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Guideline* AND Antibiotic* AND outcome*

David Chirio, Marion Le Marechal, Pamela Moceri, Arnaud de la Chapelle, Sylvie Chaillou-Optiz, Anaïs Mothes, Cédric Foucault, Laurence Maulin, Chirine Parsaï, Pierre-Marie Roger, Elisa Demonchy
We aimed to identify factors associated with unfavorable outcome in patients treated for infective endocarditis (IE), with a focus on departure from European guidelines. We conducted a retrospective audit of all adult patients treated for endocarditis during a 1-year period across a regional network of nine care centers in the south-east of France. Medical records were reviewed regarding patient and infection characteristics, antibiotic therapy, outcome, and compliance to the European Society of Cardiology guidelines...
October 15, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Sanne Ten Berg, Erik A H Loeffen, Marianne D van de Wetering, Daniëlle H J Martens, Carla M van Ede, Leontien C M Kremer, Wim J E Tissing
INTRODUCTION: Febrile neutropenia (FN) is a common complication of the intensive treatment strategies used in pediatric oncology. By close adherence to high-quality guidelines, which can be evaluated by indicators, the burden of FN can potentially be reduced. OBJECTIVES: The aims of this study were tripartite-(1) to develop structure, process, and outcome indicators, (2) to evaluate the implementation of the Dutch Childhood Oncology Group (DCOG) guideline on FN, and (3) to produce baseline measures on local quality of FN care (in the north of the Netherlands)...
October 14, 2018: Pediatric Blood & Cancer
Eric R Coon, Raj Srivastava, Greg Stoddard, Jacob Wilkes, Andrew T Pavia, Samir S Shah
: media-1vid110.1542/5804909691001PEDS-VA_2018-0345 Video Abstract BACKGROUND: Guidelines recommend a prolonged course (10 days) of intravenous (IV) antibiotic therapy for infants with uncomplicated, late-onset group B Streptococcus (GBS) bacteremia. Our objective was to determine the frequency with which shorter IV antibiotic courses are used and to compare rates of GBS disease recurrence between prolonged and shortened IV antibiotic courses. METHODS: We performed a multicenter retrospective cohort study of infants aged 7 days to 4 months who were admitted to children's hospitals in the Pediatric Health Information System database from 2000 to 2015 with GBS bacteremia...
October 11, 2018: Pediatrics
Vera Durão, Anabela Silva, Rita Macedo, Paulo Durão, André Santos-Silva, Raquel Duarte
SETTING: Nontuberculous mycobacteria (NTM) are increasingly recognized as causative agents of opportunistic infections in humans for which effective treatment is challenging. There is, however, very little information on the prevalence of NTM drug resistance in Portugal. OBJECTIVE AND DESIGN: Our aim was to analyze the drug susceptibility testing (DST) performed in NTM at the Portuguese National Health Institute Dr. Ricardo Jorge from February 2003 to February 2016...
October 8, 2018: Pulmonology
Jose Tiago Silva, Mario Fernández-Ruiz, Jose Maria Aguado
PURPOSE OF REVIEW: Solid organ transplantation (SOT) is the best therapeutic option for both acute and chronic end-stage diseases. The development of more potent and safer immunosuppressants and the improvement of prophylactic practices have significantly diminished the morbidity and mortality associated with rejection and opportunistic infections. However, infections produced by multidrug-resistant (MDR) Gram-negative bacilli (GNB) have recently emerged as a significant threat. RECENT FINDINGS: The Spanish Society of Transplantation (SET), the Group for Study of Infection in Transplantation of the Spanish Society of Infectious Diseases and Clinical Microbiology (GESITRA-SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI) have recently published their recommendations concerning the management of MDR GNB infections in SOT recipients...
October 6, 2018: Current Opinion in Infectious Diseases
John S Barbieri, Natalie Spaccarelli, David J Margolis, William D James
Acne is one of the most common diseases worldwide and affects approximately 50 million individuals in the United States. Oral antibiotics are the most common systemic agent prescribed for the treatment of acne. However, their use may be associated with a variety of adverse outcomes including bacterial resistance and disruption of the microbiome. As a result, multiple treatment guidelines call for limiting the use of oral antibiotics in the treatment of acne, although actual prescribing often does not follow these guidelines...
October 5, 2018: Journal of the American Academy of Dermatology
Adam T Hill, Philip M Gold, Ali El Solh, Joshua P Metlay, Belinda Ireland, Richard S Irwin
BACKGROUND: Patients commonly present to primary care services with upper and lower respiratory tract infections and guidelines to help clinicians investigate and treat acute cough due to suspected pneumonia and influenza are needed. METHODS: A systematic search was carried out with eight PICO questions related to acute cough with suspected pneumonia or influenza. RESULTS: There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza that were not hospitalized...
October 5, 2018: Chest
Chih-Hung Wang, Cheng-Yi Wu, Wan-Ching Lien, Kao-Lang Liu, Hsiu-Po Wang, Yao-Ming Wu, Shyr-Chyr Chen
BACKGROUND: Percutaneous cholecystostomy (PC) is an effective treatment for severe acute cholecystitis (AC). Guidelines recommend PC as rescue therapy for patients with mild or moderate AC who do not receive emergent cholecystectomy. This study aims to investigate whether PC could be a first-line treatment for these patients. METHODS: Adult patients admitted through the emergency department between October 2004 and December 2013 were retrospectively reviewed. Patients with mild or moderate AC who did not undergo emergent cholecystectomy were included...
October 4, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
(no author information available yet)
INTRODUCTION: Abdominal-based microvascular breast reconstruction constitutes approximately one-fifth of reconstructions following mastectomy for breast cancer. Enhanced recovery after surgery (ERAS) protocols have been implemented to improve patient care. The aim of this project was to identify variation in the perioperative care of women undergoing microvascular breast reconstruction to inform development of an ERAS protocol. METHODS: Surveys were developed for plastic surgeons, anaesthetists and the lead clinician for breast reconstruction at each unit...
August 25, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Randolph Fish, Elizabeth Kutter, Daniel Bryan, Gordon Wheat, Sarah Kuhl
Infections involving diabetic foot ulcers (DFU) are a major public health problem and have a substantial negative impact on patient outcomes. Osteomyelitis in an ulcerated foot substantially increases the difficulty of successful treatment. While literature suggests that osteomyelitis in selected patients can sometimes be treated conservatively, with no, or minimal removal of bone, we do not yet have clear treatment guidelines and the standard treatment failure fallback remains amputation. The authors report on the successful treatment, with a long term follow up, of a 63 YO diabetic female with distal phalangeal osteomyelitis using bacteriophage, a form of treatment offering the potential for improved outcomes in this era of escalating antibiotic resistance and the increasingly recognized harms associated with antibiotic therapy...
October 2, 2018: Antibiotics
Andrew D Jung, Jennifer Baker, Christopher A Droege, Vanessa Nomellini, Jay Johannigman, John B Holcomb, Michael D Goodman, Timothy A Pritts
BACKGROUND: Minimizing the interval between diagnosis of sepsis and administration of antibiotics improves patient outcomes. We hypothesized that a commercially available bedside clinical surveillance visualization system (BSV) would hasten antibiotic administration and decrease length of stay (LOS) in surgical intensive care unit (SICU) patients. METHODS: A BSV, integrated with the electronic medical record and displayed at bedside, was implemented in our SICU in July 2016...
November 2018: Journal of Surgical Research
David J Feller-Kopman, Chakravarthy B Reddy, Malcolm M DeCamp, Rebecca L Diekemper, Michael K Gould, Travis Henry, Narayan P Iyer, Y C Gary Lee, Sandra Z Lewis, Nick A Maskell, Najib M Rahman, Daniel H Sterman, Momen M Wahidi, Alex A Balekian
BACKGROUND: This Guideline, a collaborative effort from the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology, aims to provide evidence-based recommendations to guide contemporary management of patients with a malignant pleural effusion (MPE). METHODS: A multidisciplinary panel developed seven questions using the PICO (Population, Intervention, Comparator, and Outcomes) format. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the Evidence to Decision framework was applied to each question...
October 1, 2018: American Journal of Respiratory and Critical Care Medicine
Jiong Zhou, Xiaojun Ma
OBJECTIVES: We aimed to assess the status and possible problems of Antimicrobial stewardship (AMS) in Grade-A tertiary hospitals in China. METHODS: A questionnaire was designed according to the U.S. Centers for Disease Control and Prevention "Core Elements of Hospital Antibiotic Stewardship Programs". We extracted 10%-15% from Grade A tertiary hospitals in every province of mainland China, a total of 165 hospitals were selected. Electronic questionnaires were forwarded to these hospitals...
September 26, 2018: Clinical Microbiology and Infection
Ali Nasrallah, Ali Bacharouch, Fadia Jaafar, Mariam Ayyash, R Alexander Blackwood
OBJECTIVES: The high incidence of Acute Otitis Media (AOM) along with low antibiotic efficacy in the treatment of AOM is particularly favorable for the emergence of antimicrobial resistance. The promotion of more conservative antibiotic prescription habits has become an important focus of governments and academic societies. Little is known about the awareness and use of AOM practice guidelines by physicians in the Middle East. Our aim is to characterize AOM management in Lebanon by using an anonymous survey instrument to uncover potential disparities in treatment trends and evaluate differences in clinical guideline adherence patterns...
November 2018: International Journal of Pediatric Otorhinolaryngology
Anwen L Cope, Nick Francis, Fiona Wood, Ivor G Chestnutt
BACKGROUND: Dental pain can have a detrimental effect on quality of life. Symptomatic apical periodontitis and acute apical abscess are common causes of dental pain and arise from an inflamed or necrotic dental pulp, or infection of the pulpless root canal system. Clinical guidelines recommend that the first-line treatment for teeth with these conditions should be removal of the source of inflammation or infection by local, operative measures, and that systemic antibiotics are currently only recommended for situations where there is evidence of spreading infection (cellulitis, lymph node involvement, diffuse swelling) or systemic involvement (fever, malaise)...
September 27, 2018: Cochrane Database of Systematic Reviews
Sam E Grigg, Patrick Date, Zoe Loh, Ortis Estacio, Douglas F Johnson, Eliza A Hawkes, Andrew Grigg
PURPOSE: There is a paucity of data regarding the utility of routine urine cultures in adults with febrile neutropenia (FN) without urinary symptoms receiving protocolised antibiotics. This is reflected by inconsistent recommendations in international and regional FN guidelines. We addressed this issue by retrospectively reviewing the impact of routine urine cultures on antibiotic management in haematology cancer inpatients at a tertiary hospital. METHODS: All haematology inpatients over a 5-year period (2011-2015) were retrospectively reviewed for episodes of FN (neutrophil count < 0...
September 27, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Rick T van Uum, Roderick P Venekamp, Alies Sjoukes, Alma C van de Pol, G Ardine de Wit, Anne G M Schilder, Roger A M J Damoiseaux
BACKGROUND: Whilst current guidelines highlight the importance of pain management for children with acute otitis media (AOM), there is evidence to suggest that this is not implemented in everyday practice. We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness. METHODS: This cluster randomised controlled trial aims to recruit 250 children aged 6 months to 10 years presenting with AOM to general practitioners (GPs) in 30 primary care centres (PCCs) across the Netherlands...
September 17, 2018: Trials
Jannicke Slettli Wathne, Lars Kåre Selland Kleppe, Stig Harthug, Hege Salvesen Blix, Roy M Nilsen, Esmita Charani, Ingrid Smith
Background: There is limited evidence from multicenter, randomized controlled studies to inform planning and implementation of antibiotic stewardship interventions in hospitals. Methods: A cluster randomized, controlled, intervention study was performed in selected specialities (infectious diseases, pulmonary medicine and gastroenterology) at three emergency care hospitals in Western Norway. Interventions applied were audit with feedback and academic detailing. Implementation strategies included co-design of interventions with stakeholders in local intervention teams and prescribers setting local targets for change in antibiotic prescribing behaviour...
2018: Antimicrobial Resistance and Infection Control
Marieke B Lemiengre, Mieke L van Driel, Dan Merenstein, Helena Liira, Marjukka Mäkelä, An Im De Sutter
BACKGROUND: Acute rhinosinusitis is an acute infection of the nasal passages and paranasal sinuses that lasts less than four weeks. Diagnosis of acute rhinosinusitis is generally based on clinical signs and symptoms in ambulatory care settings. Technical investigations are not routinely performed, nor are they recommended in most countries. Some trials show a trend in favour of antibiotics, but the balance of benefit versus harm is unclear.We merged two Cochrane Reviews for this update, which comprised different approaches with overlapping populations, resulting in different conclusions...
September 10, 2018: Cochrane Database of Systematic Reviews
Khalid Eljaaly, Mushira A Enani, Jaffar A Al-Tawfiq
Imipenem and meropenem are the recommended antipseudomonal carbapenems for nosocomial pneumonia per clinical practice guidelines. However, these agents have a relatively broader spectrum of activity than other antibiotics and need to be reserved. Carbapenems might cause higher rate of superinfection. The aim of this study was to compare the rate of superinfection between patients who received imipenem or meropenem versus those who received non-carbapenem treatment. PubMed, EMBASE, Cochrane Library databases and two trial registries were searched for relevant randomized controlled trials of hospitalized adults with pneumonia through February 24, 2017 without date or language restrictions...
September 6, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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