Infectious disease clinics of North America
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Infect. Dis. Clin. North Am. · Mar 2014
ReviewDiagnosis, management, and prevention of catheter-associated urinary tract infections.
Catheter-associated urinary tract infection (CAUTI) is common, costly, and causes significant patient morbidity. CAUTIs are associated with hospital pathogens with a high propensity toward antimicrobial resistance. ⋯ Duration of urinary catheterization is the predominant risk for CAUTI; preventive measures directed at limiting placement and early removal of urinary catheters have an impact on decreasing CAUTI rates. The use of bladder bundles and collaboratives, coupled with the support and active engagement from both hospital leaders and followers, seem to help prevent this common problem.
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Infect. Dis. Clin. North Am. · Mar 2014
ReviewDiagnosis and management of urinary tract infection in the emergency department and outpatient settings.
Emergency physicians encounter urinary tract infections (UTIs) in a wide spectrum of disease severity and patient populations. The challenges of managing UTIs in an emergency department include limited history, lack of follow-up, and lack of culture and susceptibility results. Most patients do not require an extensive diagnostic evaluation and can be safely managed as outpatients with oral antibiotics. The diagnostic approach to and treatment of adults presenting to emergency departments with UTIs are reviewed.
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Infect. Dis. Clin. North Am. · Jun 2013
ReviewPharmacologic issues of antiretroviral agents and immunosuppressive regimens in HIV-infected solid organ transplant recipients.
HIV-positive patients are now undergoing solid organ transplantation at increasing rates, with successful outcomes. Transplantation in this unique patient population presents new challenges in the postoperative management of both antiretroviral regimens and immunosuppressive regimens. This review highlights the drug-drug interactions between commonly used immunosuppressive and antiretroviral agents. As more antiretroviral regimens are cautiously initiated in the posttransplant period, further research is needed to identify drug-drug interactions to minimize toxicities and improve long-term survival and graft function.
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Infect. Dis. Clin. North Am. · Mar 2013
ReviewWhat is the best antimicrobial treatment for severe community-acquired pneumonia (including the role of steroids and statins and other immunomodulatory agents).
Community-acquired pneumonia (CAP) is the leading cause of death from infectious diseases in the United States. The mortality rate due to severe CAP has shown little improvement over the past few years, with a rate as high as 50% mainly in patients admitted to intensive care units. ⋯ Several therapies have been tested in patients with severe CAP in recent years. This article reviews recent data regarding different treatments including antimicrobials and adjunctive therapies in patients with severe CAP.
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Infect. Dis. Clin. North Am. · Mar 2013
ReviewWhat is the role of antimicrobial stewardship in improving outcomes of patients with CAP?
Community-acquired pneumonia (CAP) is one of the most common infectious diagnoses encountered in clinical practice and one of the leading causes of death in the United States. Adherence to antibiotic treatment guidelines is inconsistent and the erroneous diagnosis of CAP and misuse of antibiotics is prevalent in both inpatients and outpatients. This review summarizes interventions that may be promoted by antimicrobial stewardship programs to improve outcomes for patients with CAP.