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https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#1
Bradley A Lloyd, Clinton K Murray, William Bradley, Faraz Shaikh, Deepak Aggarwal, M Leigh Carson, David R Tribble
In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a 5-year period (June 2009 through May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5,196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28277411/testing-for-urinary-tract-infection-in-the-influenza-respiratory-syncytial-virus-positive-febrile-infant-aged-2-to-12-months
#2
Anna Kathleen Schlechter Salinas, David S Hains, Tamekia Jones, Camden Harrell, Mark Meredith
OBJECTIVE: Infants 12 months or younger with influenza and respiratory syncytial virus (RSV) commonly present to the emergency department (ED) with fever. Previous publications have recommended that these patients have a urinalysis and urine culture performed. We aimed to assess the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the ED. We also examined whether the 2011 American Academy of Pediatrics (AAP) UTI clinical practice guidelines could be used to identify patients at lower risk of UTI...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28270546/variability-in-antibiotic-prescribing-for-community-acquired-pneumonia
#3
Lori K Handy, Matthew Bryan, Jeffrey S Gerber, Theoklis Zaoutis, Kristen A Feemster
BACKGROUND AND OBJECTIVES: Published guidelines recommend amoxicillin for most children with community-acquired pneumonia (CAP), yet macrolides and broad-spectrum antibiotics are more commonly prescribed. We aimed to determine the patient and clinician characteristics associated with the prescription of amoxicillin versus macrolide or broad-spectrum antibiotics for CAP. METHODS: Retrospective cohort study in an outpatient pediatric primary care network from July 1, 2009 to June 30, 2013...
March 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28258279/management-of-respiratory-tract-infections-in-young-children-a-qualitative-study-of-primary-care-providers-perspectives
#4
Ruby Biezen, Bianca Brijnath, Danilla Grando, Danielle Mazza
Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective using across-sectional qualitative research design based on the theoretical domains framework and the Capability, Opportunity and Motivation-B model...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#5
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
March 2, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28251670/retrospective-audit-of-antimicrobial-prescribing-practices-for-acute-exacerbations-of-chronic-obstructive-pulmonary-diseases-in-a-large-regional-hospital
#6
D J Brownridge, S T R Zaidi
WHAT IS KNOWN AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines...
March 1, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28247726/-features-of-diagnosis-and-treatment-of-various-disorders-of-urination-by-physicians-of-the-republic-of-dagestan-and-other-regions-of-the-north-caucasus-and-southern-federal-districts
#7
Z K Gadzhieva, Yu B Kazilov, Yu G Alyaev, I A Aboyan
PURPOSE: This study was aimed to the evaluation of the features of diagnosis and treatment of various urination disorders by physicians of the Republic of Dagestan. MATERIALS AND METHODS: A anonymous questionnaire survey of 32 urologists of the Republic of Dagestan was performed. In addition to urologists, survey was performed among 104 doctors of other specialties, who also treat patients with various urination disorders in their practice: neurologists (9), obstetricians (22), therapists (38), and surgeons (35)...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28247620/-chronic-prostatitis-a-new-paradigm-of-treatment
#8
V A Bozhedomov
This paper proposes health care recommendations for men with chronic prostatitis (CP) taking into account etiopathogenesis and the clinical presentation of the disease. The proposal is based on the experience of federal and regional clinics of urology and gynecology, respective departments for postgraduate education and on the analysis of scientific literature. It is shown that managing patients with CP requires consideration of factors beyond the traditional practice of urology. The author validates the need to use the modern prostatitis classification UPOINT instead of the traditional NIH NIDDK (1995) to increase the effectiveness of treatment...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28247617/-are-there-alternatives-to-antimicrobial-therapy-and-prophylaxis-of-uncomplicated-urinary-tract-infections
#9
K G Naber, J F Alidjanov
The acute uncomplicated cystitis in women is one of the most frequently diagnosed bacterial infection. A clinically symptomatic urinary tract infection must be differentiated from the asymptomatic bacteriuria, which is not considered an infection but rather a colonization which should not be treated. For the antimicrobial therapy according to the European guidelines the old oral antibiotics (fosfomycin trometamol, nitrofurantoin, pivmecillinam) should be prescribed, against which E. coli is still susceptible in over 90%...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28192108/timely-use-of-probiotics-in-hospitalized-adults-prevents-clostridium-difficile-infection-a-systematic-review-with-meta-regression-analysis
#10
Nicole T Shen, Anna Maw, Lyubov L Tmanova, Alejandro Pino, Kayley Ancy, Carl V Crawford, Matthew S Simon, Arthur T Evans
BACKGROUND & AIMS: Systematic reviews have provided evidence for the efficacy of probiotics in preventing Clostridium difficile infection (CDI), but guidelines do not recommend probiotic use for prevention of CDI. We performed an updated systematic review to help guide clinical practice. METHODS: We searched MEDLINE, EMBASE, International Journal of Probiotics and Prebiotics, and The Cochrane Library databases for randomized controlled trials evaluating use of probiotics and CDI in hospitalized adults taking antibiotics...
February 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28185664/review-of-the-role-of-probiotics-in-gastrointestinal-diseases-in-adults
#11
Juan José Sebastián Domingo
BACKGROUND: Probiotics may act as biological agents that modify the intestinal microbiota and certain cytokine profiles, which can lead to an improvement in certain gastrointestinal diseases. OBJECTIVES: To conduct a review of the evidence of the role of probiotics in certain gastrointestinal diseases in adults. SEARCH METHODS: Review conducted using appropriate descriptors, filters and limits in the PubMed database (MEDLINE). SELECTION CRITERIA: The MeSH terms used were Probiotics [in the title] AND Gastrointestinal Diseases, with the following limits or filters: Types of study: Systematic Reviews, Meta-Analysis, Guideline, Practice Guideline, Consensus Development Conference (and Consensus Development Conference NIH), Randomized Controlled Trial, Controlled Clinical Trial and Clinical Trial; age: adults (19 or older); language: English and Spanish; in humans, and with at least one abstract...
February 6, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28179485/variation-in-sepsis-evaluation-across-a-national-network-of-nurseries
#12
Sagori Mukhopadhyay, James A Taylor, Isabelle Von Kohorn, Valerie Flaherman, Anthony E Burgos, Carrie A Phillipi, Nui Dhepyasuwan, Elizabeth King, Miren Dhudasia, Karen M Puopolo
BACKGROUND AND OBJECTIVES: The extent to which clinicians use currently available guidelines for early-onset sepsis (EOS) screening has not been described. The Better Outcomes through Research for Newborns network represents 97 nurseries in 34 states across the United States. The objective of this study was to describe EOS risk management strategies across a national sample of newborn nurseries. METHODS: A Web-based survey was sent to each Better Outcomes through Research for Newborns network nursery site representative...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28173888/current-state-of-antimicrobial-stewardship-in-children-s-hospital-emergency-departments
#13
Rakesh D Mistry, Jason G Newland, Jeffrey S Gerber, Adam L Hersh, Larissa May, Sarah M Perman, Nathan Kuppermann, Peter S Dayan
BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution...
February 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28165791/improving-documentation-in-surgical-operation-notes
#14
Hammad Parwaiz, Rushan Perera, John Creamer, Hamish Macdonald, Ian Hunter
BACKGROUND: Accurate documentation in surgical operation notes is crucial in facilitating the postoperative care of surgical patients and forms an important medicolegal document. This study audited the quality and completeness of documentation in surgical operation notes at a single district general hospital against the Royal College of Surgeons (2014) Good Surgical Practice guidelines, and looked to improve clinical practice through improved compliance with these guidelines. METHOD: A total of 101 operation notes were audited from a variety of surgical specialities in November 2014 (cycle 1) and 100 notes in May 2015 (cycle 2)...
February 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28161290/safety-of-treatments-for-inflammatory-bowel-disease-clinical-practice-guidelines-of-the-italian-group-for-the-study-of-inflammatory-bowel-disease-ig-ibd
#15
Livia Biancone, Vito Annese, Sandro Ardizzone, Alessandro Armuzzi, Emma Calabrese, Flavio Caprioli, Fabiana Castiglione, Michele Comberlato, Mario Cottone, Silvio Danese, Marco Daperno, Renata D'Incà, Giuseppe Frieri, Walter Fries, Paolo Gionchetti, Anna Kohn, Giovanni Latella, Monica Milla, Ambrogio Orlando, Claudio Papi, Carmelina Petruzziello, Gabriele Riegler, Fernando Rizzello, Simone Saibeni, Maria Lia Scribano, Maurizio Vecchi, Piero Vernia, Gianmichele Meucci
Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs...
January 17, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28152727/a-prospective-study-of-an-inpatient-febrile-neutropenia-clinical-practice-guideline-in-oncology-patients
#16
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28147426/-spontaneous-bacterial-peritonitis
#17
Ľubomír Skladaný, Silvia Kasová, Anna Purgelová, Natália Bystrianska, Svetlana Adamcová-Selčanová
AIM OF STUDY: Spontaneous bacterial peritonitis (SBP) is the most frequent infectious complication of liver cirrhosis with serious consequences. Initially, SBP is always treated with empirical, not targeted, antibiotic therapy. Since a retrospective study performed in our department showed suboptimal effectiveness (only 40 %) of empirical antibiotic therapy in accordance with the EASL guidelines, a decision was made to change the protocol. The aims of this prospective study were to determine: (1) the incidence and characteristics of SBP in real clinical practice - in a liver unit of a tertiary hospital, (2) the effectiveness of new antibiotic therapy selected based on analysis of the spectrum of pathogens and their resistance to antibiotics as identified in a retrospective cohort study on SBP carried out in our department, (3) mortality, and to compare these findings with the literature data...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28145848/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty-executive-summary
#18
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28145823/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty
#19
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28134708/chorioamnionitis-time-for-a-new-approach
#20
Tara M Randis, Richard A Polin, George Saade
PURPOSE OF REVIEW: The association between maternal chorioamnionitis and early-onset sepsis in the newborn has long been recognized, and established guidelines recommend treating all exposed infants with broad-spectrum antibiotics until infection can be ruled out. However, recent data suggest that close observation of well appearing term and late-preterm newborns may be a preferable alternative. The present review addresses the evidence in favor of newly proposed changes to the diagnosis and management of women and newborns following a maternal diagnosis of chorioamnionitis...
April 2017: Current Opinion in Pediatrics
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