Presenting Symptoms Independently Predict Mortality in Septic Shock

Presenting Symptoms Independently Predict Mortality in Septic Shock

More than one third of patients with septic shock presented to the emergency department with vague symptoms that were not specific to infection. These patients had delayed antibiotic administration and higher risk of mortality... read more

Immunotherapy for Sepsis: A Good Idea or Another Dead End?

Immunotherapy for Sepsis: A Good Idea or Another Dead End?

THE treatment of sepsis remains an intractable problem in critical care. It has been called the “graveyard”1 for pharmaceutical companies in recognition of dozens of negative clinical trials; this reflects multiple distinct... read more

Bacterial protein structure could aid development of new antibiotics

Bacterial protein structure could aid development of new antibiotics

Bacterial cells have an added layer of protection, called the cell wall, that animal cells don't. Assembling this tough armor entails multiple steps, some of which are targeted by antibiotics like penicillin and vancomycin.... read more

Antibiotic Decisions in the ICU: A Dragon’s Tale

Antibiotic Decisions in the ICU: A Dragon’s Tale

Medical decision-making about antibiotic use in critically ill patients is challenging and complex. The need for antibiotic stewardship requires judicious prescription and choice of antimicrobials, as the need for effective... read more

Utility of Adjunct Antibiotics After I+D – Systematic Review + Meta-Analysis

Utility of Adjunct Antibiotics After I+D – Systematic Review + Meta-Analysis

Skin and soft tissue abscesses are a common emergency department (ED) presentation. The approach to management has changed little in recent decades: incision and drainage (I+D) and then discharge home with follow up. However,... read more

Distinguishing Pneumonia From Pneumonitis to Safely Discontinue Antibiotics

Distinguishing Pneumonia From Pneumonitis to Safely Discontinue Antibiotics

Consequences of pulmonary aspiration can be biphasic with dissimilar sequelae. An early phase, coined pneumonitis, involves an inflammatory reaction to gastrointestinal contents with a pH typically less than 2.4 resulting... read more

Current efforts to fight sepsis aren’t working. We need a bolder approach

Current efforts to fight sepsis aren’t working. We need a bolder approach

Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it's easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right:... read more

Epidemiology of Sepsis in Turkish ICUs

Epidemiology of Sepsis in Turkish ICUs

The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms,... read more

Excess dietary zinc worsens Clostridium difficile infection

Excess dietary zinc worsens Clostridium difficile infection

The consumption of dietary supplements and cold therapies containing high concentrations of zinc is now being called into question, following research that suggests it may worsen Clostridium difficile infection. The findings... read more

Empiric Antibiotics Tend To Be Prolonged in ICU

Empiric Antibiotics Tend To Be Prolonged in ICU

Using antibiotics in critically ill patients is very much walking a tightrope. No one wants to miss an infection in a patient who could go downhill quickly, but no one wants to overuse these precious drugs, either.... read more

The Emerging Role of the Microbiota in the ICU

The Emerging Role of the Microbiota in the ICU

The importance of the intestinal and lung microbiotas is often overlooked on the ICU. Currently, we can explore the microbiome using a vast array of techniques, giving us 'meta' libraries of data, which has allowed researchers... read more

Severe Sepsis Care in the Emergency Department

Severe Sepsis Care in the Emergency Department

Drs. John C. Perkins and Michael E. Winters have assembled an expert team of authors on the topic of Sepsis in the Emergency Department. Article topics include: Defining and Diagnosing Sepsis; Appropriate Antibiotic Therapy;... read more

Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration

Dr. Fraser, MD, speaks with Jean Baptiste Lascarrou, MD, about the article, "Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration: Differentiating Pneumonia from Pneumonitis," published in... read more

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections

Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections

Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying... read more

Phage Treatment of an Aortic Graft Infected with Pseudomonas Aeruginosa

Phage Treatment of an Aortic Graft Infected with Pseudomonas Aeruginosa

Another phage therapy success. Bacteria-killing Viruses found in a pond knocked out an antibiotic resistant infection. Management of prosthetic vascular graft infections caused by Pseudomonas aeruginosa can be a significant... read more

Prehospital Antibiotics Improved Some Aspects of Sepsis Care

Prehospital Antibiotics Improved Some Aspects of Sepsis Care

Training EMS personnel in early recognition of sepsis improved some aspects of care within the acute care chain, but did not reduce mortality, according to results of a randomized trial. Emergency medical service (EMS) personnel... read more

Decision-making in the detection and management of patients with sepsis in resource-limited settings

Decision-making in the detection and management of patients with sepsis in resource-limited settings

We read with interest the study by Andrews et al. and the related correspondence from Shrestha et al. We share the concern that clinical examination (and observations) appear(s) to be perceived as relatively unimportant in... read more