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https://www.readbyqxmd.com/read/28299218/can-surgery-be-avoided-exclusive-antibiotic-treatment-for-pelvic-actinomycosis
#1
M P Ruiz, E M Williams, C M Markey, A M Johnson, P B Morales-Ramirez
Pelvic actinomycosis is an uncommon, slowly progressing granulomatous infection that has been associated with the presence of intrauterine devices. Due to its unspecific clinical and radiologic findings, it can mimic pelvic or intra-abdominal malignancy leading to mutilating surgery of high morbidity. Rarely, diagnosis is made preoperatively and in most cases surgical intervention is necessary. The patient in our case is a 42-year-old female with an IUD for 15 years diagnosed with pelvic actinomycosis. Patient was uniquely diagnosed preoperatively through paracentesis and treated conservatively with prolonged antibiotic therapy and without any type of surgical intervention...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28279491/proposal-for-shorter-antibiotic-therapies
#2
C Wintenberger, B Guery, E Bonnet, B Castan, R Cohen, S Diamantis, P Lesprit, L Maulin, Y Péan, E Peju, L Piroth, J P Stahl, C Strady, E Varon, F Vuotto, R Gauzit
OBJECTIVES: Reducing antibiotic consumption has now become a major public health priority. Reducing treatment duration is one of the means to achieve this objective. Guidelines on the therapeutic management of the most frequent infections recommend ranges of treatment duration in the ratio of one to two. The Recommendation Group of the French Infectious Diseases Society (SPILF) was asked to collect literature data to then recommend the shortest treatment durations possible for various infections...
March 6, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#3
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28243046/single-dose-intra-procedural-ceftriaxone-during-endoscopic-ultrasound-fine-needle-aspiration-of-pancreatic-cysts-is-safe-and-effective-results-from-a-single-tertiary-center
#4
Amir Klein, Rose Qi, Shyam Nagubandi, Eric Lee, Vu Kwan
BACKGROUND: Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) is universally used for the investigation and diagnosis of pancreatic cystic lesions (PCL). Infectious complications following EUS-FNA of PCL are rare. Antibiotic prophylaxis to reduce the risk of infection is recommended; however, there is no consensus on the optimal regimen or route of administration. Potential advantages of a single-dose intravenous (IV) antibiotic over a prolonged oral regimen include simplicity, guaranteed delivery and fewer antibiotic related adverse events, but there are only limited data to support this...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28229205/-spectrum-of-pathogens-in-postoperative-complications-of-visceral-surgery-the-problem-of-multidrug-resistance
#5
A Kramer, J Pochhammer, P Walger, U Seifert, M Ruhnke, J C Harnoss
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, are the most common findings. Although in general surgery 10% of the S. aureus causing postoperative wound infections were methicillin resistant (MRSA), no cases of multidrug-resistant Gram-negative (MRGN) bacteria were reported...
February 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28151844/impact-of-percutaneous-drainage-on-outcome-of-intra-abdominal-infection-associated-with-pediatric-perforated-appendicitis
#6
William Bonadio, Miriam Langer, Julie Cueva, Astrid Haaland
BACKGROUND: Perforated appendicitis can result in potentially serious complications requiring prolonged medical care. The optimal approach to successfully managing this condition is controversial. METHODS: Review of 80 consecutive cases of pediatric acute perforated appendicitis with intra-abdominal infection [IAI] medically managed with parenteral antibiotics and percutaneous drainage [PD] during a 7-year period. RESULTS: All patients received broad spectrum parenteral antibiotic therapy...
January 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28108390/fatal-sepsis-caused-by-multidrug-resistant-bacteroides-fragilis-harboring-a-cfia-gene-and-an-upstream-insertion-sequence-element-in-japan
#7
Itaru Nakamura, Kotaro Aoki, Yuri Miura, Tetsuo Yamaguchi, Tetsuya Matsumoto
Here, we report a case of fatal sepsis resulting from an intra-abdominal infection caused by a Bacteroides fragilis strain containing a CfiA4 metallo-β-lactamase and an upstream insertion sequence (IS) element. Meropenem was used as empiric therapy for septic shock as a result of the intra-abdominal infection, although two rounds of carbapenem treatment had been administered previously. B. fragilis was isolated from two anaerobic blood culture bottles 4 days after the onset of septic shock. Susceptibility testing revealed that the isolate was non-susceptible to all tested agents except metronidazole and tigecycline...
January 17, 2017: Anaerobe
https://www.readbyqxmd.com/read/28108098/comparative-efficacies-of-daptomycin-vancomycin-and-linezolid-in-experimental-enterococcal-peritonitis
#8
Toshiki Kajihara, Shigeki Nakamura, Naoki Iwanaga, Kazuhiro Oshima, Katsuji Hirano, Taiga Miyazaki, Koichi Izumikawa, Katsunori Yanagihara, Yoshitsugu Miyazaki, Noboru Hattori, Nobuoki Kohno, Shigeru Kohno, Hiroshi Mukae
Enterococci have become increasingly important pathogens for nosocomial infection (e.g. bacteremia, intra-abdominal infection, endocarditis, etc.), related to their intrinsic resistance to many antibiotics. Although the in vitro susceptibility of daptomycin (DAP) against Enterococci is well established, the Food and Drug Administration has only approved its use for complicated skin and skin structure infections induced by Enterococcus faecalis. In this study we evaluated the potential therapeutic application of DAP in a murine model of enterococcal experimental peritonitis...
January 17, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28032485/clinical-and-therapeutic-implications-of-aeromonas-bacteremia-14-years-nation-wide-experiences-in-korea
#9
Ji Young Rhee, Dong Sik Jung, Kyong Ran Peck
BACKGROUND: To elucidate the clinical presentation, antimicrobial susceptibility, and prognostic factors of monomicrobial Aeromonas bacteremia in order to determine the most effective optimal therapy. MATERIALS AND METHODS: We reviewed the medical records of Aeromonas bacteremia patients for the period January 2000 to December 2013 in a retrospective multi-center study. RESULTS: A total of 336 patient records were reviewed, with 242 having community-acquired bacteremia...
December 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/27930281/patients-with-risk-factors-for-complications-do-not-require-longer-antimicrobial-therapy-for-complicated-intra-abdominal-infection
#10
Rishi Rattan, Casey J Allen, Robert G Sawyer, John Mazuski, Therese M Duane, Reza Askari, Kaysie L Banton, Jeffrey A Claridge, Raul Coimbra, Joseph Cuschieri, E Patchen Dellinger, Heather L Evans, Christopher A Guidry, Preston R Miller, Patrick J ONeill, Ori D Rotstein, Michaela A West, Kimberley Popovsky, Nicholas Namias
A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II 15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27917692/once-daily-high-dose-tigecycline-pharmacokinetic-pharmacodynamic-based-dosing-for-optimal-clinical-effectiveness-dosing-matters-revisited
#11
Burke A Cunha, Jeffrey Baron, Cheston B Cunha
Tigecycline has emerged as first line therapy for serious systemic infections due to important pathogens (except P. aeruginosa and Proteus sp.), including multi-drug resistant (MDR) and Gram negative bacilli (GNB), including carbapenem resistant Enterobacteriae. Tigecycline has a 'low resistance potential,' is protective against C. difficile, and is often the only antibiotic effective against MDR GNB, e.g., Klebsiella sp. Areas covered: Standard dose tigecycline therapy has been used for intra-abdominal infections, complicated skin/skin structure infections (cSSSIs), and CAP...
December 22, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27911477/vascularized-appendicular-lymph-node-transfer-for-treatment-of-extremity-lymphedema-a-case-report
#12
Pedro Ciudad, Oscar J Manrique, Shivprasad Date, Wei-Ling Chang, Fabio Nicoli, Stamatis Sapountzis, Hsu-Tang Cheng, Mouchammed Agko, Hung-Chi Chen
Vascularized lymph node transfer has demonstrated promising results for the treatment of extremity lymphedema. In an attempt to find the ideal donor site, several vascularized lymph nodes have been described. Each has a common goal of decreasing morbidity and avoiding iatrogenic lymphedema while obtaining good clinical results. Herein, we present the preliminary clinical outcomes of an intra-abdominal lymph node flap option based on the appendicular artery and vein used for the treatment of extremity lymphedema...
December 2, 2016: Microsurgery
https://www.readbyqxmd.com/read/27895014/ceftazidime-avibactam-as-salvage-therapy-for-infections-caused-by-carbapenem-resistant-organisms
#13
Elizabeth Temkin, Julian Torre-Cisneros, Bojana Beovic, Natividad Benito, Maddalena Giannella, Raúl Gilarranz, Cameron Jeremiah, Belén Loeches, Isabel Machuca, María José Jiménez-Martín, José Antonio Martínez, Marta Mora-Rillo, Enrique Navas, Michael Osthoff, Juan Carlos Pozo, Juan Carlos Ramos Ramos, Marina Rodriguez, Miguel Sánchez-García, Pierluigi Viale, Michel Wolff, Yehuda Carmeli
Ceftazidime-avibactam (CAZ-AVI) is a recently approved β-lactam-β-lactamase inhibitor combination with the potential to treat serious infections caused by carbapenem-resistant organisms. Few patients with such infections were included in the CAZ-AVI clinical trials, and clinical experience is lacking. We present a case series of patients with infections caused by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (CRPa) who were treated with CAZ-AVI salvage therapy on a compassionate-use basis...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27890724/clinical-characteristics-and-antimicrobial-susceptibilities-of-anaerobic-bacteremia-in-an-acute-care-hospital
#14
Thean Yen Tan, Lily Siew Yong Ng, Lee Ling Kwang, Suma Rao, Li Ching Eng
This study investigated the clinical features of anaerobic bacteraemia in an acute-care hospital, and evaluated the antimicrobial susceptibility of these isolates to commonly available antibiotics. Microbiological and epidemiological data from 2009 to 2011were extracted from the laboratory information system and electronic medical records. One hundred and eleven unique patient episodes consisting of 116 anaerobic isolates were selected for clinical review and antibiotic susceptibility testing. Susceptibilities to amoxicillin-clavulanate, clindamycin, imipenem, metronidazole, moxifloxacin, penicillin and piperacillin-tazobactam were performed using Etest strips with categorical interpretations according to current CLSI breakpoints...
November 25, 2016: Anaerobe
https://www.readbyqxmd.com/read/27866659/value-of-propensity-score-matching-for-equalizing-comparator-groups-in-observational-database-studies-a-case-study-in-anti-infectives
#15
C Daniel Mullins, Frank R Ernst, Michelle R Krukas, Joseph Solomkin, Christian Eckmann, Ahmed Shelbaya, Alvaro Quintana, Arlene Reisman
PURPOSE: Propensity score methodologies can reduce bias and confounding in nonrandomized studies, including pharmaceutical comparative effectiveness studies. An observational case study was developed to demonstrate the impact of propensity score adjustments on outcomes (ie, discharge status) of patients hospitalized for complicated intra-abdominal infections. METHODS: Two cohorts were examined: intensive care unit (ICU) (vs non-ICU) patients and tigecycline-treated patients (vs patients receiving other antibiotics)...
December 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27851857/assessing-the-efficacy-and-safety-of-eravacycline-vs-ertapenem-in-complicated-intra-abdominal-infections-in-the-investigating-gram-negative-infections-treated-with-eravacycline-ignite-1-trial-a-randomized-clinical-trial
#16
Joseph Solomkin, David Evans, Algirdas Slepavicius, Patrick Lee, Andrew Marsh, Larry Tsai, Joyce A Sutcliffe, Patrick Horn
Importance: Eravacycline is a novel, fully synthetic fluorocycline antibiotic of the tetracycline class with in vitro activity against clinically important gram-negative, gram-positive aerobic, and facultative bacteria including most of those resistant to cephalosporins, fluoroquinolones, β-lactam/β-lactamase inhibitors, multidrug resistant strains and carbapenem-resistant Enterobacteriaceae, and most anaerobic pathogens. Objective: To evaluate the efficacy and safety of eravacycline compared with ertapenem in adult hospitalized patients with complicated intra-abdominal infections (cIAIs)...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27794239/a-case-report-of-necrotizing-fasciitis-of-the-abdominal-wall-a-rare-life-threatening-complication-of-a-common-disease-process
#17
Anya Romanoff, Jeffrey Freed, Tomas Heimann
INTRODUCTION: Acute appendicitis is one of the most common surgical diseases, but perforated appendicitis resulting in necrotizing fasciitis of the abdominal wall is exceedingly rare. PRESENTATION OF CASE: A 71-year-old male presented to the emergency department with one week of severe right-sided abdominal pain. He was hypothermic, hypotensive, and tachycardic. His abdomen was distended, with a large, tender, erythematous region over the right abdominal wall. Laboratory evaluation revealed leukocytosis, acute kidney injury, and lactic acidosis...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27785551/the-effect-of-pre-operative-optimization-on-post-operative-outcome-in-crohn-s-disease-resections
#18
Alaa El-Hussuna, Igors Iesalnieks, Nir Horesh, Sabah Hadi, Yael Dreznik, Oded Zmora
BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO on the post-operative outcome in CD. METHOD: This is a multicentre retrospective cohort study. The primary outcome was 30-day post-operative complications. Secondary outcomes were intra-abdominal septic complications, surgical site infection (SSI), re-operation, length of post-operative stay in a hospital and re-admission...
January 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27758148/ceftazidime-avibactam-for-the-treatment-of-complicated-intra-abdominal-infections
#19
REVIEW
Sara A Buckman, Tamara Krekel, Anouk E Muller, John E Mazuski
The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole...
December 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27704002/optimal-treatment-for-complicated-intra-abdominal-infections-in-the-era-of-antibiotic-resistance-a-systematic-review-and-meta-analysis-of-the-efficacy-and-safety-of-combined-therapy-with-metronidazole
#20
Hiroshige Mikamo, Akira Yuasa, Keiko Wada, Bruce Crawford, Naomi Sugimoto
Background.  Carbapenem-resistant Enterobacteriaceae has increased dramatically in the last decade, resulting in infections that are difficult to treat and associated with high mortality rates. To prevent further antibacterial resistance, it is necessary to use carbapenem selectively. A combination of metronidazole with an antimicrobial agent active against aerobes is an alternative effective treatment for patients with complicated intra-abdominal infections (cIAIs). This study aimed to compare efficacy and safety of metronidazole combination therapies and carbapenem and to provide clinical evidence regarding the optimal treatment of cIAI...
September 2016: Open Forum Infectious Diseases
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