The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · Dec 2004
Randomized Controlled Trial Multicenter Study Clinical TrialReduced colonization and infection with miconazole-rifampicin modified central venous catheters: a randomized controlled clinical trial.
Central venous catheters (CVC) are a major cause of nosocomial bloodstream infections. Catheters modified with miconazole and rifampicin that constantly and slowly release antimicrobial substances are assumed to be beneficial in reducing rates of colonization and catheter-related infections. ⋯ CVC supersaturated with miconazole and rifampicin were associated with a significantly lower risk for catheter colonization and catheter-related infections compared to standard catheters.
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J. Antimicrob. Chemother. · Oct 2004
Prospective audit of bacteraemia management in a university hospital ICU using a general strategy of short-course monotherapy.
As optimal antibiotic therapy for bacteraemia remains unknown, different strategies have evolved. Routine practice in the University College London Hospitals intensive care unit (ICU) is to use short-course (5-6 days) monotherapy, unless specifically indicated (e.g. endocarditis, osteomyelitis). We decided to assess this approach for treating community-, hospital-, and ICU-acquired bacteraemia by monitoring clinical response, relapse rate and patient outcome. ⋯ Our general strategy of short-course antibiotic monotherapy for treating bacteraemia in the critically ill appears to provide a satisfactory clinical response, low relapse rate and no long-term complications in a well-defined group of patients. Multicentre studies are warranted to compare short versus long course therapy, and monotherapy versus combination therapy.
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J. Antimicrob. Chemother. · Aug 2004
Multicenter StudyA multicentre pharmacoepidemiological study of therapeutic practices in invasive fungal infections in France during 1998-1999.
To study the pharmacoepidemiology of the prescription of systemic antifungal agents in 48 French haematology, intensive care and infectious diseases units. ⋯ Our results emphasize factors associated with the antifungal therapeutic decision and with the outcome of IFI.
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Widespread inappropriate prescribing of antibiotics in UK hospitals has led to the introduction of specialist antibiotic pharmacists. Their role is to monitor antibiotic use, advise clinicians, educate all grades of healthcare workers and help to develop policy. ⋯ As these practitioners become more accomplished it will be possible to expand their role to include direct intervention in patient treatment. Simple measures, such as modification of intravenous treatment to oral and automatic stop orders, could greatly enhance patient care.
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J. Antimicrob. Chemother. · Aug 2004
Outcome of inappropriate initial antimicrobial treatment in patients with methicillin-resistant Staphylococcus aureus bacteraemia.
To determine the impact of delayed treatment of methicillin-resistant Staphylococcus aureus bacteraemia (MRSA bacteraemia) on mortality. ⋯ Our data suggest that an initial delay of 2 days in the use of appropriate antibiotics, especially of vancomycin or other glycopeptides, before the preliminary microbiological report may not adversely affect the outcome in patients with MRSA bacteraemia.