Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Case Reports
Possible neuropsychiatric reaction to high-dose oseltamivir during acute 2009 H1N1 influenza A infection.
The safety of high-dose oseltamivir during treatment of 2009 H1N1 influenza A infection for critically ill patients is unknown. Here we report on a case patient with severe, delayed-onset neuropsychiatric symptoms after administration of high-dose oseltamivir. Clinicians should be vigilant to the possible increased risk of complications associated with high-dose oseltamivir therapy for 2009 H1N1 influenza A infection.
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The 2005 guidelines of the American Thoracic Society-Infectious Diseases Society of America Guidelines for Hospital for managing hospital-acquired pneumonia classified patients according to time of onset and risk factors for potentially drug-resistant microorganisms to select the empirical antimicrobial treatment. We assessed the microbial prediction and validated the adequacy of these guidelines for antibiotic strategy. ⋯ The 2005 guidelines predict potentially drug-resistant microorganisms worse than the 1996 guidelines. Adherence to guidelines resulted in more adequate treatment and a trend to a better clinical response in group 2, but it did not influence mortality.
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There is ongoing debate about the efficacy of surgical masks versus N95 respirators for protection against pandemic novel swine-origin influenza A (H1N1)-2009. Our hospital, which is designated to manage outbreaks of emerging infection, has robust surveillance systems to detect infection in staff. The incidence of pandemic H1N1-2009 remained low in staff with use of surgical masks.