Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Review Historical Article
The controversial and short-lived early use of rehydration therapy for cholera.
Oral rehydration treatment has prevented the deaths of millions of infants in the developing world. During the cholera outbreak of 1832 in Britain, 3 important advances in fluid therapy transiently emerged: intravenous fluid therapy, oral salt and water treatment, and chemical analysis of body fluids. ⋯ Early attempts to introduce oral fluid therapy failed to become established as cornerstones of clinical medicine because of a lack of convincing science and because of personal animosities. From the period just after World War II through the 1970s, the modern era of rehydration of patients with cholera and dehydrating diarrhea slowly developed, a process that may represent the finest example of translational research applying biochemical and physiologic observations to the clinic.
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The guidelines of the Centers for Disease Control and Prevention do not recommend the use of an antimicrobial- or antiseptic-impregnated catheter for short-term use. In previous studies, we have found a higher incidence of central venous catheter-related bacteremia among patients with femoral and central jugular accesses than among patients with other venous accesses. ⋯ Rifampicin-minonazole-impregnated catheters are associated with a statistically significant reduction in the incidence of catheter-related bacteremia in patients with short-term catheter use at the central jugular and femoral sites.
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High rates of resistance to trimethoprim-sulfamethoxazole (TMP-SMX) among uropathogenic Escherichia coli are recognized, and concerns exist about emerging fluoroquinolone resistance. ⋯ These results suggest that the prevalence of TMP-SMX-resistant infection among patients with uncomplicated pyelonephritis is > or =20% in many areas of the United States, and risk stratification cannot identify patients at low risk of infection. Rates of fluoroquinolone-resistant E. coli infection appear to be low among patients with uncomplicated pyelonephritis but higher among those with complicated infections. Fluoroquinolones should remain to be the preferred empirical treatment for women with uncomplicated pyelonephritis.
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Comment Letter Randomized Controlled Trial
Amphotericin B: the higher the dose, the higher the toxicity.