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EM Infectious Disease

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23 papers 25 to 100 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/29530657/is-loop-drainage-technique-more-effective-for-treatment-of-soft-tissue-abscess-compared-with-conventional-incision-and-drainage
#1
EDITORIAL
Brit Long, Michael D April
No abstract text is available yet for this article.
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29530658/systemic-antibiotics-for-the-treatment-of-skin-and-soft-tissue-abscesses-a-systematic-review-and-meta-analysis
#2
REVIEW
Michael Gottlieb, Joshua M DeMott, Marilyn Hallock, Gary D Peksa
STUDY OBJECTIVE: The addition of antibiotics to standard incision and drainage is controversial, with earlier studies demonstrating no significant benefit. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure rates. METHODS: PubMed, the Cumulative Index of Nursing and Allied Health Literature, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all randomized controlled trials comparing adjuvant antibiotics with placebo in the treatment of drained abscesses, with an outcome of treatment failure assessed within 21 days...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28611889/evaluating-the-laboratory-risk-indicator-to-differentiate-cellulitis-from-necrotizing-fasciitis-in-the-emergency-department
#3
Michael M Neeki, Fanglong Dong, Christine Au, Jake Toy, Nima Khoshab, Carol Lee, Eugene Kwong, Ho Wang Yuen, Jonathan Lee, Arbi Ayvazian, Pamela Lux, Rodney Borger
INTRODUCTION: Necrotizing fasciitis (NF) is an uncommon but rapidly progressive infection that results in gross morbidity and mortality if not treated in its early stages. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is used to distinguish NF from other soft tissue infections such as cellulitis or abscess. This study analyzed the ability of the LRINEC score to accurately rule out NF in patients who were confirmed to have cellulitis, as well as the capability to differentiate cellulitis from NF...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28657870/a-placebo-controlled-trial-of-antibiotics-for-smaller-skin-abscesses
#4
RANDOMIZED CONTROLLED TRIAL
Robert S Daum, Loren G Miller, Lilly Immergluck, Stephanie Fritz, C Buddy Creech, David Young, Neha Kumar, Michele Downing, Stephanie Pettibone, Rebecca Hoagland, Samantha J Eells, Mary G Boyle, Trisha Chan Parker, Henry F Chambers
BACKGROUND: Uncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear. METHODS: We conducted a multicenter, prospective, double-blind trial involving outpatient adults and children. Patients were stratified according to the presence of a surgically drainable abscess, abscess size, the number of sites of skin infection, and the presence of nonpurulent cellulitis...
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/26962903/trimethoprim-sulfamethoxazole-versus-placebo-for-uncomplicated-skin-abscess
#5
RANDOMIZED CONTROLLED TRIAL
David A Talan, William R Mower, Anusha Krishnadasan, Fredrick M Abrahamian, Frank Lovecchio, David J Karras, Mark T Steele, Richard E Rothman, Rebecca Hoagland, Gregory J Moran
BACKGROUND: U.S. emergency department visits for cutaneous abscess have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). The role of antibiotics for patients with a drained abscess is unclear. METHODS: We conducted a randomized trial at five U.S. emergency departments to determine whether trimethoprim-sulfamethoxazole (at doses of 320 mg and 1600 mg, respectively, twice daily, for 7 days) would be superior to placebo in outpatients older than 12 years of age who had an uncomplicated abscess that was being treated with drainage...
March 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28829884/effect-of-oral-prednisolone-on-symptom-duration-and-severity-in-nonasthmatic-adults-with-acute-lower-respiratory-tract-infection-a-randomized-clinical-trial
#6
RANDOMIZED CONTROLLED TRIAL
Alastair D Hay, Paul Little, Anthony Harnden, Matthew Thompson, Kay Wang, Denise Kendrick, Elizabeth Orton, Sara T Brookes, Grace J Young, Margaret May, Sandra Hollinghurst, Fran E Carroll, Harriet Downing, David Timmins, Natasher Lafond, Magdy El-Gohary, Michael Moore
Importance: Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence. Objective: To assess the effects of oral corticosteroids for acute lower respiratory tract infection in adults without asthma. Design, Setting, and Participants: Multicenter, placebo-controlled, randomized trial (July 2013 to final follow-up October 2014) conducted in 54 family practices in England among 401 adults with acute cough and at least 1 lower respiratory tract symptom not requiring immediate antibiotic treatment and with no history of chronic pulmonary disease or use of asthma medication in the past 5 years...
August 22, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28041826/interpretation-of-cerebrospinal-fluid-white-blood-cell-counts-in-young-infants-with-a-traumatic-lumbar-puncture
#7
MULTICENTER STUDY
Todd W Lyons, Andrea T Cruz, Stephen B Freedman, Mark I Neuman, Fran Balamuth, Rakesh D Mistry, Prashant Mahajan, Paul L Aronson, Joanna E Thomson, Christopher M Pruitt, Samir S Shah, Lise E Nigrovic
STUDY OBJECTIVE: We determine the optimal correction factor for cerebrospinal fluid WBC counts in infants with traumatic lumbar punctures. METHODS: We performed a secondary analysis of a retrospective cohort of infants aged 60 days or younger and with a traumatic lumbar puncture (cerebrospinal fluid RBC count ≥10,000 cells/mm3 ) at 20 participating centers. Cerebrospinal fluid pleocytosis was defined as a cerebrospinal fluid WBC count greater than or equal to 20 cells/mm3 for infants aged 28 days or younger and greater than or equal to 10 cells/mm3 for infants aged 29 to 60 days; bacterial meningitis was defined as growth of pathogenic bacteria from cerebrospinal fluid culture...
May 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27716262/new-aspects-in-the-management-of-pneumonia
#8
REVIEW
Elena Prina, Adrian Ceccato, Antoni Torres
Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27694410/corticosteroids-for-community-acquired-pneumonia-a-critical-view-of-the-evidence
#9
EDITORIAL
James D Chalmers
No abstract text is available yet for this article.
October 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27720233/are-antibiotics-necessary-for-dental-pain-without-overt-infection
#10
REVIEW
Michael Gottlieb, Basem Khishfe
No abstract text is available yet for this article.
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#11
REVIEW
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27076965/corticosteroids-in-the-adjunctive-therapy-of-community-acquired-pneumonia-an-appraisal-of-recent-meta-analyses-of-clinical-trials
#12
REVIEW
Charles Feldman, Ronald Anderson
Improving the outcome of patients with community-acquired pneumonia (CAP) is an ongoing challenge, even in the setting of significant advances in antimicrobial chemotherapy and critical care. Recognition of the underlying involvement of inflammation-mediated organ dysfunction as a determinant of adverse outcomes in CAP has aroused intense interest in the protective potential of adjunctive anti-inflammatory therapies in CAP, particularly the role of corticosteroids (CS). This is the primary topic of the current review which is focused on an evaluation of the latest meta-analyses encompassing both recent and earlier clinical trials, with particular emphasis on the stringent meta-analysis undertaken by Siemieniuk and colleagues (Ann Intern Med 2015;163:519-528)...
March 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27130585/procalcitonin-guided-therapy-for-the-initiation-of-antibiotics-in-the-ed-a-systematic-review
#13
REVIEW
Yuri van der Does, Pleunie P M Rood, Juanita A Haagsma, Peter Patka, Eric C M van Gorp, Maarten Limper
BACKGROUND: Procalcitonin (PCT) is a new biomarker with a higher accuracy in the diagnosis of bacterial infections. Utilization of PCT may reduce the number of unnecessary antibiotics prescribed to patients and consequently may decrease the rise in antibiotic resistance. The aim of this systematic review is to determine if a PCT-guided algorithm can safely reduce the number of antibiotics prescribed to all patients with a suspected of infection in the emergency department (ED). METHODS: MEDLINE, EMBASE, Web of Science, COCHRANE central, PubMed publisher, and Google scholar were searched...
July 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/15494903/practice-guidelines-for-the-management-of-bacterial-meningitis
#14
Allan R Tunkel, Barry J Hartman, Sheldon L Kaplan, Bruce A Kaufman, Karen L Roos, W Michael Scheld, Richard J Whitley
No abstract text is available yet for this article.
November 1, 2004: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/21636122/dexamethasone-and-length-of-hospital-stay-in-patients-with-community-acquired-pneumonia-a-randomised-double-blind-placebo-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Sabine C A Meijvis, Hans Hardeman, Hilde H F Remmelts, Rik Heijligenberg, Ger T Rijkers, Heleen van Velzen-Blad, G Paul Voorn, Ewoudt M W van de Garde, Henrik Endeman, Jan C Grutters, Willem Jan W Bos, Douwe H Biesma
BACKGROUND: Whether addition of corticosteroids to antibiotic treatment benefits patients with community-acquired pneumonia who are not in intensive care units is unclear. We aimed to assess effect of addition of dexamethasone on length of stay in this group, which might result in earlier resolution of pneumonia through dampening of systemic inflammation. METHODS: In our double-blind, placebo-controlled trial, we randomly assigned adults aged 18 years or older with confirmed community-acquired pneumonia who presented to emergency departments of two teaching hospitals in the Netherlands to receive intravenous dexamethasone (5 mg once a day) or placebo for 4 days from admission...
June 11, 2011: Lancet
https://www.readbyqxmd.com/read/25608756/adjunct-prednisone-therapy-for-patients-with-community-acquired-pneumonia-a-multicentre-double-blind-randomised-placebo-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Claudine Angela Blum, Nicole Nigro, Matthias Briel, Philipp Schuetz, Elke Ullmer, Isabelle Suter-Widmer, Bettina Winzeler, Roland Bingisser, Hanno Elsaesser, Daniel Drozdov, Birsen Arici, Sandrine Andrea Urwyler, Julie Refardt, Philip Tarr, Sebastian Wirz, Robert Thomann, Christine Baumgartner, Hervé Duplain, Dieter Burki, Werner Zimmerli, Nicolas Rodondi, Beat Mueller, Mirjam Christ-Crain
BACKGROUND: Clinical trials yielded conflicting data about the benefit of adding systemic corticosteroids for treatment of community-acquired pneumonia. We assessed whether short-term corticosteroid treatment reduces time to clinical stability in patients admitted to hospital for community-acquired pneumonia. METHODS: In this double-blind, multicentre, randomised, placebo-controlled trial, we recruited patients aged 18 years or older with community-acquired pneumonia from seven tertiary care hospitals in Switzerland within 24 h of presentation...
April 18, 2015: Lancet
https://www.readbyqxmd.com/read/26416494/irrigation-of-cutaneous-abscesses-does-not-improve-treatment-success
#17
RANDOMIZED CONTROLLED TRIAL
Brian Chinnock, Gregory W Hendey
STUDY OBJECTIVE: Irrigation of the cutaneous abscess cavity is often described as a standard part of incision and drainage despite no randomized, controlled studies showing benefit. Our goal is to determine whether irrigation of a cutaneous abscess during incision and drainage in the emergency department (ED) decreases the need for further intervention within 30 days compared with no irrigation. METHODS: We performed a single-center, prospective, randomized, nonblinded study of ED patients receiving an incision and drainage for cutaneous abscess, randomized to irrigation or no irrigation...
March 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/23184813/adjuvant-steroid-therapy-in-community-acquired-pneumonia-a-systematic-review-and-meta-analysis
#18
REVIEW
Majid Shafiq, Muhammad S Mansoor, Adnan A Khan, M Rizwan Sohail, Mohammad H Murad
BACKGROUND: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality among adults. Although steroids appear to be beneficial in animal models of CAP, clinical trial data in humans are either equivocal or conflicting. PURPOSE: Our purpose was to perform a systematic review and meta-analysis of studies examining the impact of steroid therapy on clinical outcomes among adults admitted with CAP. DATA SOURCES AND STUDY SELECTION: We identified randomized controlled trials (RCTs) through a systematic search of published literature up to July 2011...
February 2013: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/26258555/corticosteroid-therapy-for-patients-hospitalized-with-community-acquired-pneumonia-a-systematic-review-and-meta-analysis
#19
REVIEW
Reed A C Siemieniuk, Maureen O Meade, Pablo Alonso-Coello, Matthias Briel, Nathan Evaniew, Manya Prasad, Paul E Alexander, Yutong Fei, Per O Vandvik, Mark Loeb, Gordon H Guyatt
BACKGROUND: Community-acquired pneumonia (CAP) is common and often severe. PURPOSE: To examine the effect of adjunctive corticosteroid therapy on mortality, morbidity, and duration of hospitalization in patients with CAP. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials through 24 May 2015. STUDY SELECTION: Randomized trials of systemic corticosteroids in hospitalized adults with CAP...
October 6, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26277247/community-acquired-pneumonia
#20
REVIEW
Elena Prina, Otavio T Ranzani, Antoni Torres
Community-acquired pneumonia causes great mortality and morbidity and high costs worldwide. Empirical selection of antibiotic treatment is the cornerstone of management of patients with pneumonia. To reduce the misuse of antibiotics, antibiotic resistance, and side-effects, an empirical, effective, and individualised antibiotic treatment is needed. Follow-up after the start of antibiotic treatment is also important, and management should include early shifts to oral antibiotics, stewardship according to the microbiological results, and short-duration antibiotic treatment that accounts for the clinical stability criteria...
September 12, 2015: Lancet
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