Current opinion in infectious diseases
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Curr. Opin. Infect. Dis. · Apr 2015
ReviewAntibiotic de-escalation in the ICU: how is it best done?
An antimicrobial policy consisting of the initial use of wide-spectrum antimicrobials followed by a reassessment of treatment when culture results are available is termed de-escalation therapy. Our aim is to examine the safety and feasibility of antibiotic de-escalation in critically ill patients providing practical tips about how to accomplish this strategy in the critical care setting. ⋯ Antibiotic de-escalation is a well tolerated management strategy in critically ill patients but unfortunately is not widely adopted.
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Curr. Opin. Infect. Dis. · Apr 2015
ReviewEvidence update on prevention of surgical site infection.
Surgical site infection (SSI) is a common healthcare-associated infection and complicates up to 10-20% of operations with considerable strain on healthcare resources. Apart from the widely adopted use of appropriate hair removal, antibiotic prophylaxis, avoidance of hypothermia and perioperative glycaemic control to reduce SSIs, this review has considered new research and systematic reviews, and whether their findings should be included in guidelines. ⋯ The incidence of SSI after surgery is not falling. Based on this review of published trials and evidence-based systematic reviews some advances might be included into these care bundles. More research is needed together with improved compliance with care bundles.
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Curr. Opin. Infect. Dis. · Apr 2015
ReviewWhat is the best therapeutic approach to methicillin-resistant Staphylococcus aureus pneumonia?
The purpose of this review is to define what the best therapeutic approach is for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. ⋯ Linezolid seems to be a better choice than vancomycin for the treatment of MRSA ventilator-associated pneumonia. It is still unclear whether this affirmation holds for other forms of MRSA pneumonia. Further research is needed to define whether newer antibiotics are better alternatives than currently recommended agents.