Tag: antibiotics
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
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
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
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
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
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
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
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 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
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
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?
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
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
"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
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
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
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