It Is a Marathon, Not a Sprint – Sustainability of Stewardship in ICUs

ICUs are arguably the most important yet most challenging hospital environments for antimicrobial stewardship. The stakes are high with critically ill patients, where the burden of resistant Gram-negative pathogens is greater... read more

It Is a Marathon, Not a Sprint – Sustainability of Stewardship in ICUs

Evaluation and Treatment of Renal and Perinephric Abscesses

A 30-year-old woman with past medical history of type 2 diabetes presents to the emergency department with 3 days of vague abdominal/back pain, with associated subjective fever, chills, nausea and vomiting. She states she... read more

Evaluation and Treatment of Renal and Perinephric Abscesses

Ultrasound Probe: POCUS for Flexor Tenosynovitis

A 21 year-old female with no past medical history presented to the emergency department (ED) with ring finger pain and swelling of her right hand over the past six days. According to the patient, she initially developed a... read more

Ultrasound Probe: POCUS for Flexor Tenosynovitis

ED Evaluation and Management of Non-Obstetric Abdominal Pain in the Pregnant Patient

A 27-year-old G4P2 female at 25-weeks gestation presents to the emergency department with right upper quadrant abdominal pain. The pain began yesterday and was initially a generalized discomfort that localized to the right... read more

ED Evaluation and Management of Non-Obstetric Abdominal Pain in the Pregnant Patient

Management of Children With Fever at Risk for Pediatric Sepsis

Many febrile children (41%) present with warning signs for sepsis, with only few of them undergoing investigations or treatment for true sepsis. Children with positive isolates in blood or CSF culture presented in a heterogeneous... read more

Management of Children With Fever at Risk for Pediatric Sepsis

Approach to New Fever or Rigors in the ICU Patient

Failure to recognize neutropenic fever as a separate entity that requires immediate treatment. Routinely ordering urinalysis and sputum cultures (for most patients, this will only lead to false-positive results and unnecessary... read more

Approach to New Fever or Rigors in the ICU Patient

Biomarkers of Sepsis: Time for a Reappraisal

The precise roles of most biomarkers in the management of septic patients have not been well defined, and of the many biomarkers that have been studied, only a few have been evaluated in large or repeated studies. As... read more

Biomarkers of Sepsis: Time for a Reappraisal

Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues

Renowned microbiologist Dr. Martin J. Blaser invites us into the wilds of the human microbiome, where for hundreds of thousands of years bacterial and human cells have existed in a peaceful symbiosis that is responsible for... read more

Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues

Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine

The epic history of how antibiotics were born, saving millions of lives and creating a vast new industry known as Big Pharma. As late as the 1930s, virtually no drug intended for sickness did any good; doctors could set... read more

Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine

Alton’s Antibiotics and Infectious Disease: The Layman’s Guide to Available Antibacterials in Austere Settings

Alton's Antibiotics and Infectious Disease is a unique simplified guide to using antibacterial and antifungal veterinary medications. It is meant to help the non-medical professional in disaster, survival, and other austere... read more

Alton’s Antibiotics and Infectious Disease: The Layman’s Guide to Available Antibacterials in Austere Settings

New Genomic Tests Aim to Diagnose Deadly Infections Faster

Rapid genomic tests are poised to change the way doctors diagnose and treat infections, but their cost may limit widespread use. Ryan Springer's mystery illness began last summer with a dull ache in his chest. Over the... read more

New Genomic Tests Aim to Diagnose Deadly Infections Faster

Time to Recognition of Sepsis in the Emergency Department Using Electronic Health Record Data

Systemic inflammatory response syndrome and Sequential Organ Failure Assessment initially identified distinct populations. Using systemic inflammatory response syndrome resulted in earlier electronic health record sepsis... read more

Time to Recognition of Sepsis in the Emergency Department Using Electronic Health Record Data

Superbugs: The Race to Stop an Epidemic

A New York Times bestselling author shares this exhilarating story of cutting-edge science and the race against the clock to find new treatments in the fight against the antibiotic-resistant bacteria known as superbugs. Physician,... read more

Superbugs: The Race to Stop an Epidemic

Compliance With Evidence-Based Processes of Care After Transitions Between Staff Intensivists

No significant impact of transitions of care observed between individual staff physicians on evidence-based processes of care for mechanically ventilated adult patients. However, transitions were associated with a lower likelihood... read more

Compliance With Evidence-Based Processes of Care After Transitions Between Staff Intensivists

Could the Furosemide Stress Test Clarify Resuscitative Goals?

Imagine that you admit a patient with septic shock. You resuscitate the patient as best you can with inopressors, fluids, and antibiotics. An adequate blood pressure is achieved. A reasonable amount of fluid is administered.... read more

Could the Furosemide Stress Test Clarify Resuscitative Goals?

Delay in Antibiotic Administration Is Associated With Mortality Among Septic Shock Patients With Staphylococcus Aureus Bacteremia

The results of this study further support the importance of prompt appropriate antibiotic administration for patients with septic shock. Physicians should consider acting quickly to administer antibiotics with S. aureus... read more

Delay in Antibiotic Administration Is Associated With Mortality Among Septic Shock Patients With Staphylococcus Aureus Bacteremia

Sepsis

Written by an international group of experts in the field, Sepsis, Third Edition is a valuable resource that provides the most practical information for clinicians and practitioners who treat this complication in the ICU.... read more

Sepsis

Time to Treatment and Mortality during Mandated Emergency Care for Sepsis

More rapid completion of a 3-hour bundle of sepsis care and rapid administration of antibiotics, but not rapid completion of an initial bolus of intravenous fluids, were associated with lower risk-adjusted in-hospital mortality. Among... read more

Time to Treatment and Mortality during Mandated Emergency Care for Sepsis

Incidence of Bloodstream Infections, Length of Hospital Stay, and Survival in Patients With Recurrent CDI Treated With Fecal Microbiota Transplantation or Antibiotics

In a propensity score–matched cohort, patients with recurrent Clostridioides difficile Infection (CDI) treated with fecal microbiota transplantation (FMT) were less likely to develop primary bloodstream infection (BSI). Of... read more

Incidence of Bloodstream Infections, Length of Hospital Stay, and Survival in Patients With Recurrent CDI Treated With Fecal Microbiota Transplantation or Antibiotics

Probiotics Linked to Bloodstream Infections in ICU Patients

People carry a community of microbes in and on our bodies, and they can have a powerful influence on our physiology in many ways. Probiotics, which are live microbes, are intended to improve human health, and they sometimes... read more

Probiotics Linked to Bloodstream Infections in ICU Patients

Probiotics for the Prevention of Antibiotic-associated Diarrhea in Children

Antibiotic-associated diarrhea (AAD) occurs when antibiotics disturb the natural balance of "good" and "bad" bacteria in the intestinal tract causing harmful bacteria to multiply beyond their normal numbers. The symptoms... read more

Probiotics for the Prevention of Antibiotic-associated Diarrhea in Children

Prophylactic Antibiotics After Cardiac Arrest?

This is a multicenter, double-blind, placebo-controlled trial of patients resuscitated from shockable out-of-hospital cardiac arrest.​ Patients were randomized to placebo versus intravenous amoxicillin-clavulanate for two... read more

Prophylactic Antibiotics After Cardiac Arrest?