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Empiric antibiotic treatment of sepsis

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https://www.readbyqxmd.com/read/29109168/risk-factors-and-outcomes-for-ineffective-empiric-treatment-in-gram-negative-sepsis-stratification-by-onset-of-infection
#1
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
#2
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...
August 2, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
(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
#12
(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/28728477/increased-rate-of-penicillin-non-susceptible-strains-of-n-meningitidis-in-naples-italy
#13
Giovanni Di Caprio, Novella Carannante, Mariano Bernardo, Susanna Cuccurullo, Carlo Pallotto, Carlo Tascini
Neisseria meningitidis is a causative agent of community-acquired sepsis and meningitis in humans. These diseases are associated with high mortality and morbidity if treatment is not started promptly. The empiric antibiotic treatment depends on patient factors and local epidemiology. In the past years, an increased number meningococcal strain with reduced susceptibility to penicillin has also been described. We analysed the susceptibility pattern of 11 N. meningitidis strains isolated between 2013 and 2016...
December 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28711676/should-we-consider-faecal-colonisation-with-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-empirical-therapy-of-community-onset-sepsis
#14
Daša Stupica, Lara Lusa, Mirijam Nahtigal Klevišar, Sara Terzić, Mateja Pirš, Manica Mueller Premru, Franc Strle
In patients colonised with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), the preference for carbapenems (CRBs) over non-CRB antibiotics for empirical therapy of sepsis is questionable from an ecologic perspective. Moreover, how well colonisation predicts an ESBL-E aetiology of infection has been poorly investigated. The purpose of this retrospective observational study was to determine the positive predictive value (PPV) of ESBL-E faecal colonisation for ESBL-E sepsis aetiology and the impact of empirical therapy on treatment outcome...
October 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28705768/the-clinical-and-microbiological-characteristics-of-infections-in-burn-patients-from-the-formosa-fun-coast-dust-explosion
#15
Tzu-Chao Lin, Rui-Xin Wu, Chih-Chien Chiu, Ya-Sung Yang, Yi Lee, Jung-Chung Lin, Feng-Yee Chang
BACKGROUND/PURPOSE: Bloodstream infection is a leading cause of mortality among burn patients. This study aimed to evaluate the risk factors, causative pathogens, and the relationship between bloodstream infections and other infections among burn patients from the Formosa Fun Coast Dust Explosion. METHODS: This retrospective study evaluated the demographic and clinical characteristics, infection types, causative pathogen(s), and isolates' antibiotic susceptibilities from patients who were hospitalized between June 27 and September 31, 2015...
June 22, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28661973/determinants-of-antibiotic-tailoring-in-pediatric-intensive-care-a-national-survey
#16
Patricia S Fontela, Caroline Quach, Mohammad E Karim, Douglas F Willson, Elaine Gilfoyle, James Dayre McNally, Milagros Gonzales, Jesse Papenburg, Steven Reynolds, Jacques Lacroix
OBJECTIVES: To describe the criteria that currently guide empiric antibiotic treatment in children admitted to Canadian PICUs. DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists and pediatric infectious diseases specialists. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used focus groups and literature review to design the survey questions and its four clinical scenarios (sepsis, pneumonia, meningitis, and intra-abdominal infections)...
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28657382/a-pilot-study-evaluating-the-prescribing-of-ceftriaxone-in-hospitals-in-ghana-findings-and-implications
#17
Daniel Kwame Afriyie, Seth Kwabena Amponsah, Justice Dogbey, Kwabena Agyekum, Samuel Kesse, Ilse Truter, Johanna C Meyer, Brian Godman
BACKGROUND AND OBJECTIVES: Widespread empiric use of antibiotics exists especially in developing countries. This is a concern since inappropriate use of antibiotics, including their extended inappropriate use, will increase resistance rates. Consequently, there is a need to evaluate antibiotic utilisation across healthcare sectors to improve future use. This includes ceftriaxone, widely used among hospitals including those in Ghana. METHODS: A cross-sectional study to evaluate the appropriateness of ceftriaxone prescribing in a leading hospital in Ghana...
October 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28588177/antibiotic-susceptibility-pattern-of-bacteria-isolated-from-various-specimens-of-patients-with-hematological-malignancy
#18
J Roy, D C Nag
Infection is a life threatening complication in patients with hematological malignancy. So, proper treatment of infection with suitable antibiotic is very important in these patients. The aim of this study was to determine the antibiotic susceptibility of bacteria isolated from various specimens of patients with hematological malignancy, so that, an appropriate regimen of empiric antibiotic treatment can be established for these patients. This observational study was done in the Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2012 to August 2012...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28566116/adherence-to-local-antimicrobial-guidelines-for-initial-treatment-of-community-acquired-infections
#19
Trine Langfeldt Hagen, Mathias Amdi Hertz, Gábor Balázs Uhrin, Michael Dalager-Pedersen, Henrik Carl Schønheyder, Henrik Nielsen
INTRODUCTION: Adherence to antimicrobial guidelines is key to ensuring a correct treatment of severe infections and to lessening misuse of broad-spectrum antimicrobials. We conducted a retrospective cross-sectional study at the Emergency Department of Aalborg University Hospital, North Denmark Region. Our aim was to examine adherence to local antimicrobial guidelines in the empirical treatment of community-acquired infections and to identity any predictors of guideline non-adherence. METHODS: We identified 1,555 patients who had blood cultures performed and were admitted to the medical emergency department in 2016...
June 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28552972/pseudomonas-aeruginosa-urinary-tract-infections-in-hospitalized-patients-mortality-and-prognostic-factors
#20
Jose Luis Lamas Ferreiro, Judith Álvarez Otero, Lucía González González, Luis Novoa Lamazares, Alexandra Arca Blanco, Jose Ramón Bermúdez Sanjurjo, Irene Rodríguez Conde, María Fernández Soneira, Javier de la Fuente Aguado
BACKGROUND: The aim of this study was to analyze the mortality and predictors of 30-day mortality among hospitalized patients with Pseudomonas aeruginosa urinary tract infection (PAUTI) and the impact of antibiotic treatment on survival. METHODS: Patients admitted to our hospital with PAUTI or those diagnosed of PAUTI during hospitalization for other disease between September 2012 and September 2014 were included. Repeated episodes from the same patient were excluded...
2017: PloS One
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