Tag: antibiotics

Upvote Story 15
In this multicentre study, we could not demonstrate any difference between Lp299 and CHX used in oral care procedures regarding their impact on colonisation with emerging potentially pathogenic enteric bacteria in the oropharynx and trachea. Potentially pathogenic enteric bacteria not present at inclusion were identified in oropharyngeal samples from 29 patients in the CHX group and in 31 samples in the probiotic group. One hundred... Read More | Comment
Upvote Story 7
Proton pump inhibitors are not associated with an increased risk for Clostridium difficile infection in ICU patients, according to the results of a retrospective cohort study. PPI use was not associated with a significant increase in CDI risk among patients who did not receive antibiotics (aHR = 1.56; 95% CI, 0.72-3.35). However, PPI use was actually associated with a lower risk for CDI among patients... Read More | Comment
Upvote Story 5
“There is no mortality benefit for that.” How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn’t bother with it. But, what does it actually mean if there is no proven mortality benefit? Several factors conspire to make it nearly impossible to prove mortality benefit in critical care: Mortality is... Read More | Comment
Upvote Story 5
Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The findings do not support the use of low-dose theophylline as adjunctive therapy to inhaled corticosteroids for the prevention of COPD exacerbations. Of the 1567 participants analyzed, mean (SD) age was 68.4 (8.4)... Read More | Comment
Upvote Story 9
In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality, in ventilated ICU patients when compared with standard care, which included universal daily BWs with CHX during ICU stay and a hand hygiene program. Furthermore, the unitwide prevalence of carriage with antibiotic-resistant... Read More | Comment
Upvote Story 5
The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these practices. Since the first use of selective decontamination of the digestive tract (SDD) in critically ill patients in the 1980s, the effectiveness of this approach to prevent ICU-acquired infections and reduce... Read More | Comment
Upvote Story 5
As an internal medicine resident and pulmonary/critical care fellow, I loved fluoroquinolones. They were effective, easy to prescribe, and had 100% oral bioavailability. However, working full-time in the ICU has forced me to realize that these drugs aren’t so wonderful for the critically ill. Ironically, the advantages of fluoroquinolones have also been their Achilles’ heel (no pun intended). Fluoroquinolones are the #1 most commonly used... Read More | Comment
Upvote Story 4
Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although the incidence of viral-induced sepsis is not precisely known, it is suspected to be common and may represent an important subset of children with “culture-negative sepsis.” It is therefore critical for clinicians to suspect and test for viral infection in children with culture-negative... Read More | Comment
Upvote Story 13
Sepsis is medicine’s last remaining preserve for unrestrained antibiotic prescribing. The Surviving Sepsis Campaign guidelines recommend empirical broad-spectrum therapy within one hour of triage for both sepsis and septic shock. This recommendation, and mandates that compel it, encourage clinicians to adopt an approach of “treat first, ask questions later” for patients with any possibility of serious infection. This approach fails to account for the difficulties... Read More | Comment
Upvote Story 19
A superbug resistant to all known antibiotics that can cause “severe” infections or even death is spreading undetected through hospital wards across the world, scientists in Australia warned on Monday. Researchers at the University of Melbourne discovered three variants of the multidrug-resistant bug in samples from 10 countries, including strains in Europe that cannot be reliably tamed by any drug currently on the market. The... Read More | Comment
Upvote Story 16
Only few new molecules have an adequate activity against MDR gram-negative pathogens, especially carbapenemase-producer strains. Among these, ceftozolane/tazobactam has been recently approved for clinical use. Other compounds, such as avibactam combinations, plazomicin, and eravacycline, have shown promising activity in phase 2 and 3 clinical trials. A limited number of large trials have assessed the treatment options for commonly encountered resistant pathogens Read More | Comment
Upvote Story 7
Clostridium difficile infection (CDI) is less common than antibiotic-associated diarrhea and irritable bowel syndrome. There is significant concern about overdiagnosis and subsequent overtreatment of CDI with increasing use of NAATs, especially when applied inappropriately to patients who do not have diarrhea or for patients with another cause of diarrhea. This can lead to CDI overdiagnosis and delay in diagnosis and treatment of the actual underlying... Read More | Comment
Upvote Story 5
In patients with endocarditis on the left side of the heart who were in stable condition, changing to oral antibiotic treatment was noninferior to continued intravenous antibiotic treatment. After randomization, antibiotic treatment was completed after a median of 19 days (interquartile range, 14 to 25) in the intravenously treated group and 17 days (interquartile range, 14 to 25) in the orally treated group (P=0.48). In... Read More | Comment
Upvote Story 15
Recent medical history has largely viewed our bacterial symbionts as pathogens to be eradicated rather than essential partners in optimal health. However, one of the most exciting scientific advances in recent years has been the realization that commensal microorganisms (our microbiome) play vital roles in our physiology as humans in nutrition, vitamin synthesis, drug metabolism, protection against infection, and recovery from illness. Recent data show... Read More | Comment
Upvote Story 11
Procalcitonin-guided antibiotic treatment in ICU patients with infection and sepsis patients results in improved survival and lower antibiotic treatment duration. Mortality in the 2252 procalcitonin-guided patients was significantly lower compared with the 2230 control group patients (21.1% vs 23.7%; adjusted odds ratio 0.89, 95% confidence interval (CI) 0.8 to 0.99; p = 0.03). For this meta-analysis focusing on procalcitonin-guided antibiotic management in critically ill patients with sepsis... Read More | Comment