Severe Sepsis Care in the Emergency Department

Severe Sepsis Care in the Emergency Department

Drs. John C. Perkins and Michael E. Winters have assembled an expert team of authors on the topic of Sepsis in the Emergency Department. Article topics include: Defining and Diagnosing Sepsis; Appropriate Antibiotic Therapy;... read more

Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration

Dr. Fraser, MD, speaks with Jean Baptiste Lascarrou, MD, about the article, "Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration: Differentiating Pneumonia from Pneumonitis," published in... read more

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying... read more

Phage Treatment of an Aortic Graft Infected with Pseudomonas Aeruginosa

Phage Treatment of an Aortic Graft Infected with Pseudomonas Aeruginosa

Another phage therapy success. Bacteria-killing Viruses found in a pond knocked out an antibiotic resistant infection. Management of prosthetic vascular graft infections caused by Pseudomonas aeruginosa can be a significant... read more

Prehospital Antibiotics Improved Some Aspects of Sepsis Care

Prehospital Antibiotics Improved Some Aspects of Sepsis Care

Training EMS personnel in early recognition of sepsis improved some aspects of care within the acute care chain, but did not reduce mortality, according to results of a randomized trial. Emergency medical service (EMS) personnel... read more

Decision-making in the detection and management of patients with sepsis in resource-limited settings

Decision-making in the detection and management of patients with sepsis in resource-limited settings

We read with interest the study by Andrews et al. and the related correspondence from Shrestha et al. We share the concern that clinical examination (and observations) appear(s) to be perceived as relatively unimportant in... read more

The Effects of Antibiotic Cycling and Mixing on Antibiotic Resistance in ICU

The Effects of Antibiotic Cycling and Mixing on Antibiotic Resistance in ICU

Whether antibiotic rotation strategies reduce prevalence of antibiotic-resistant, Gram-negative bacteria in intensive care units (ICUs) has not been accurately established. We aimed to assess whether cycling of antibiotics... read more

Sepsis Incidence: A Population-Based Study

Sepsis Incidence: A Population-Based Study

The incidence of sepsis with organ dysfunction is higher than most previous estimates independent of definition. The inclusion of all inpatients started on intravenous antibiotic treatment of sepsis in a population makes... read more

Oral Versus Intravenous Antibiotics for the Treatment Of Bone and Joint Infection

Oral Versus Intravenous Antibiotics for the Treatment Of Bone and Joint Infection

Oral antibiotic therapy is non-inferior to IV therapy when used during the first six weeks in the treatment for bone and joint infection, as assessed by definitive treatment failure within one year of randomisation. These... read more

Do We Need New Trials of Procalcitonin-Guided Antibiotic Therapy?

Do We Need New Trials of Procalcitonin-Guided Antibiotic Therapy?

Using biomarkers as a guide to tailor the duration of antibiotic treatment in respiratory infections is an attractive hypothesis assessed in several studies. Recent work aiming to summarize the evidence assessed the effect... read more

Prompt Administration of Antibiotics and Fluids in the Treatment of Sepsis

Prompt Administration of Antibiotics and Fluids in the Treatment of Sepsis

We conclude that antibiotic therapy is highly time sensitive, and efforts should be made to deliver this critical therapy as early as possible in sepsis, perhaps extending into the first point of medical contact outside the... read more

Importance of Second Antibiotic Doses in ED Sepsis Patients

Importance of Second Antibiotic Doses in ED Sepsis Patients

Most studies evaluating early antibiotic administration in sepsis patients focus on timing of the first dose. We highlight many of these studies in our recent review article on Appropriate Antibiotic Therapy in Emergency... read more

Is Fever the Normal Temperature of Sepsis

Is Fever the Normal Temperature of Sepsis

We know that hypothermia in sepsis is associated with increased mortality but other than that we tend to see fever in sepsis as something bad. We tend to perceive sepsis patients as more sick the more the temperature is elevated.... read more

Diagnostic Stewardship for Healthcare-Associated Infections

Diagnostic Stewardship for Healthcare-Associated Infections

Healthcare-associated infections (HAIs) are associated with increased morbidity and mortality, prolonged hospital stays, and unnecessary cost. The financial stakes of HAIs for hospitals were underscored in 2008 when the Centers... read more