Tag: antibiotics
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
Six Reasons to Avoid Fluoroquinolones in the Critically Ill
As an internal medicine resident and pulmonary/critical care fellow, I loved fluoroquinolones. They were effective, easy to prescribe, and had 100% oral bioavailability. However, working full-time in the ICU has forced me... read more
Viral Sepsis in Children
Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although the incidence of viral-induced sepsis is not precisely known,... read more
Drug-resistant Superbug Spreading in Hospitals
A superbug resistant to all known antibiotics that can cause "severe" infections or even death is spreading undetected through hospital wards across the world, scientists in Australia warned on Monday. Researchers at the... read more
New antibiotics and antimicrobial combination therapy for the treatment of gram-negative bacterial infections
Only few new molecules have an adequate activity against MDR gram-negative pathogens, especially carbapenemase-producer strains. Among these, ceftozolane/tazobactam has been recently approved for clinical use. Other compounds,... read more
Diagnosis and Treatment of Clostridium difficile Infection
Clostridium difficile infection (CDI) is less common than antibiotic-associated diarrhea and irritable bowel syndrome. There is significant concern about overdiagnosis and subsequent overtreatment of CDI with increasing use... read more
Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis
In patients with endocarditis on the left side of the heart who were in stable condition, changing to oral antibiotic treatment was noninferior to continued intravenous antibiotic treatment. After randomization, antibiotic... read more
Probiotic and Synbiotic Therapy in the Critically Ill
Recent medical history has largely viewed our bacterial symbionts as pathogens to be eradicated rather than essential partners in optimal health. However, one of the most exciting scientific advances in recent years has been... read more
Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in ICU patients with infection and sepsis patients
Procalcitonin-guided antibiotic treatment in ICU patients with infection and sepsis patients results in improved survival and lower antibiotic treatment duration. Mortality in the 2252 procalcitonin-guided patients was significantly... read more
Dying as a Pathway to Death in Sepsis
Mortality from sepsis remains high, with at least 270,000 deaths annually in the United States and more than 5 million deaths worldwide. Despite increasing understanding of the pathophysiology of sepsis, outside of targeted... read more
Lies, Damned Lies, and Sepsis Bundles
The Surviving Sepsis Campaign recently released an update to the bundles of care it recommends for "sepsis" patients. You may have heard of the three-hour bundle, which essentially means that you do a bunch of stuff (lactate,... read more
