The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · Jul 2008
Risk factors for nephrotoxicity associated with continuous vancomycin infusion in outpatient parenteral antibiotic therapy.
Continuous vancomycin infusion is increasingly used for outpatient management of infections, but the relationship between vancomycin and nephrotoxicity is controversial. We investigated the risk factors associated with nephrotoxicity in this setting. ⋯ We have identified independent risk factors for nephrotoxicity in patients receiving continuous infusion vancomycin in OPAT. A serum steady-state vancomycin concentration > or =28 mg/L markedly increases the risk.
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J. Antimicrob. Chemother. · Jun 2008
Gram-negative bacteraemia in non-ICU patients: factors associated with inadequate antibiotic therapy and impact on outcomes.
A considerable number of gram-negative bacteraemias occur outside intensive care units (ICUs). Inadequate antibiotic therapy in ICUs has been associated with adverse outcomes; however, there are no prospective studies in non-ICU patients. ⋯ Nearly one-third of the non-ICU patients with gram-negative bacteraemia received inadequate empirical antibiotic therapy. There was no difference in adverse outcomes between patients receiving inadequate or adequate therapy in this study.
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J. Antimicrob. Chemother. · May 2008
Profound effect of study design factors on ventilator-associated pneumonia incidence of prevention studies: benchmarking the literature experience.
The ventilator-associated pneumonia incident proportion (VAP-IP) is highly variable among control groups of studies of methods for its prevention. The objective here is to develop and validate a literature-derived benchmark against which these groups can be profiled. ⋯ Study design factors such as concurrency and study size have potentially greater influence on the VAP-IP than do the VAP prevention methods under study. The outlier status of control groups were inapparent in the individual studies and the meta-analyses and yet would have confounded the estimates of treatment effect.
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J. Antimicrob. Chemother. · Apr 2008
Multidrug-resistant Acinetobacter meningitis in neurosurgical patients with intraventricular catheters: assessment of different treatments.
The treatment of multidrug-resistant Acinetobacter baumannii meningitis is a serious therapeutic problem due to the limited penetration of antibiotics into the CSF. We describe the clinical features and the outcome of a group of patients with nosocomial neurosurgical meningitis treated with different therapeutic options. ⋯ Nosocomial Acinetobacter meningitis has a high mortality. Combined therapy with iv and intrathecal colistin is a useful and safe option in the treatment of nosocomial Acinetobacter meningitis.
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J. Antimicrob. Chemother. · Apr 2008
Review Meta AnalysisStatins for infection and sepsis: a systematic review of the clinical evidence.
Statins are currently used for hyperlipidaemia control and considered useful for protection from cardiovascular events. In addition, there is increasing evidence for the potential use of statins in preventing and treating infections. ⋯ The majority of the studies suggest that statins may have a positive role in the treatment of patients with sepsis and infection. However, the majority of the reviewed studies have the inherent methodological limitations of retrospective studies. Conclusions regarding this important clinical question should wait for the results of ongoing relevant randomized controlled trials.