotics, it is occasionally refractory and culture-negative. SUMMARY: The causes of refractory PD-related peritonitis include antibiotic-resistant bacteria, fungal peritonitis, biofilm formation in PD catheters, bacterial translocation from the gastrointestinal tract, and encapsulating peritoneal sclerosis...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29977443/discontinuation-of-postoperative-prophylactic-antibiotics-after-noninstrumented-spinal-surgery-results-of-a-quality-improvement-project
#6
Ariane Lewis, Jessica Lin, Herbert James, Travis C Hill, Rajeev Sen, Donato Pacione
Background: Numerous medical society guidelines recommend discontinuation of antibiotics at a maximum of 24 hours after noninstrumented spinal surgery, even when a drain is left in place. As a result of these recommendations, our institution's Neurosurgery Quality Improvement Committee decided to stop administering prolonged prophylactic systemic antibiotics (PPSAs) to patients with drains after noninstrumented spinal surgery. Methods: We retrospectively reviewed data for patients who had noninstrumented spinal surgery performed by a neurosurgeon at our institution between December 2012 and July 2014 (PPSA period) and December 2014 and July 2016 (non-PPSA period) and had a drain left in place postoperatively...
July 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29886847/cytomegalovirus-reactivation-in-a-critically-ill-patient-a-case-report
#7
Demet Demirkol, Umay Kavgacı, Burcu Babaoğlu, Serhan Tanju, Banu Oflaz Sözmen, Suda Tekin
BACKGROUND: The aim of this case report is to discuss diagnostic workup and clinical management of cytomegalovirus reactivation in a critically ill immunocompetent pediatric patient. CASE PRESENTATION: A 2-year-old white boy who had no medical history presented with respiratory distress and fever. His Pediatric Risk of Mortality and Pediatric Logistic Organ Dysfunction scores were 20 and 11, respectively. Our preliminary diagnosis was multiple organ dysfunction secondary to sepsis...
June 11, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29861148/an-evaluation-of-provider-chosen-antibiotic-indications-as-a-targeted-antimicrobial-stewardship-intervention
#8
Veronica Timmons, Jennifer Townsend, Robin McKenzie, Catherine Burdalski, Victoria Adams-Sommer
BACKGROUND: Provider-entered indications for antibiotics have been recommended as a tracking tool for antibiotic stewardship programs. The accuracy and utility of these indications are unknown. METHODS: Drug-specific lists of evidence-based indications were integrated into an electronic health system as an ordering hard-stop. We reviewed antibiotic orders with provider-entered indications to determine whether the chosen indication matched the documentation and whether antibiotic use was appropriate...
October 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#9
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29555547/perioperative-management-of-adult-diabetic-patients-intraoperative-period
#10
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
Perioperative hyperglycaemia (>1.80g/L or 10mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasing blood sugar levels with insulin between 0.90 and 1.80g/L but it may occur more frequently when the goal is strict normoglycaemia. We propose continuous administration of insulin therapy via an electronic syringe (IVES) in type-1 diabetes (T1D) and type-2 diabetes (T2D) patients if required or in cases of stress hyperglycaemia...
June 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29545956/agranulocytosis-associated-with-topiramate-a-case-report-and-review-of-published-cases
#11
Saroj Lohani, Niranjan Tachamo, Salik Nazir, Anthony Donato
A 41-year-old female presented to the hospital with sore throat and shortness of breath. She was hypoxic with an oxygen saturation of 87% in room air. Physical examination revealed swollen uvula with exudates. She had been started on topiramate for treatment of migraine few months ago. The dose of topiramate was increased to 100 mg twice daily 2 weeks ago. Complete blood count revealed an absolute neutrophil count (ANC) of 8 c/mm3 . She was intubated and started on broad-spectrum antibiotics. She was transferred to our hospital on the fifth day of hospitalization...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29530843/combination-of-tedizolid-and-daptomycin-against-methicillin-resistant-staphylococcus-aureus-in-an-in-vitro-model-of-simulated-endocardial-vegetations
#12
Jordan R Smith, Juwon Yim, Seth Rice, Kyle Stamper, Razie Kebriaei, Michael J Rybak
Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen responsible for health care-associated infections, and treatment options are limited. Tedizolid (TZD) is a novel oxazolidinone antibiotic with activity against MRSA. Previously, daptomycin (DAP) has demonstrated synergy with other antibiotics against MRSA. We sought to determine the efficacy of the combination of TZD and DAP against MRSA in an in vitro model of simulated endocardial vegetations (SEVs). TZD simulations of 200 mg once daily and DAP simulations of 6 mg/kg of body weight and 10 mg/kg once daily were tested alone and in the combinations TZD plus DAP at 6 mg/kg or DAP at 10 mg/kg against two clinical strains of MRSA, 494 and 67...
May 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29528749/biomarker-guided-antibiotic-cessation-in-sepsis-evidence-and-future-challenges
#13
Andrew N Claxton, Paul M Dark
Sepsis is a medical emergency, which requires the initiation of broad-spectrum antimicrobial agents as early as possible. In the absence of positive microbiological cultures providing targeted antimicrobial advice, broad-spectrum antibiotics are commonly continued until there is clinical evidence of infection resolution. With an absence of robust evidence to inform when it is safe to stop antimicrobial agents in sepsis, the duration of antimicrobial courses may be longer than is required. Prolonged courses of potent broad-spectrum antimicrobials increase the risk of adverse drug events and contribute to the growing emergence of multidrug resistant pathogens, which is a global public health emergency...
March 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29503228/early-linezolid-associated-lactic-acidosis-in-a-patient-with-child-s-class-c-liver-cirrhosis-and-end-stage-renal-disease
#14
Chih-Ning Cheng, Shu-Wen Lin, Chien-Chih Wu
Linezolid, an oxazolidinone antibiotic, does not required dose adjustment in patients with Child's class A and B liver cirrhosis. The dose adjustment data for Child's class C liver cirrhosis is inadequate. We reported a case of Child's class C liver cirrhosis, in which lactic acidosis, an adverse effect related to prolonged use, occurred only after two weeks of linezolid treatment. A 63-year old male had underlying diseases, such as end-stage renal disease (ESRD) and Child's class C liver cirrhosis, and was admitted for hepatic encephalopathy management and liver transplantation evaluation...
October 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29485795/drug-induced-photosensitivity-a-continuing-diagnostic-challenge
#15
REVIEW
Liborija Lugović-Mihić, Tomislav Duvančić, Iva Ferček, Petra Vuković, Iva Japundžić, Diana Ćesić
When taking different drugs, their possible side effects on the skin should be considered, including skin reactions connected to photosensitivity. This photosensitivity caused by drugs can appear as phototoxic reactions (which occur more often) or photoallergic reactions (which occur less often and include allergic mechanisms). The following drugs stand out as medications with a high photosensitivity potential: nonsteroidal anti-inflammatory drugs (NSAIDs), cardiovascular drugs (such as amiodarone), phenothiazines (especially chlorpromazine), retinoids, antibiotics (sulfonamides, tetracyclines, especially demeclocycline and quinolones), etc...
June 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29360463/ceragenin-csa13-reduces-clostridium-difficile-infection-in-mice-by-modulating-the-intestinal-microbiome-and-metabolites
#16
Jiani Wang, Sally Ghali, Chunlan Xu, Caroline C Mussatto, Christina Ortiz, Elaine C Lee, Diana H Tran, Jonathan P Jacobs, Venu Lagishetty, Kym F Faull, Travis Moller, Maura Rossetti, Xinhua Chen, Hon Wai Koon
BACKGROUND & AIMS: Clostridium difficile induces intestinal inflammation by releasing toxins A and B. The antimicrobial compound cationic steroid antimicrobial 13 (CSA13) has been developed for treating gastrointestinal infections. The CSA13-Eudragit formulation can be given orally and releases CSA13 in the terminal ileum and colon. We investigated whether this form of CSA13 reduces C difficile infection (CDI) in mice. METHODS: C57BL/6J mice were infected with C difficile on day 0, followed by subcutaneous administration of pure CSA13 or oral administration of CSA13-Eudragit (10 mg/kg/d for 10 days)...
May 2018: Gastroenterology
https://www.readbyqxmd.com/read/29246188/antibiotic-treatment-in-patients-with-chronic-low-back-pain-and-modic-changes-the-aim-study-study-protocol-for-a-randomised-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Kjersti Storheim, Ansgar Espeland, Lars Grøvle, Jan Sture Skouen, Jörg Aßmus, Audny Anke, Anne Froholdt, Linda M Pedersen, Anne Julsrud Haugen, Terese Fors, Elina Schistad, Olav Lutro, Gunn Hege Marchand, Thomas Kadar, Nils Vetti, Sigrun Randen, Øystein Petter Nygaard, Jens Ivar Brox, Margreth Grotle, John-Anker Zwart
BACKGROUND: A previous randomised controlled trial (RCT) of patients with chronic low back pain (LBP) and vertebral bone marrow (Modic) changes (MCs) on magnetic resonance imaging (MRI), reported that a 3-month, high-dose course of antibiotics had a better effect than placebo at 12 months' follow-up. The present study examines the effects of antibiotic treatment in chronic LBP patients with MCs at the level of a lumbar disc herniation, similar to the previous study. It also aims to assess the cost-effectiveness of the treatment, refine the MRI assessment of MCs, and further evaluate the impact of the treatment and the pathogenesis of MCs by studying genetic variability and the gene and protein expression of inflammatory biomarkers...
December 15, 2017: Trials
https://www.readbyqxmd.com/read/29190284/listeria-monocytogenes-switches-from-dissemination-to-persistence-by-adopting-a-vacuolar-lifestyle-in-epithelial-cells
#18
Mounia Kortebi, Eliane Milohanic, Gabriel Mitchell, Christine Péchoux, Marie-Christine Prevost, Pascale Cossart, Hélène Bierne
Listeria monocytogenes causes listeriosis, a foodborne disease that poses serious risks to fetuses, newborns and immunocompromised adults. This intracellular bacterial pathogen proliferates in the host cytosol and exploits the host actin polymerization machinery to spread from cell-to-cell and disseminate in the host. Here, we report that during several days of infection in human hepatocytes or trophoblast cells, L. monocytogenes switches from this active motile lifestyle to a stage of persistence in vacuoles...
November 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/29151319/patients-attitudes-and-knowledge-about-drug-use-a-survey-in-turkish-family-healthcare-centres-and-state-hospitals
#19
Ahmet Akıcı, Salih Mollahaliloğlu, Başak Dönertaş, Şenay Özgülcü, Ali Alkan, Nesrin Filiz Başaran
Background/aim: Irrational drug use is a common problem. This study aimed to evaluate patients' knowledge and habits concerning drug use, and compare them in terms of some sociodemographic characteristics. Materials and methods: A face-to-face questionnaire was given to outpatients from family healthcare centres (FHCs) and state hospitals (SHs) in 12 provinces in Turkey during May 2010. A total of 4470 patients (FHCs: 2209; SHs: 2261) responded to the questionnaire (response rate: 93.1%). Results: Getting prescriptions without a physical examination was common (second place in FHCs; third place in SHs); 51...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29101134/-well-it-literally-stops-me-from-having-a-life-when-it-s-really-bad-a-nested-qualitative-interview-study-of-patient-views-on-the-use-of-self-management-treatments-for-the-management-of-recurrent-sinusitis-snifs-trial
#20
Geraldine M Leydon, Lisa McDermott, Tammy Thomas, Amy Halls, Ben Holdstock-Brown, Stephen Petley, Clare Wiseman, Paul Little
OBJECTIVE: To explore the experience and perceptions of illness, the decision to consult a general practitioner and the use of self-management approaches for chronic or recurrent sinusitis. DESIGN: Qualitative semistructured interview study. SETTING: UK primary care. PARTICIPANTS: 32 participants who had been participating in the 'SNIFS' (Steam inhalation and Nasal Irrigation For recurrent Sinusitis) trial in the South of England...
November 3, 2017: BMJ Open
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