Metabolic Sepsis Resuscitation

Metabolic Sepsis Resuscitation

There are roughly two strategies for adjusting the intensity of treatment: Titrated strategy: Treatment intensity is adjusted to match the severity of the disease. Escalation-deescalation strategy: Treatment intensity is... read more

Antibiotics for the Critically Ill Patient

Antibiotics for the Critically Ill Patient

We spend a lot of time obsessing over the finer details of critical care: which fluid is best? which vasopressor is best? will another liter of fluid help? These details are important, but for a septic patient something... read more

Early Lactate Measurements Appear to Improve Results for Septic Patients

Early Lactate Measurements Appear to Improve Results for Septic Patients

The study by Churpek and colleagues was designed to evaluate both the frequency of urgent lactate measurements and their association with clinician interventions and mortality. An elevated lactate level means that a patient's... read more

Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations

Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations

Significant gaps exist between CDC recommendations to improve antibiotic use and antibiotic practices during the newborn period. There is wide variation in point prevalence AURs. Three-quarters of infants who received antibiotics... read more

Principles of Fluid Management and Stewardship in Septic Shock

Principles of Fluid Management and Stewardship in Septic Shock

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... read more

Antimicrobial Chemical Tied to Antibiotic Resistance Genes in Dust

Antimicrobial Chemical Tied to Antibiotic Resistance Genes in Dust

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... read more

Antimicrobial copper touch surfaces may help fight global threat of antibiotic resistance

Antimicrobial copper touch surfaces may help fight global threat of antibiotic resistance

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... read more

Bacteria ‘alarm clock’ may cause repeat infections in patients

Bacteria ‘alarm clock’ may cause repeat infections in patients

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... read more

The combination of procalcitonin and C-reactive protein or presepsin alone improves the accuracy of diagnosis of neonatal sepsis

The combination of procalcitonin and C-reactive protein or presepsin alone improves the accuracy of diagnosis of neonatal sepsis

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... read more

A Bold New Strategy for Stopping the Rise of Superbugs

A Bold New Strategy for Stopping the Rise of Superbugs

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... read more

Cost-effectiveness of Procalcitonin Testing to Guide Antibiotic Treatment Duration in Critically Ill Patients

Cost-effectiveness of Procalcitonin Testing to Guide Antibiotic Treatment Duration in Critically Ill Patients

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... read more

Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?

Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?

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... read more

PPIs do not increase risk for C. difficile infection in ICU

PPIs do not increase risk for C. difficile infection in ICU

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... read more

Chasing Mortality Endpoints is a Fool’s Errand

Chasing Mortality Endpoints is a Fool’s Errand

"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... read more

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

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... read more

Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients

Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients

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,... read more

Decontamination of Oral or Digestive Tract for Patients in the ICU

Decontamination of Oral or Digestive Tract for Patients in the ICU

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... read more