Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Dec 2012
In primary health care, never prescribe antibiotics to patients suspected of having an uncomplicated sore throat caused by group A beta-haemolytic streptococci without first confirming the presence of this bacterium.
There are several consensus-describing decision rules for patients in primary health care with a sore throat. The objective of this study was to estimate the number of unnecessary antibiotic prescriptions in primary health care given to patients with a sore throat, due to these different decision rules. A further aim was to suggest revised rules for decision-making in primary health care, when a sore throat caused by group A beta-haemolytic streptococci (GAS) is suspected. ⋯ The single most important rule in primary health care to minimize the risk of unnecessary antibiotic prescription to patients with an uncomplicated sore throat, and where an infection with GAS is suspected, is to never prescribe antibiotics at the first visit without first confirming the presence of this bacterium. Adding more decision rules may to some extent further reduce the number of unnecessary antibiotic prescriptions.
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Scand. J. Infect. Dis. · Nov 2012
Changes in the aerobic faecal flora of patients treated with antibiotics for acute intra-abdominal infection.
An open observational study was performed to investigate changes in the rectal flora and antibiotic susceptibility among faecal bacteria in patients treated with antibiotics for acute intra-abdominal infection. ⋯ Following antibiotic treatment, a shift in the aerobic rectal flora to species with intrinsic antibiotic resistance was observed. This indicates that the emergence of resistance is not due to new mutations, but rather to selection of more resistant species. This should be taken into account when designing treatments for secondary intra-abdominal infections.
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Scand. J. Infect. Dis. · Oct 2012
Reliability of a rapid test for the clinical diagnosis of influenza A/H1N1 2009.
The rapid diagnosis of a pandemic influenza A/H1N1 2009 (H1N1pdm) virus infection is required in ambulatory care settings, since early identification can prevent further transmission. However, the sensitivity of rapid influenza diagnostic tests (RIDTs) is still questionable, and specific indicators for H1N1pdm and/or false-negative results by RIDTs have not been clearly determined. ⋯ We have demonstrated that the RIDT is reliable for the diagnosis of H1N1pdm infection. Taking into consideration the time interval between onset and consultation and other features of H1N1pdm, such as contagiousness and headache, it may be necessary to re-test RIDT-negative cases later.
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Scand. J. Infect. Dis. · Oct 2012
Venous lactate levels can be used to identify patients with poor outcome following community-onset norovirus enteritis.
Norovirus enteritis (NVE) can be fatal in frail patients. High blood lactate levels indicate hypoperfusion and predict mortality in many infectious diseases. The objective was to determine the frequency and association with mortality of elevated lactate levels in patients with community-onset NVE. ⋯ We observed a high proportion of patients with elevated lactate levels in community-onset NVE. Lactate elevation could predict mortality. Measurement of blood lactate may be a valuable tool in the clinical management of patients with a suspected norovirus infection.
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Scand. J. Infect. Dis. · Sep 2012
Role of plasma bactericidal/permeability-increasing protein, group IIA phospholipase A(2), C-reactive protein, and white blood cell count in the early detection of severe sepsis in the emergency department.
To study the diagnostic values of bactericidal/permeability-increasing protein (BPI), group IIA phospholipase A(2) (PLA(2)GIIA), white blood cell count (WBC), and C-reactive protein (CRP) in identifying severe sepsis upon admission in an emergency room. ⋯ PLA(2)GIIA seemed to be superior to CRP, BPI, and WBC in differentiating patients with severe sepsis. BPI gave no additional information in this respect.