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https://www.readbyqxmd.com/read/29329124/septic-arthritis-of-the-wrist
#1
John D Jennings, Asif M Ilyas
Septic arthritis of the wrist is an uncommon condition, but one that can result in substantial morbidity. Timely identification and treatment is critical to patient care. No serum laboratory values have been shown to consistently confirm wrist joint infection. Thus, diagnosis is made based mainly on a thorough patient history, physical examination, and joint aspiration. When infection is suspected, aspiration of the wrist should be performed to confirm the diagnosis. Broad-spectrum antibiotics and joint aspiration or surgery are required to manage the infection and prevent sequelae...
January 11, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#2
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#3
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29324209/using-process-improvement-tools-to-improve-the-care-of-patients-with-neutropenic-fever-in-the-emergency-room
#4
Avantika Dang, Lauren N Gjolaj, Myka Whitman, Gustavo Fernandez
PURPOSE: The purpose of this study was to improve the care of patients with neutropenic fever in an academic acute care hospital's emergency room (ER). METHODS: Using the define, measure, analyze, improve, control method, a two-phase project with three critical to quality metrics (reduction in time to antibiotic administration, increase in percentage of patients with neutropenic fever identified as an oncology emergency, and increase in patients cohorted on oncology units) was completed...
January 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29313312/influence-of-single-dose-antibiotic-prophylaxis-for-early-onset-pneumonia-in-high-risk-intubated-patients
#5
Timothy D Lewis, Kelly A Dehne, Kathryn Morbitzer, Denise H Rhoney, Casey Olm-Shipman, J Dedrick Jordan
BACKGROUND: Early-onset pneumonia (EOP) after endotracheal intubation is common among critically ill patients with a neurologic injury and is associated with worse clinical outcomes. METHODS: This retrospective cohort study observed outcomes pre- and post-implementation of an EOP prophylaxis protocol which involved the administration of a single dose of ceftriaxone 2 g around the time of intubation. The study included patients ≥ 18 years who were admitted to the University of North Carolina Medical Center (UNCMC) neuroscience intensive care unit (NSICU) between April 1, 2014, and October 26, 2016, and intubated for ≥ 72 h...
January 8, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29313072/-antibiotic-stewardship-measures-for-optimizing-prescription-of-anti-infective-agents
#6
REVIEW
C Lanckohr, H Bracht
Antibiotic stewardship (ABS) comprises a bundle of different interventions to improve anti-infective treatment in a hospital setting. An important component of ABS interventions is the interdisciplinary approach to infection management. Besides improving infrastructural aspects on a hospital level, including surveillance of the use of anti-infective agents and nosocomial infections, collation and interpretation of statistics on resistance and formulation of local treatment guidelines, ABS teams go to the wards and advise treating physicians on antibiotic therapy...
January 8, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29304746/a-multi-center-study-on-the-risk-factors-of-infection-caused-by-multi-drug-resistant-acinetobacter-baumannii
#7
Huiping Huang, Borong Chen, Gang Liu, Jing Ran, Xianyu Lian, Xinhua Huang, Nan Wang, Zhengjie Huang
BACKGROUND: Acinetobacter baumannii (AB) is critical for healthcare-associated infections (HAI) with significant regional differences in the resistance rate, but its risk factors and infection trends has not been well studied. We aimed to explore the risk factors, epidemiological characteristics and resistance of multidrug-resistant Acinetobacter baumannii (MDR-AB) in intensive care unit inpatients. METHODS: Data of patients with MDR-AB (195 cases), and with antibiotic-sensitive AB infection (294 cases, control) during January to December, 2015 in three medical centers in Xiamen, China were conducted and analyzed in the present retrospective study...
January 5, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29298792/lemierre-s-syndrome-a-pain-in-the-neck-with-far-reaching-consequences
#8
Thomas James Stubington, Paul James
Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29288367/antimicrobial-resistance-and-antibiotic-stewardship-programs-in-the-icu-insistence-and-persistence-in-the-fight-against-resistance-a-position-statement-from-esicm-escmid-waaar-round-table-on-multi-drug-resistance
#9
Jan J De Waele, Murat Akova, Massimo Antonelli, Rafael Canton, Jean Carlet, Daniel De Backer, George Dimopoulos, José Garnacho-Montero, Jozef Kesecioglu, Jeffrey Lipman, Mervyn Mer, José-Artur Paiva, Mario Poljak, Jason A Roberts, Jesus Rodriguez Bano, Jean-François Timsit, Jean-Ralph Zahar, Matteo Bassetti
Antimicrobial resistance (AMR) is a clear and present danger to patients in any intensive care unit (ICU) around the world. Whereas AMR may affect any patient in the hospital, patients in the ICU are particularly at risk of acquiring AMR infections due to the intensity of the treatment, use of invasive devices, increased risk of transmission and exposure to antibiotics. AMR is present in every ICU, although prevalence is geographically different and AMR pathogens encountered are variable. Intensive care and infectious disease specialists from the European Society of Intensive Care Medicine, European Society of Microbiology and Infectious Diseases and World Alliance Against Antimicrobial Resistance, united in the ANTARCTICA (Antimicrobial Resistance in Critical Care) coalition, call for increased awareness and action among health care professionals to reduce AMR development in critically ill patients, to improve treatment of AMR infections and to coordinate scientific research in this high-risk patient population...
December 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29286945/an-interpretable-machine-learning-model-for-accurate-prediction-of-sepsis-in-the-icu
#10
Shamim Nemati, Andre Holder, Fereshteh Razmi, Matthew D Stanley, Gari D Clifford, Timothy G Buchman
OBJECTIVES: Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival in septic patients. However, no clinically validated system exists for real-time prediction of sepsis onset. We aimed to develop and validate an Artificial Intelligence Sepsis Expert algorithm for early prediction of sepsis. DESIGN: Observational cohort study. SETTING: Academic medical center from January 2013 to December 2015...
December 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29284961/comparison-of-efficacy-of-amoxicillin-versus-ciprofloxacin-in-postsurgical-management-of-transalveolar-extraction
#11
Balan Natarajan, Gowri Balakrishnan, Kavin Thangavelu
Background: The transalveolar extraction and the use of pharmacological antibiotic therapy following the surgical procedure in management of postoperative infection go hand in hand in minor oral surgery. Attention has often been focused on antibiotic therapy administered at different time schedules (before or after surgery or both). This investigation reveals how the use of different molecules and dosages is critical in the postoperative period and has always provided positive result...
November 2017: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/29281974/development-of-an-intervention-to-reduce-antibiotic-use-for-childhood-coughs-in-uk-primary-care-using-critical-synthesis-of-multi-method-research
#12
Patricia J Lucas, Jenny Ingram, Niamh M Redmond, Christie Cabral, Sophie L Turnbull, Alastair D Hay
BACKGROUND: Overuse of antibiotics contributes to the global threat of antimicrobial resistance. Antibiotic stewardship interventions address this threat by reducing the use of antibiotics in occasions or doses unlikely to be effective. We aimed to develop an evidence-based, theory-informed, intervention to reduce antibiotic prescriptions in primary care for childhood respiratory tract infections (RTI). This paper describes our methods for doing so. METHODS: Green and Krueter's Precede/Proceed logic model was used as a framework to integrate findings from a programme of research including 5 systematic reviews, 3 qualitative studies, and 1 cohort study...
December 28, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29276051/discovery-research-and-development-of-new-antibiotics-the-who-priority-list-of-antibiotic-resistant-bacteria-and-tuberculosis
#13
Evelina Tacconelli, Elena Carrara, Alessia Savoldi, Stephan Harbarth, Marc Mendelson, Dominique L Monnet, Céline Pulcini, Gunnar Kahlmeter, Jan Kluytmans, Yehuda Carmeli, Marc Ouellette, Kevin Outterson, Jean Patel, Marco Cavaleri, Edward M Cox, Chris R Houchens, M Lindsay Grayson, Paul Hansen, Nalini Singh, Ursula Theuretzbacher, Nicola Magrini
BACKGROUND: The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs. METHODS: We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated...
December 21, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29243536/variation-in-pediatric-organ-donor-management-practices-among-us-organ-procurement-organizations
#14
Robert S Ream, Eric S Armbrecht
INTRODUCTION: Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. RESEARCH QUESTION: To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29225790/update-on-ventilator-associated-pneumonia
#15
REVIEW
Jean-Francois Timsit, Wafa Esaied, Mathilde Neuville, Lila Bouadma, Bruno Mourvllier
Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials...
2017: F1000Research
https://www.readbyqxmd.com/read/29220754/association-of-high-mortality-with-extended-spectrum-%C3%AE-lactamase-esbl-positive-cultures-in-community-acquired-infections
#16
Sumit Ray, Dimple Anand, Sankalp Purwar, Arijit Samanta, Kaustubh V Upadhye, Prasoon Gupta, Debashis Dhar
PURPOSE: Infections due to multidrug resistant organisms have become a serious health concern worldwide. The present study was conducted to investigate the spectrum of microbial resistance pattern in the community and their effects on mortality. METHODS: A retrospective review and analysis of prospectively collected data was done of all patients admitted with diagnosis of sepsis in two tertiary care ICU's for a period of two years. Demographics, culture positivity, microbial spectrum, resistance pattern and outcome data were collected...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29219627/non-oncotic-properties-of-albumin-a-multidisciplinary-vision-about-the-implications-for-critically-ill-patients
#17
Ricard Ferrer, Xavier Mateu, Emilio Maseda, Juan Carlos Yébenes, César Aldecoa, Candelaria De Haro, Juan Carlos Ruiz-Rodriguez, José Garnacho-Montero
Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients...
December 8, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29208694/variation-in-care-and-clinical-outcomes-in-children-hospitalized-with-orbital-cellulitis
#18
Jessica L Markham, Matthew Hall, Jessica L Bettenhausen, Angela L Myers, Henry T Puls, Russell J McCulloh
OBJECTIVES: To describe variation in the care of children hospitalized with orbital cellulitis and to determine associations with length of stay (LOS), emergency department (ED) revisits, and hospital readmissions. METHODS: By using the Pediatric Health Information System, we performed a multicenter, retrospective study of children aged 2 months to 18 years with a primary International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis code for orbital cellulitis from 2007 to 2014...
December 5, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29188591/contact-dermatitis-after-prescription-of-an-ophthalmic-ointment-containing-fradiomycin-sulfate-a-retrospective-database-study-using-japanese-health-insurance-claims-data
#19
Naomi Sugimoto, Kazuhiko Kuribayashi, Yuji Yamamoto, Satoshi Nagayasu, Osamu Suga, Yoko Fujimoto
BACKGROUND: Topical ointments containing fradiomycin sulfate, such as fradiomycin sulfate/methylprednisolone (F/M) and fradiomycin sulfate/betamethasone sodium phosphate (F/B), are known to cause allergic contact dermatitis (CD) in some patients, especially when used for the periocular region. F/M is commonly prescribed to patients for various conditions; however, there are no reports with respect to the incidence of CD caused by F/M in actual practice. OBJECTIVE: The aim was to investigate the incidence of CD using a data-based retrospective cohort study...
November 30, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/29180280/association-between-augmented-renal-clearance-antibiotic-exposure-and-clinical-outcome-in-critically-ill-septic-patients-receiving-high-doses-of-%C3%AE-lactams-administered-by-continuous-infusion-a-prospective-observational-study
#20
Cedric Carrie, Laurent Petit, Nicolas D'houdain, Noemie Sauvage, Vincent Cottenceau, Melanie Lafitte, Cecile Foumenteze, Quentin Hisz, Deborah Menu, Rachel Legeron, Dominique Breilh, Francois Sztark
BACKGROUND: This study aimed to assess whether augmented renal clearance (ARC) impacts negatively on antibiotic concentrations and clinical outcomes in patients treated by high doses of β-lactams administered continuously for a first infection in surgical intensive care unit. METHODS: Over a 9-month period, all critically ill patients treated by one of the monitored β-lactam antibiotics for a documented infection without renal impairment were eligible. During the first three days of antibiotic therapy, every patient underwent 24-hour creatinine clearance (CrCL) measurements and therapeutic drug monitoring...
November 24, 2017: International Journal of Antimicrobial Agents
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