Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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BK virus-associated hemorrhagic cystitis (BKV-HC) is a severe complication after allogeneic hematopoietic stem cell transplantation (HSCT), but antiviral treatment for this condition has not been evaluated. ⋯ Cidofovir may be a potentially effective therapy for BKV-HC, but evidence supporting its use requires randomized controlled trials.
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Comparative Study
Predicting mortality in patients with ventilator-associated pneumonia: The APACHE II score versus the new IBMP-10 score.
Ventilator-associated pneumonia (VAP) is the leading cause of mortality associated with nosocomial infection. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score at the time of diagnosis of VAP is considered the best scoring system to predict mortality in patients with VAP. The objective of this study was to develop a simple score to predict mortality in patients with VAP and to compare its results with those for the APACHE II scoring system. ⋯ This preliminary work indicates that a 5-point score, the IBMP-10, is comparable to the APACHE II score in its ability to predict mortality in patients with VAP. If future studies validate the IBMP-10 score, physicians may be have a simple tool to evaluate the disease severity and to predict outcomes in patients with VAP.
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Review Meta Analysis
Safety and efficacy of corticosteroids for the treatment of septic shock: A systematic review and meta-analysis.
Septic shock is common and results in significant morbidity and mortality. Adjunctive treatment with corticosteroids is common, but definitive data are lacking. We aimed to determine the efficacy and safety of corticosteroid therapy among patients with septic shock. ⋯ In patients with septic shock, corticosteroid therapy appears to be safe but does not reduce 28-day all-cause mortality rates. It does, however, significantly reduce the incidence of vasopressor-dependent shock, which may be a clinically worthwhile goal.
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We explored the association between antituberculosis drug pharmacokinetics and treatment outcomes among patients with pulmonary tuberculosis in Botswana. ⋯ Lower than expected antituberculosis drug C(max) occurred frequently, and low pyrazinamide C(max) was associated with poor treatment outcome. Exploring the global prevalence and significance of these findings may suggest modifications in treatment regimens that could improve tuberculosis cure rates.
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Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing. ⋯ The epidemiology and choice of therapy for candidemia are rapidly changing. Additional study is warranted to differentiate host factors and differences in virulence among Candida species and to determine the best therapeutic regimen.