Tag: antibiotics
Sepsis: Personalization vs. Protocolization?
The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more
Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more
How to Deal with Severe Acute Pancreatitis in the Critically Ill
Management of severe acute pancreatitis (SAP) is multimodal with emphasis on monitoring, adequate fluid resuscitation, avoiding prophylactic use of antibiotics, cause-directed procedures or treatment, and organ support. There... read more
New Approaches Reduces Inappropriate Antibiotic Usage
A UC Davis study of 9 emergency departments and urgent care centers in California and Colorado found educating physicians and patients about safe antibiotic use can cut overuse by 30%. The study, funded under a contract from... read more
Antibiotics for Sepsis
Antibiotics for Sepsis - Does Each Hour Really Count? Or is it Incestuous Amplification? - by Prof Mervyn Singer "Each hour's delay in initiating antibiotics costs lives" is a doctrine that has attained quasi religious status.... read more
Identifying At-Risk Patients for Sub-optimal Beta-lactam Exposure in Critically Ill Patients with Severe Infections
Conventional beta-lactam dosing is flawed in critically ill patients. Useful tools such as the MeroRisk Calculator need to be comprehensively evaluated clinically, and if successful should be added into clinical practice... read more
The Epidemiology of Symptomatic Catheter-associated Urinary Tract Infections in the ICU
Catheter-associated urinary tract infection (CAUTI) occurs frequently in critical illness with significant morbidity, mortality, and additional hospital costs. The epidemiology of symptomatic ward-acquired CAUTI (within 48... read more
Environment key battle ground in fight to tackle antibiotic resistance
The environment could be as important a battle ground as the clinic in the global fight against the spread of antibiotic resistance, new research has shown. A study conducted at the University of Exeter Medical School concluded... read more
Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System
Today I'll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most... read more
ED Door-to-Antibiotic Time and Long-term Mortality in Sepsis
Delays in ED antibiotic initiation time are associated with clinically important increases in long-term, risk-adjusted sepsis mortality. This study investigated the association of door-to-antibiotic time with long-term mortality... read more
Evidence Backs Giving Probiotics with Antibiotics
So much of what we're told to do calls for sweeping practice changes or titanic additions to our routine approach. My own articles have advocated for tremendous shifts in typical techniques, and one need not look far to find... read more
Optimizing Beta-Lactam Treatment in the ICU
The French Society of Pharmacology and Therapeutics (SFPT) and the French Society of Anesthesia and Intensive Care Medicine (SFAR) have released guidelines on the optimization of beta-lactam treatment in intensive care unit... read more
Antibiotics for Sepsis – Finding the Equilibrium
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... read more
Procalcitonin does not curb antibiotic use for lower respiratory tract infection
In the Procalcitonin Antibiotic Consensus Trial (ProACT), the use of a procalcitonin-guided antibiotic prescription guideline did not result in less exposure to antibiotics than did usual care among patients presenting to... read more
Diagnosis and Management of Acute Exacerbations of COPD – Pharmacology CME
As more and more patients present to the ED with symptoms that suggest an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) –worsening dyspnea, cough and sputum production – emergency clinicians can... read more
Updates and Controversies in the Early Management of Sepsis and Septic Shock
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: ... read more
Clostridium difficile infection in the ICU
About 10% of patients with diarrhea will test positive for CDI. Around 2% of ICU patients develop an episode of CDI. Estimating the severity of CDI is essential for prognosis and therapy. Diagnosis and estimation of disease... read more
