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Sepsi empiric antibiotic treatment

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https://www.readbyqxmd.com/read/29343506/how-to-use%C3%A2-procalcitonin
#1
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29341844/empiric-antibiotics-for-sepsis
#2
Sara A Buckman, Isaiah R Turnbull, John E Mazuski
BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and treatment are the cornerstones of management. METHODS: Review of the English-language literature. RESULTS: For both sepsis and septic shock "antimicrobials [should be] be initiated as soon as possible and within one hour" (Surviving Sepsis Campaign). The risk of progression from severe sepsis to septic shock increases 8% for each hour before antibiotics are started...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29284155/a-retrospective-analysis-comparing-oral-stepdown-therapy-for-enterobacteriaceae-bloodstream-infections-fluoroquinolones-versus-beta-lactams
#3
Nicholas J Mercuro, Patricia Stogsdill, Minkey Wungwattana
Enterobacteriaceae bloodstream infections (EB-BSI) are a common manifestation of Gram-negative sepsis, and are initially managed with empiric intravenous (IV) antibiotics. Upon stabilization and source control, patients are often transitioned to an oral agent. The fluoroquinolone (FQ) class plays a prominent role in stepdown therapy for severe infections due to favorable pharmacokinetic parameters; however, serious adverse effects have been documented with their use. Two hundred and twenty-four adults with EB-BSI initiated on empiric IV antibiotics with stepdown to oral beta-lactam (BLM) (n= 84) or FQ (n= 140) were included to compare clinical success and identify risk factors for treatment failure...
December 25, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29275925/utility-of-early-onset-sepsis-risk-calculator-for-neonates-born-to-mothers-with-chorioamnionitis
#4
David Carola, Mansi Vasconcellos, Amy Sloane, Dorothy McElwee, Caroline Edwards, Jay Greenspan, Zubair H Aghai
OBJECTIVES: To evaluate the performance of the early-onset sepsis (EOS) risk calculator in a cohort of neonates born to mothers with clinical chorioamnionitis, and to compare the diagnostic utility of the EOS calculator, clinical signs, and laboratory evaluations for correctly identifying EOS in this cohort. STUDY DESIGN: This was a retrospective study of neonates born at ≥35 weeks of gestation to mothers with chorioamnionitis. The risk and management categories for all neonates were calculated using the EOS calculator, and these results were analyzed and compared with laboratory data and clinical signs...
December 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29225798/30-day-readmission-antibiotics-costs-and-costs-of-delay-to-adequate-treatment-of-enterobacteriaceae-uti-pneumonia-and-sepsis-a-retrospective-cohort-study
#5
Marya D Zilberberg, Brian H Nathanson, Kate Sulham, Weihong Fan, Andrew F Shorr
Background: Enterobacteriaceae are common pathogens in pneumonia, sepsis and urinary tract infection (UTI). Though rare, carbapenem resistance (CRE) among these organisms complicates efforts to ensure adequate empiric antimicrobial therapy. In turn this negatively impacts such outcomes as mortality and hospital costs. We explored proportion of total costs represented by antibiotics, 30-day readmission rates, and per-day costs of inadequate antimicrobial coverage among patients with Enterobacteriaceae pneumonia, sepsis and/or UTI in the context of inappropriate (IET) vs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29214016/genotypic-characterization-of-gentamicin-and-cephalosporin-resistant-escherichia-coli-isolates-from-blood-cultures-in-a-norwegian-university-hospital-2011-2015
#6
Øyvind Andreas Fladberg, Silje Bakken Jørgensen, Hege Vangstein Aamot
Background: Cephalosporin resistance in clinical E. coli isolates is increasing internationally. The increase has been caused by virulent and often multidrug-resistant clones, especially the extended spectrum β-lactamase (ESBL) producing E. coli clone O25b-ST131. Methods: In Norway, recommended empirical treatment of sepsis consists of gentamicin and penicillin combined, or a broad-spectrum cephalosporin. To investigate if increased gentamicin and cephalosporins resistance rates in our hospital could be caused by specific clones, we conducted a retrospective study on E...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29201522/clinical-effect-of-discordance-in-empirical-treatment-of-cases-with-urinary-tract-infection-accompanied-by-bacteremia
#7
İlyas Dökmetaş, Aziz Ahmad Hamidi, Mehmet Emin Bulut, Sinan Çetin, Ahsen Öncül, Nuray Uzun
Objective: It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. Material and methods: We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29164361/bacteraemia-in-emergency-departments-effective-antibiotic-reassessment-is-associated-with-a-better-outcome
#8
Charlotte Aillet, Didier Jammes, Agnès Fribourg, Sophie Léotard, Olivier Pellat, Patricia Etienne, Dominique Néri, Djamel Lameche, Olivier Pantaloni, Serge Tournoud, Pierre-Marie Roger
Patients with bacteraemia constitute an useful population for an audit of antibiotic treatments. Empirical antibiotic therapy (EAT) and its reassessment must take into account clinical data and microbiological results. Our aim was to determine the impact of these sequential steps of the therapy on survival. This was a retrospective multicentre study which included patients admitted to emergency departments (ED) for whom blood cultures were positive over a 4-month period. Microbial results were compiled from the database of the laboratories...
November 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29109168/risk-factors-and-outcomes-for-ineffective-empiric-treatment-in-gram-negative-sepsis-stratification-by-onset-of-infection
#9
Scott T Micek, Nicholas Hampton, Marin Kollef
Sepsis and septic shock remain serious infections with reported mortality rates in excess of forty percent. Timely antibiotic therapy in sepsis and septic shock is recognized as an important determinant of outcome. However, the administration of ineffective empiric treatment (IET) (an initial antibiotic regimen that is not active against the identified pathogen(s) based on in vitro susceptibility testing) is associated with excess mortality compared to effective empiric treatment (EET). We examined all hospitalized patients between January 2010 and October 2015 at Barnes-Jewish Hospital with the presence of a sterile site (blood, or pleural, abdominal, cerebrospinal, synovial, and pericardial fluid) culture positive for Gram-negative (GN) bacteria combined with primary or secondary ICD-9-CM codes for severe sepsis (995...
November 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29020203/empirical-antibiotic-treatment-does-not-improve-outcomes-in-catheter-associated-urinary-tract-infection-prospective-cohort-study
#10
Tanya Babich, Oren Zusman, Michal Elbaz, Haim Ben-Zvi, Mical Paul, Leonard Leibovici, Tomer Avni
Background: Catheter associated urinary tract infection (CAUTI) is the most common healthcare-associated acquired infection. We aimed to describe the short- and long-term survival of patients with CAUTI and the impact of the empirical antibiotic treatment on survival rates. Methods: In this prospective observational study we included consecutive adult patients with a chronic indwelling catheter-associated UTI and sepsis hospitalized in medical departments. The primary outcomes were 30-days all-cause mortality and long-term survival at end of the follow-up...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28993098/acute-oncology-care-a-narrative-review-of-the-acute-management-of-neutropenic-sepsis-and-immune-related-toxicities-of-checkpoint-inhibitors
#11
Thomas Knight, Shin Ahn, Terry W Rice, Tim Cooksley
Cancer care has become increasingly specialized and advances in therapy have resulted in a larger number of patients receiving care. There has been a significant increase in the number of patients presenting with cancer related emergencies including treatment toxicities and those directly related to the malignancy. Suspected neutropenic sepsis is an acute medical emergency and empirical antibiotic therapy should be administered immediately. The goal of empirical therapy is to cover the most likely pathogens that will cause life-threatening infections in neutropenic patients...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28989114/is-a-randomized-trial-of-a-short-course-of-aminoglycoside-added-to-%C3%AE-lactam-antibiotics-for-empirical-treatment-in-critically-ill-patients-with-sepsis-justified
#12
D S Y Ong, C H van Werkhoven, O L Cremer, G E Thwaites, M J M Bonten
No abstract text is available yet for this article.
October 5, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28980093/incidence-of-fever-and-positive-bacterial-cultures-in-neonates-receiving-prostaglandin
#13
Fares Alghanem, Stephanie L Rakestraw, Kurt R Schumacher, Gabe E Owens
Prostaglandin E (PGE1) is necessary to maintain ductus arteriosus patency in many newborns with congenital heart disease. Because PGE1 therapy commonly leads to fever, and given this population's fragile state, a complete sepsis workup is often performed in febrile, but otherwise asymptomatic, patients. This practice of liberal evaluation with bacterial cultures, empiric antibiotic treatment, and delays in essential surgical intervention may result in poor resource utilization and lead to increased iatrogenic morbidity...
October 4, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28972883/periorbital-necrotizing-fasciitis-induced-by-streptococcus-pyogenes-a-case-report-and-clarification
#14
Dorothée L Deneubourg, Zulma Catherine, Patrice Lejuste, Pierre Breton
Periorbital necrotizing fasciitis (PONF) is a rare condition of the face. PONF can lead to blindness, functional and esthetic sequelae, multiple-organ failure, and death. The aim of this report is to raise the awareness of this severe condition in maxillofacial surgeons. This report describes the case of a 30-year-old woman who presented with a bilateral palpebral edema and pain 3 days after a jugal wound was sutured. Necrosis of the skin of the left palpebral unit was extending rapidly. The patient had signs of sepsis...
September 11, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28924483/thyroidectomy-for-the-treatment-of-graves-thyrotoxicosis-in-thioamide-induced-agranulocytosis-and-sepsis
#15
Colin L Knight, Shamil D Cooray, Jaideep Kulkarni, Michael Borschmann, Mark Kotowicz
A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol's iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28919283/clinical-manifestations-risk-factors-and-prognosis-of-patients-with-morganella-morganii-sepsis
#16
David Erlanger, Marc Victor Assous, Yonit Wiener-Well, Amos Moshe Yinnon, Eli Ben-Chetrit
BACKGROUND: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. METHODS: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichiacoli sepsis were matched by year of diagnosis and infection acquisition site. RESULTS: The study group included 136 adult patients. Mean age and gender of study and control groups were similar...
September 6, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28885390/epidemiology-of-admissions-from-the-emergency-department-among-febrile-infants-younger-than-90-days-in-the-united-states-2002-to-2012
#17
Diana K Nguyen, Ross J Fleischman, Scott Friedlander, Kenneth M Zangwill
BACKGROUND AND OBJECTIVES: Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. Our objective was to determine the likelihood of admission and associated complications of care for such infants, particularly those at lowest risk for SBI. METHODS: This is a retrospective cohort study including multisite emergency department (ED) visits using administrative data from the Pediatric Emergency Care Applied Research Network Core Data Project...
September 5, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28840713/ultrasensitive-detection-of-antiseptic-antibiotics-in-aqueous-media-and-human-urine-using-deep-uv-resonance-raman-spectroscopy
#18
Christian Domes, Robert Domes, Jürgen Popp, Mathias W Pletz, Torsten Frosch
Deep UV resonance Raman spectroscopy is introduced as an analytical tool for ultrasensitive analysis of antibiotics used for empirical treatment of patients with sepsis and septic shock, that is, moxifloxacin, meropenem, and piperacillin in aqueous solution and human urine. By employing the resonant excitation wavelengths λexc = 244 nm and λexc = 257 nm, only a small sample volume and short acquisition times are needed. For a better characterization of the matrix urine, the main ingredients were investigated...
August 25, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28742677/committee-opinion-no-712-intrapartum-management-of-intraamniotic-infection
#19
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742671/committee-opinion-no-712-summary-intrapartum-management-of-intraamniotic-infection
#20
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
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