Tag: antibiotics

Upvote Story 9
There are only four major indications for fluid administration in the critically ill: resuscitation, maintenance, replacement and nutrition (enteral or parenteral). In this review, a conceptual framework is presented looking at fluids as drugs by taking into account the four D’s (drug selection, dose, duration and de-escalation) and the four phases of fluid therapy within the ROSE concept (resuscitation, optimization, stabilization and evacuation). The four... Read More | Comment
Upvote Story 10
For patients in the ED who are suspected of having sepsis, swift, effective management is vital to improving outcomes. This issue reviews the latest evidence on the diagnosis and treatment of sepsis and septic shock: How do the definitions of sepsis affect treatment decisions – and CMS quality measurements? Is SOFA scoring in the ED possible? Is quickSOFA scoring helpful? How can you identify the... Read More | Comment
Upvote Story 13
This book is unique in approaching multiple organ dysfunction syndrome (MODS) from the perspective of its pathophysiological mechanism, and addressing aspects that are overlooked in most of the available literature. Eminent experts in the field from Europe and beyond offer new insights into risk stratification, severity assessment, and management of critically ill patients with sepsis. The principal focus is on recently developed concepts in infection... Read More | Comment
Upvote Story 5
Most people have heard about antibiotic-resistant germs. But how about antibiotic-resistant dust? A new Northwestern University study has found that an antimicrobial chemical called triclosan is abundant in dust — and linked to changes in its genetic makeup. The result is dust with organisms that could cause an antibiotic-resistant infection. Hartmann’s study compared dust samples collected from 42 athletic facilities in the Pacific Northwest region.... Read More | Comment
Upvote Story 6
Copper is a powerful antimicrobial with rapid, broad-spectrum efficacy against bacteria and viruses, and has been shown to kill disease-causing pathogens, including influenza A, E.coli and norovirus, and resistant bacteria including Methicillin-resistant Staphylococcus aureus (MRSA), Carbapenem-resistant Enterobacteriaceae (CRE) and Vancomycin-resistant enterococcus (VRE). It shares this benefit with a range of copper alloys—such as brasses and bronzes—forming a family of materials collectively called ‘antimicrobial copper’. Antimicrobial... Read More | Comment
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Scientists have discovered a bacteria ‘alarm clock’ that wakes dormant Salmonella in the body, allowing the bug to trigger a repeat infection. The researchers, from Imperial College London, say the ‘alarm clock’ is shared among different types of bacteria—including Salmonella and E. coli. The findings may explain why some people suffer repeated bouts of infections—for instance ear or urinary tract infections—despite taking antibiotics. The team... Read More | Comment
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The combination of PCT and CRP or presepsin alone improves the accuracy of diagnosis of neonatal sepsis. However, further studies are required to confirm these findings. A total of 28 studies enrolling 2661 patients were included in our meta-analysis. The pooled sensitivity of CRP (0.71 (0.63, 0.78)) was weaker than that of PCT (0.85 (0.79, 0.89)), PCT + CRP (0.91 (0.84, 0.95)) and presepsin (0.94 (0.80, 0.99))... Read More | Comment
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Researchers conducted a review of the effects of corticosteroids given in addition to antibiotics to children with septic arthritis. Evidence was sought until April 2018. After searching for all relevant studies, reviewers found two studies with 149 children. These studies were conducted in hospitalized children with a normal immune system between the ages of three months and 18 years living in Costa Rica and Israel.... Read More | Comment
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Scientists have pinpointed a molecule that accelerates the evolution of drug-resistant microbes. Now they’re trying to find a way to block it. The British chemist Leslie Orgel reputedly once said that “evolution is cleverer than you are.” This maxim, now known as Orgel’s Second Rule, isn’t meant to imply that evolution is intelligent or conscious, but simply that it’s inventive beyond the scope of human... Read More | Comment
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Although the impact of PCT guidance on total healthcare-related costs during the initial hospitalisation episode is likely negligible, the lower in-hospital mortality may lead to a non-significant increase in costs over a one-year time horizon. However, since uncertainty remains, it is recommended to investigate the long-term cost-effectiveness of PCT guidance, from a societal perspective, in different countries and settings. A trial-based analysis was performed to... Read More | Comment
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
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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
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“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
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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