Current opinion in infectious diseases
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Curr. Opin. Infect. Dis. · Aug 2009
ReviewPrevention and treatment of invasive fungal diseases in neutropenic patients.
Despite advances in the diagnosis and management, invasive fungal diseases contribute substantially to the morbidity and mortality of patients with prolonged neutropenia. ⋯ With the validation of preemptive strategies in clinical trials, we will likely have evidence-based targeted use of antifungals. PCR-based techniques are also promising tools for preemptive strategies and are undergoing evaluation. Knowledge of host genetic factors may be important in stratifying the risk for fungal disease during periods of high risk.
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Curr. Opin. Infect. Dis. · Jun 2009
ReviewOptimizing intensive care management in paediatric sepsis.
Paediatric sepsis continues to be a disease with unacceptably high morbidity and mortality, despite huge advances in paediatric intensive care organization and technology. This review examines the epidemiology, pathophysiology and advances in the treatment of paediatric sepsis. ⋯ This review aims to evaluate the recent therapeutic advances and potential for further developments in the management of paediatric sepsis in the ICU.
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Curr. Opin. Infect. Dis. · Apr 2009
ReviewBundles to prevent ventilator-associated pneumonia: how valuable are they?
To review the value of care bundles to prevent ventilator-associated pneumonia (VAP). ⋯ The Ventilator Bundle is an effective method to reduce VAP rates in ICUs. The ventilator bundle should be modified and expanded to include specific processes of care that have been definitively demonstrated to be effective in VAP reduction or a specific VAP bundle created to focus on VAP prevention.
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Nosocomial tracheobronchitis is common among intubated critically ill patients. Ventilator-associated tracheobronchitis (VAT) represents an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia. The aim of this review is to discuss recent findings on VAT. ⋯ Antibiotic treatment is beneficial in VAT patients. Future studies should confirm these promising results and determine the best duration of antimicrobial therapy in these patients.
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Curr. Opin. Infect. Dis. · Apr 2009
ReviewAerosolized antibiotics to treat ventilator-associated pneumonia.
This review summarizes the recent data on antibiotic aerosolization to treat ventilator-associated pneumonia. ⋯ Despite recent promising findings, the widespread use of aerosolized antibiotics to treat ventilator-associated pneumonia cannot be recommended. It should be restricted to the treatment of multidrug-resistant Gram-negative ventilator-associated pneumonia.