Tag: antimicrobial
Outcomes of Older Adults With Sepsis at Admission to an ICU
Our study suggests that treating older adults with therapies recommended by the Surviving Sepsis Campaign may improve outcomes in this age group, although mortality remains high for older adults with sepsis. In addition,... read more
Effect of Antimicrobial De-escalation Strategy on 14-day Mortality Among ICU Patients
The prevalence of antimicrobial de-escalation (ADE) strategy was low among intensive care unit patients. The ADE strategy demonstrated a protective effect or no adverse effect on 14-day mortality compared to the No Change... read more
ICU Precision Diagnosis with Metagenomic Sequencing
Despite promising results, metagenomics remains underutilized in the ICU. Several factors still limit its inclusion in routine critical care, including the lack of definitive clinical trials testing its utility, few laboratories... read more
ICM White Paper Proposes Infection Prevention Roadmap Integrating AMR and Sepsis
The COVID-19 pandemic has put a spotlight on the devastating global health and societal implications an infection can have when there are no preventative interventions or treatment options available. Many countries and most... read more
Timing of Antibiotic Therapy in the ICU
Severe or life threatening infections are common among patients in the intensive care unit (ICU). Most infections in the ICU are bacterial or fungal in origin and require antimicrobial therapy for clinical resolution. Antibiotics... read more
Antimicrobial‑associated Harm in Critical Care
The belief that, for the individual patient, the benefit of prompt and continued use of antimicrobials outweighs any potential harm is a significant barrier to improved stewardship of these vital agents. Antimicrobial... read more
Long-Term Sustainability and Acceptance of Antimicrobial Stewardship in Intensive Care
An antimicrobial stewardship program implemented over a decade resulted in sustained suggestion and acceptance rates. These findings support the need for a persistent presence of audit-and-feedback over time with more frequent... read more
It Is a Marathon, Not a Sprint – Sustainability of Stewardship in ICUs
ICUs are arguably the most important yet most challenging hospital environments for antimicrobial stewardship. The stakes are high with critically ill patients, where the burden of resistant Gram-negative pathogens is greater... read more
New Genomic Tests Aim to Diagnose Deadly Infections Faster
Rapid genomic tests are poised to change the way doctors diagnose and treat infections, but their cost may limit widespread use. Ryan Springer's mystery illness began last summer with a dull ache in his chest. Over the... read more
Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination
Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU... read more
Candida Bloodstream Infection Under Veno-arterial ECMO Therapy
Cavayas et al. recently described invasive fungal infections in patients under extra-corporeal membrane oxygenation (ECMO) of the Extracorporeal Life Support Organization registry. They found a 1.2% prevalence of Candida... read more
Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Sepsis
Among patients with severe manifestations of sepsis, initiation of empirical antimicrobial therapy significantly reduces the sensitivity of blood cultures drawn shortly after treatment initiation. Of 3,164 participants... read more
New Guidelines for Hospital-acquired Pneumonia/Ventilator-associated Pneumonia
American and European guidelines have many areas of common agreement such as limiting antibiotic duration. Both guidelines were in favor of a close clinical assessment. Neither recommended a regular use of biomarkers but... read more
UV Light Reduces Hospital-acquired Infections
A new study published in the American Journal of Infection Control (AJIC) shows that ultraviolet (UV) disinfection technology, called PurpleSun, eliminates up to 97.7 percent of pathogens in the operating room (OR). Using... read more
Antimicrobial Exposure and the Risk of Delirium in Critically Ill Patients
First-, second-, and third-generation cephalosporins doubled the odds of delirium after baseline co-morbidities, ICU type, the course of critical care, and other competing antimicrobial and psychotropic medication risks were... 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
Understanding Central Nervous System Efficacy of Antimicrobials
Defining the optimal treatment of Central Nervous System (CNS) infections is one of the most challenging tasks for the intensivists; the therapeutic window is narrow, and the alternative drug options more limited than with... read more