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Duration of antibiotic therapy

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https://www.readbyqxmd.com/read/29792103/prolonged-use-of-antibiotics-after-birth-is-associated-with-increased-morbidity-in-preterm-infants-with-negative-cultures
#1
C Fajardo, B Alshaikh, A Harabor
BACKGROUND: Most preterm infants are exposed to a variable duration of antibiotic therapy after birth despite negative cultures. Data is emerging about the risks of prolonged antibiotics. We sought to assess the association between length of initial antibiotic course and neonatal outcomes in a cohort from a single large perinatal centre. METHODS: Retrospective cohort study of prospectively collected data on all infants with a birth weight of less than 1250 g hospitalized in our NICU in a 4-year window and who had negative blood and CSF cultures in the first 2 days of life...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
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
#2
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/29788907/mycobacterium-avium-complex-vertebral-osteomyelitis-in-the-absence-of-hiv-infection-a-case-report-and-review
#3
Megan E Gray, Peter W Liu, Brian Wispelwey
BACKGROUND: Mycobacterium Avium Complex (MAC) is an established microbiologic cause of pulmonary disease, lymphadenitis, and disseminated disease in cases of advanced immune suppression. However, MAC manifesting as vertebral osteomyelitis is less common, and is particularly rare in the absence of Acquired Immunodeficiency Syndrome (AIDS). Prompt diagnosis of MAC vertebral osteomyelitis is challenging, but necessary to prevent serious morbidity or mortality. CASE PRESENTATION: We report a case of MAC osteomyelitis of the lumbar spine in a 70-year-old woman on extended duration corticosteroid therapy for systemic lupus erythematosus who presented with progressive back pain...
May 22, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29786145/pilot-study-demonstrates-that-placental-histology-can-provide-an-additional-tool-for-diagnosing-early-onset-neonatal-sepsis
#4
J M A Ykema, E J D'Haens, M Havenith, J van Eyck, R A van Lingen, M A C Hemels
AIM: We explored whether placental histology could help to diagnose early-onset neonatal sepsis (EONS), guide clinical decision-making 48 hours after birth and reduce antibiotic use. METHODS: This study comprised 109 infants born at less than 32 weeks of gestation, who were admitted to the neonatal intensive care unit of Isala, Zwolle, The Netherlands, between January 2013 and December 2013. EONS was defined as clinical symptoms plus raised serial C-reactive protein >10 mg/L and a positive (proven EONS) or a negative (suspected EONS) blood culture...
May 22, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29784453/executive-summary-of-outpatient-parenteral-antimicrobial-therapy-guidelines-of-the-spanish-society-of-clinical-microbiology-and-infectious-diseases-and-the-spanish-domiciliary-hospitalisation-society
#5
Luis Eduardo López Cortés, Abel Mujal Martínez, Magdalena Fernández Martínez de Mandojana, Natalia Martín, Mercè Gil Bermejo, Joan Solà Aznar, Eulalia Villegas Bruguera, Maria José Peláez Cantero, Pilar Retamar Gentil, Miriam Delgado Vicente, Víctor José González-Ramallo, Miguel Ángel Ponce González, Manuel Mirón Rubio, M Montserrat Gómez Rodríguez de Mendarozqueta, Miguel Ángel Goenaga Sánchez, Pedro Sanroma Mendizábal, Elena Delgado Mejía, Marcos Pajarón Guerrero
Outpatient parenteral antimicrobial therapy (OPAT) programmes make it possible to start or complete intravenous antimicrobial therapy for practically any type of infection at home, provided that patient selection is appropriate for the type of OPAT programme available. Although the clinical management of infections in the home setting is comparable in many respects to that offered in conventional hospitalization (selection of antibiotics, duration of treatment, etc.), there are many aspects that are specific to this care modality...
May 18, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29782305/tatami-mats-a-source-of-pitted-keratolysis-in-a-martial-arts-athlete
#6
Anamaria Balić, Zrinka Bukvić Mokos, Branka Marinović, Daniela Ledić Drvar
Dear Editor, Pitted keratolysis (PK), also known as keratosis plantaris sulcatum, is a non-inflammatory, bacterial, superficial cutaneous infection, characterized by many discrete superficial crateriform ''pits'' and erosions in the thickly keratinized skin of the weight-bearing regions of the soles of the feet (1). The disease often goes unnoticed by the patient, but when it is noticed it is because of the unbearable malodor and hyperhidrosis of the feet, which are socially unacceptable and cause great anxiety to many of the patients...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29781043/comparison-of-four-days-versus-seven-days-duration-of-antibiotic-therapy-for-neonatal-pneumonia-a-randomized-controlled-trial
#7
N B Mathur, A Murugesan
OBJECTIVE: To compare the effect of 4 day course (study group) with 7 day course (control group) of antibiotic treatment in neonatal pneumonia, on treatment success rate. METHODS: This randomized controlled trial was conducted in a tertiary teaching hospital. Seventy, term and near-term neonates with pneumonia who had clinical remission by 48 h of antibiotic therapy were included. The neonates were randomized to receive a total of 4 d of antibiotics (Group 1) or 7 d of antibiotics (Group 2)...
May 21, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29780851/top-questions-in-uncomplicated-non-staphylococcus-aureus-bacteremia
#8
Jesse D Sutton, Sena Sayood, Emily S Spivak
The Infectious Diseases Society of America infection-specific guidelines provide limited guidance on the management of focal infections complicated by secondary bacteremias. We address the following 3 commonly encountered questions and management considerations regarding uncomplicated bacteremia not due to Staphylococcus aureus : the role and choice of oral antibiotics focusing on oral beta-lactams, the shortest effective duration of therapy, and the role of repeat blood cultures.
May 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29780587/development-of-a-vancomycin-dosing-approach-for-critically-ill-patients-receiving-hybrid-hemodialysis-using-monte-carlo-simulation
#9
Susan J Lewis, Bruce A Mueller
Objectives: Prolonged intermittent renal replacement therapy is an increasingly popular treatment for acute kidney injury in critically ill patients that runs at different flow rates and durations than conventional hemodialysis or continuous renal replacement therapies. Pharmacokinetic studies conducted in patients receiving prolonged intermittent renal replacement therapy are scarce; consequently, clinicians are challenged to dose antibiotics effectively. The purpose of this study was to develop vancomycin dosing recommendations for patients receiving prolonged intermittent renal replacement therapy...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29777282/ambulatory-intravenous-inotropic-support-and-or-levosimendan-in-pediatric-and-congenital-heart-failure-safety-survival-improvement-or-transplantation
#10
Sotiria C Apostolopoulou, George A Vagenakis, Alexandros Tsoutsinos, Felicia Kakava, Spyridon Rammos
End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29774320/scoring-idiopathic-granulomatous-mastitis-an-effective-system-for-predicting-recurrence
#11
Tonguç Utku Yılmaz, Bora Gürel, Sertaç Ata Güler, Mehmet Ali Baran, Büşra Erşan, Seda Duman, Zafer Utkan
Objective: Idiopathic granulomatous mastitis is a breast disease without a definitive etiology. There are no definitive classifications, scoring systems or certitudes. The aim of this study is to define the factors related to the recurrence and design a scoring system. Material and Methods: Patients who were admitted to the general surgery department with symptoms of granulomatous mastitis were evaluated by ultrasonography and underwent antibiotic therapy. Granulomatous mastitis is diagnosed by core biopsy and treated with steroid therapy...
April 2018: European Journal of Breast Health
https://www.readbyqxmd.com/read/29772991/reconstruction-plate-based-antibiotic-cement-spacers-clinical-outcomes-and-description-of-technique
#12
Aditya V Maheshwari, Robert Pivec, Roby Abraham, Qais Naziri
The standard of care for chronic deep peri-prosthetic hip infection is a two-stage exchange with placement of a temporary antibiotic cement spacer and treatment with intravenous antibiotics. Several commercially available cement spacer options exist. We report on a novel antibiotic spacer that may be an efficient, cost-effective alternative. Medical records of all patients treated for deep peri-prosthetic hip infection after total hip arthroplasty between 2004 and 2012 were reviewed. Each antibiotic spacer was constructed from a 12- to 16-hole recon plate bent to provide adequate soft tissue tension and a cement ball that matched the acetabulum...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29769028/-careful-goodbye-at-the-door-is-there-role-for-antimicrobial-stewardship-interventions-for-antimicrobial-therapy-prescribed-on-hospital-discharge
#13
R Chavada, J Davey, L O'Connor, D Tong
BACKGROUND: Antimicrobial stewardship (AMS) interventions largely target inpatient antimicrobial prescribing. Literature on appropriateness of antimicrobials prescribed at the interface between hospital and the community is minimal. This study was designed to assess the appropriateness of antimicrobials prescribed on hospital discharge and evaluate the impact of AMS interventions. METHODS: Patients with discharge medications processed by the pharmacy were identified using a computerized pharmacy medication tracker over a four week period...
May 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29767565/medical-management-of-deep-ulcerative-keratitis-in-cats-13-cases
#14
Michelle G Martin de Bustamante, Kathryn L Good, Brian C Leonard, Steven R Hollingsworth, Sydney G Edwards, Kelly E Knickelbein, Ann E Cooper, Sara M Thomasy, David J Maggs
Case series summary Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2...
May 1, 2018: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29757036/determinants-of-antibiotics-prescribing-among-doctors-in-a-nigerian-urban-tertiary-hospital
#15
Olayinka O Ogunleye, Joseph O Fadare, Adesola F Yinka-Ogunleye, Bene D Anand Paramadhas, Brian Godman
BACKGROUND AND OBJECTIVE: The problem of antimicrobial resistance (AMR) has assumed pandemic dimensions especially among low and middle-income countries such as Nigeria. Irrational use of currently available antimicrobial agents is a major contributory factor. There remains a paucity of documented information on the determinants of antibiotics prescribing among physicians in Nigeria to guide future strategies to reduce AMR. This study therefore aimed to investigate the patterns and determinants of antibiotics prescription among doctors in a tertiary hospital in Nigeria as the first step to improve future antibiotic use in hospitals...
May 14, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29756429/bacterial-osteomyelitis-microbiological-clinical-therapeutic-and-evolutive-characteristics-of-344-episodes
#16
E García Del Pozo, J Collazos, J A Cartón, D Camporro, V Asensi
OBJECTIVE: Osteomyelitis is a difficult-to-cure infection, with high relapse rate despite adequate therapy. Large published osteomyelitis series in adults are rare. METHODS: A total of 344 adult osteomyelitis patients were studied and followed > 12 months after hospital discharge. Demographic, microbiological, clinical, therapeutic and outcome data were analyzed. RESULTS: Mean age was 52.5 ± 18.3 years and 233 (67.7%) were male. Main osteomyelitis types were post-surgical (31...
May 11, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29755606/chronic-osteomyelitis-bacterial-flora-antibiotic-sensitivity-and-treatment-challenges
#17
Kuzma Jerzy, Hombhanje Francis
Background: Chronic osteomyelitis is a catastrophic sequel of delayed diagnosis of acute osteomyelitis. Objectives: The objectives of the study were to determine bacterial flora and antibiotic sensitivity, and to evaluate the outcome of an aggressive surgical approach to chronic osteomyelitis. Methods: This is a single surgeon, prospective cohort study on 30 consecutive patients with clinically and radiologically diagnosed chronic osteomyelitis presented to a hospital...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29750765/ideal-and-actual-impact-of-rapid-diagnostic-testing-and-antibiotic-stewardship-on-antibiotic-prescribing-and-clinical-outcomes-in-children-with-positive-blood-cultures
#18
Caroline H Reuter, Hannah L Palac, Larry K Kociolek, Xiaotian T Zheng, Yusuf Y Chao, Rupal Patel, Sameer J Patel
BACKGROUND: Implementing matrix assisted laser desorption ionization time of flight (MALDI-TOF) and multiplex PCR (mPCR) has been associated with decreased mortality and hospital length of stay in adults, but the impact in pediatrics is less understood. METHODS: This pre-post quasi-experimental study compared antibiotic prescribing for positive blood cultures in patients ≤21 years collected in 2012 (pre-intervention) and in 2015 (after MALDI-TOF/mPCR). Time to effective and optimal antimicrobial therapy were evaluated using Cox proportional hazards regression...
May 10, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29747905/prospective-evaluation-of-the-management-of-urinary-tract-infections-in-134-french-nursing-homes
#19
L Lemoine, C Dupont, A Capron, E Cerf, M Yilmaz, D Verloop, K Blanckaert, E Senneville, S Alfandari
OBJECTIVE: Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. PATIENTS AND METHODS: A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. RESULTS: Of 397 contacted facilities, 134 participated and informed 444 UTI episodes...
May 7, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29746711/a-monte-carlo-simulation-approach-for-beta-lactam-dosing-in-critically-ill-patients-receiving-prolonged-intermittent-renal-replacement-therapy
#20
Soo Min Jang, Katherine N Gharibian, Susan J Lewis, William H Fissell, Ashita J Tolwani, Bruce A Mueller
Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta-lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from critically ill patients was used to evaluate multiple dosing regimens in 4 different prolonged intermittent renal replacement therapy effluent rates and prolonged intermittent renal replacement therapy duration combinations (4 L/h × 10 hours or 5 L/h × 8 hours in hemodialysis and hemofiltration modes)...
May 10, 2018: Journal of Clinical Pharmacology
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