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Abdominal infections guidelines

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https://www.readbyqxmd.com/read/30097272/impact-of-an-emergency-medicine-pharmacist-on-empiric-antibiotic-prescribing-for-pneumonia-and-intra-abdominal-infections
#1
Benjamin D Kulwicki, Kasey L Brandt, Lauren M Wolf, Andrew J Weise, Lisa E Dumkow
PURPOSE: It is critical to engage ED providers in antimicrobial stewardship programs (ASP). Emergency medicine pharmacists (EMPs) play an important role in ASP by working with providers to choose empiric antimicrobials. This study aimed to determine the impact of an EMP on appropriate empiric antibiotic prescribing for community-acquired pneumonia (CAP) and intra-abdominal infections (CA-IAI). METHODS: A retrospective cohort study was conducted evaluating adult patients admitted with CAP or CA-IAI...
July 29, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30074124/outcome-impact-of-hemodynamic-and-depth-of-anesthesia-monitoring-during-major-cancer-surgery-a-before-after-study
#2
Mariana F Lima, Luiz Antonio Mondadori, Aline Y Chibana, Daniel B Gilio, Eduardo Henrique Giroud Joaquim, Frederic Michard
Hemodynamic and depth of anesthesia (DOA) monitoring are used in many high-risk surgical patients without well-defined indications and objectives. We implemented monitoring guidelines to rationalize hemodynamic and anesthesia management during major cancer surgery. In early 2014, we developed guidelines with specific targets (Mean arterial pressure > 65 mmHg, stroke volume variation < 12%, cardiac index > 2.5 l min-1  m-2 , central venous oxygen saturation > 70%, 40 < bispectral index < 60) for open abdominal cancer surgeries > 2 h...
August 3, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/30062007/intraoperative-oxygenation-in-adult-patients-undergoing-surgery-iops-a-retrospective-observational-study-across-29-uk-hospitals
#3
Clare M Morkane, Helen McKenna, Andrew F Cumpstey, Alex H Oldman, Michael P W Grocott, Daniel S Martin
Background: Considerable controversy remains about how much oxygen patients should receive during surgery. The 2016 World Health Organization (WHO) guidelines recommend that intubated patients receive a fractional inspired oxygen concentration (FIO2 ) of 0.8 throughout abdominal surgery to reduce the risk of surgical site infection. However, this recommendation has been widely criticised by anaesthetists and evidence from other clinical contexts has suggested that giving a high concentration of oxygen might worsen patient outcomes...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/30021693/clostridium-difficile-infection-in-patients-with-chronic-kidney-disease-in-mexico
#4
Rayo Morfin-Otero, Elvira Garza-Gonzalez, Guillermo Garcia Garcia, Hector R Perez-Gomez, Sara A Aguirre-Diaz, Esteban Gonzalez-Diaz, Sergio Esparza-Ahumada, Alfonso Fernandez-Ramirez, Francisco Cardenas-Lara, Adrian Martinez-Melendez, Rodrigo Escobedo-Sanchez, Margarita Ibarra-Hernandez, Gerardo Leon Garnica, Eduardo Rodriguez-Noriega
BACKGROUND: Clostridium difficile infection (CDI) is a leading cause of healthcare-associated diarrhea worldwide. Patients with chronic kidney disease (CKD) are especially vulnerable, as they are exposed to CDI risk factors including frequent antibiotics. MATERIALS AND METHODS: In order to identify the risk factors for CDI in CKD patients, a 33-month long case-control study was carried out at a tertiary-care hospital in Mexico. CDI was confirmed at the genetic level, and univariate and multivariate analyses were performed to identify the association between risk factors, biomarkers, and outcome options (survival, relapse, death)...
July 19, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/30019145/topical-antimicrobial-prophylaxis-in-colorectal-surgery-for-the-prevention-of-surgical-wound-infection-a-systematic-review-and-meta-analysis
#5
REVIEW
R L Nelson, A Kravets, R Khateeb, M Raza, M Siddiqui, I Taha, A Tummala, R Epple, S Huang, M Wen
BACKGROUND: Among the techniques investigated to reduce the risk of surgical wound infection or surgical space infection (SSI) in patients having colorectal surgery are topical application of antimicrobials (antibiotics and antiseptics) to the open wound or immediately after closure. The aim of the present study was to perform a systematic review of the literature on those treatments, with the exception of antibiotic ointments applied to closed skin, which are adequately assessed elsewhere, and a meta-analysis...
July 17, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/30013774/mycobacterial-chylous-ascites-report-of-three-cases-and-systematic-review
#6
REVIEW
Bipadabhanjan Mallick, Harshal S Mandavdhare, Sourabh Aggarwal, Harjeet Singh, Usha Dutta, Vishal Sharma
Background: Chylous ascites is an uncommon presentation of mycobacterial infection. Methods: We report three cases of tubercular chylous ascites, and in addition, we performed a systematic review of the published literature for the clinical presentation, treatment, and outcomes of mycobacterial chylous ascites. We followed the PRISMA guidelines for the systematic review. Results: A total of 33 cases (including three of ours) were included...
July 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/30002744/is-the-laparoscopic-approach-for-rectal-cancer-superior-to-open-surgery-a-systematic-review-and-meta-analysis-on-short-term-surgical-outcomes
#7
Piotr Małczak, Magdalena Mizera, Grzegorz Torbicz, Jan Witowski, Piotr Major, Magdalena Pisarska, Michał Wysocki, Marcin Strzałka, Andrzej Budzyński, Michał Pędziwiatr
Introduction: Over the past years the incidence of colorectal cancers has increased worldwide. Currently it is the most common gastrointestinal malignancy worldwide. The laparoscopic approach has become the gold standard for surgical treatment. However, a recently published meta-analysis showed no difference in short- and long-term oncological outcomes of laparoscopy for treating rectal cancer. Aim: To assess current literature on short-term outcomes of rectal cancer treatment using laparoscopic surgery in comparison to the open approach...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29859007/medical-and-surgical-interventions-for-the-treatment-of-urinary-stones-in-children
#8
REVIEW
Lenka Barreto, Jae Hung Jung, Ameera Abdelrahim, Munir Ahmed, Guy P C Dawkins, Marcin Kazmierski
BACKGROUND: Urolithiasis is a condition where crystalline mineral deposits (stones) form within the urinary tract. Urinary stones can be located in any part of the urinary tract. Affected children may present with abdominal pain, blood in the urine or signs of infection. Radiological evaluation is used to confirm the diagnosis, to assess the size of the stone, its location, and the degree of possible urinary obstruction. OBJECTIVES: To assess the effects of different medical and surgical interventions in the treatment of urinary tract stones of the kidney or ureter in children...
June 2, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29785564/helicobacter-pylori-infection-in-pediatric-patients-update-on-diagnosis-and-eradication-strategies
#9
REVIEW
Kallirroi Kotilea, Nicolas Kalach, Matjaž Homan, Patrick Bontems
Helicobacter pylori infection is acquired mainly in childhood and remains an essential cause of peptic ulcer disease and gastric cancer. This article provides commentary on the last ESPGHAN/NASPGHAN guidelines and on publications made after the consensus conference of 2015. The majority of infected children are asymptomatic and pediatric studies do not support a role for H. pylori in functional disorders such as recurrent abdominal pain. The role of H. pylori infection in failure to thrive, children's growth, type I diabetes mellitus (T1DM), and celiac disease remains controversial...
August 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29756637/withdrawal-of-immunosuppressant-or-biologic-therapy-for-patients-with-quiescent-crohn-s-disease
#10
REVIEW
Ray K Boyapati, Joana Torres, Carolina Palmela, Claire E Parker, Orli M Silverberg, Sonam D Upadhyaya, Tran M Nguyen, Jean-Frédéric Colombel
BACKGROUND: Crohn's disease (CD) is a chronic, relapsing and remitting disease of the gastrointestinal tract that can cause significant morbidity and disability. Current treatment guidelines recommend early intervention with immunosuppressant or biological therapy in high-risk patients with a severe disease phenotype at presentation. The feasibility of therapeutic de-escalation once remission is achieved is a commonly encountered question in clinical practice, driven by patient and clinician concerns regarding safety, adverse events, cost and national regulations...
May 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29742967/restrictive-versus-liberal-fluid-therapy-for-major-abdominal-surgery
#11
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Philip Peyton, David Story, Chris Christophi, Kate Leslie, Shay McGuinness, Rachael Parke, Jonathan Serpell, Matthew T V Chan, Thomas Painter, Stuart McCluskey, Gary Minto, Sophie Wallace
BACKGROUND: Guidelines to promote the early recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery. However, the supporting evidence is limited, and there is concern about impaired organ perfusion. METHODS: In a pragmatic, international trial, we randomly assigned 3000 patients who had an increased risk of complications while undergoing major abdominal surgery to receive a restrictive or liberal intravenous-fluid regimen during and up to 24 hours after surgery...
June 14, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29735823/antimicrobial-susceptibility-profiles-of-gram-negative-bacteria-causing-infections-collected-across-india-during-2014-2016-study-for-monitoring-antimicrobial-resistance-trend-report
#12
Balaji Veeraraghavan, Mark Ranjan Jesudason, John Antony Jude Prakasah, Shalini Anandan, Rani Diana Sahni, Agila Kumari Pragasam, Yamuna Devi Bakthavatchalam, Rajesh Joseph Selvakumar, T N Dhole, Camilla Rodrigues, Indranil Roy, Sangeetha Joshi, Bhaskar Narayan Chaudhuri, D S Chitnis
Background: The emergence of antibiotic resistance among bacterial pathogens in the hospital and community has increased the concern to the health-care providers due to the limited treatment options. Surveillance of antimicrobial resistance (AMR) in frequently isolated bacterial pathogens causing severe infections is of great importance. The data generated will be useful for the clinicians to decide empiric therapy on the local epidemiological resistance profile of the antimicrobial agents...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29726966/pattern-of-dengue-virus-infections-in-adult-patients-from-sri-lanka
#13
Umesh Jayarajah, Pradeep K de Silva, Priyankara Jayawardana, Upul Dissanayake, Aruna Kulatunga, Harshini Fernando, Lakshika Perera, Vibhavee Kannangara, Champika Udayangani, Ranga Peiris, Shuaib Faizer, Pamodh Yasawardene, Ishan de Zoysa, Suranjith L Seneviratne
Background: Sri Lanka experienced its largest dengue epidemic in 2017. This study describes the disease pattern of adult dengue patients from two hospitals in Sri Lanka. Methods: Demographic, clinical and investigation findings of adult dengue patients admitted to the two hospitals from June to August 2017 were collected and analysed. Results: A total of 1167 patients (777 males [66.2%], mean age 32.9 y) were studied. There were 775 (66.4%) patients with dengue fever (DF), 334 (28...
March 1, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29721399/emergency-management-of-spontaneous-bacterial-peritonitis-a-clinical-review
#14
REVIEW
Tracy MacIntosh
Spontaneous bacterial peritonitis (SBP) has a high mortality rate; early antimicrobial therapy is essential for improving patient outcomes. Given that cirrhotic patients are often coagulopathic, the perceived risk of bleeding may prevent providers from performing a paracentesis and ruling out this potentially deadly disease. We examine the pathophysiology and risk factors for SBP, and current guidelines for its diagnosis and treatment. We then review the time-sensitive nature of performing a paracentesis, and the current controversies and contraindications for performing this procedure in patients at risk for SBP...
March 1, 2018: Curēus
https://www.readbyqxmd.com/read/29720238/two-versus-five-days-of-antibiotics-after-appendectomy-for-complex-acute-appendicitis-appic-study-protocol-for-a-randomized-controlled-trial
#15
Anne Loes van den Boom, Elisabeth M L de Wijkerslooth, Joost van Rosmalen, Frédérique H Beverdam, Evert-Jan G Boerma, Marja A Boermeester, Joanna W A M Bosmans, Thijs A Burghgraef, Esther C J Consten, Imro Dawson, Jan Willem T Dekker, Marloes Emous, Anna A W van Geloven, Peter M N Y H Go, Luc A Heijnen, Sander A Huisman, Dayanara Jean Pierre, Joske de Jonge, Jurian H Kloeze, Marc A Koopmanschap, Hester R Langeveld, Misha D P Luyer, Damian C Melles, Johan W Mouton, Augustinus P T van der Ploeg, Floris B Poelmann, Jeroen E H Ponten, Charles C van Rossem, Wilhelmina H Schreurs, Joël Shapiro, Pascal Steenvoorde, Boudewijn R Toorenvliet, Joost Verhelst, Hendt P Versteegh, Rene M H Wijnen, Bas P L Wijnhoven
BACKGROUND: Acute appendicitis is one of the most common indications for emergency surgery. In patients with a complex appendicitis, prolonged antibiotic prophylaxis is recommended after appendectomy. There is no consensus regarding the optimum duration of antibiotics. Guidelines propose 3 to 7 days of treatment, but shorter courses may be as effective in the prevention of infectious complications. At the same time, the global issue of increasing antimicrobial resistance urges for optimization of antibiotic strategies...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29717917/higher-versus-lower-dose-of-cefotetan-or-cefoxitin-for-surgical-prophylaxis-in-patients-weighing-one-hundred-twenty-kilograms-or-more
#16
Mary Banoub, Melanie S Curless, Janessa M Smith, Andrew S Jarrell, Sara E Cosgrove, Clare Rock, Edina Avdic
BACKGROUND: Clinical practice guidelines recommend a 2-g dose of cefotetan and cefoxitin for surgical prophylaxis. Pharmacokinetic data suggest benefit from higher cefotetan and cefoxitin dosing in obese patients. However, clinical studies examining higher dosing strategies in this at-risk population are lacking. The purpose of this study was to determine whether 3 g of cefotetan or cefoxitin administered pre-operatively for patients who weigh 120 kg or more is associated with a lower proportion of surgical site infection (SSI) compared with 2 g...
July 2018: Surgical Infections
https://www.readbyqxmd.com/read/29701531/characterization-of-subclinical-bacteriuria-bacterial-cystitis-and-pyelonephritis-in-dogs-with-chronic-kidney-disease
#17
Jonathan D Foster, Harathi Krishnan, Stephen Cole
OBJECTIVE To determine the prevalence of bacteriuria (ie, a positive microbial culture result for ≥ 1 urine sample) in dogs with chronic kidney disease (CKD) and characterize findings of subclinical bacteriuria (SBU), bacterial cystitis, or pyelonephritis in these patients. DESIGN Retrospective, observational study. ANIMALS 182 dogs. PROCEDURES Medical records from January 2010 through July 2015 were reviewed to identify dogs with CKD that underwent urinalysis and urine microbial culture. Signalment, clinicopathologic data, stage of CKD according to previously published guidelines, results of urinalysis and urine culture, and abdominal ultrasonographic findings were recorded...
May 15, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29688837/use-and-effectiveness-of-peri-operative-cefotetan-versus-cefazolin-plus-metronidazole-for-prevention-of-surgical-site-infection-in-abdominal-surgery-patients
#18
Eleanor Danan, Janessa Smith, Rachel M Kruer, Edina Avdic, Pamela Lipsett, Melanie S Curless, Andrew S Jarrell
BACKGROUND: Current practice guidelines for antimicrobial prophylaxis in surgery recommend a cephamycin or cefazolin plus metronidazole for various abdominal surgeries. In February 2016, cephamycin drug shortages resulted in a change in The Johns Hopkins Hospital's (JHH) recommendation for peri-operative antibiotic prophylaxis in abdominal surgeries from cefotetan to cefazolin plus metronidazole. The primary objective of this study was to quantify the percentage of abdominal surgeries adherent to JHH peri-operative antibiotic prophylaxis guidelines...
May 2018: Surgical Infections
https://www.readbyqxmd.com/read/29680101/the-cdi-daysyms-content-development-of-a-new-patient-reported-outcome-questionnaire-for-symptoms-of-clostridium-difficile-infection
#19
REVIEW
Leah Kleinman, George H Talbot, Elke Hunsche, René Schüler, Carl Erik Nord
OBJECTIVES: To develop a patient-reported outcome (PRO) questionnaire for symptoms of Clostridium difficile infection (CDI) following the US Food and Drug Administration PRO guidelines. METHODS: Patients' experiences of CDI symptoms were elicited in open-ended discussions with patients and nurses at five US sites (stage 1). A draft PRO measure was developed after demonstration of concept saturation. Two rounds of cognitive interviews were conducted with patients at three US sites (stage 2), with revision of the draft measure after each round...
April 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29679383/shortened-courses-of-antibiotics-for-bacterial-infections-a-systematic-review-of-randomized-controlled-trials
#20
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...
June 2018: Pharmacotherapy
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