J Emerg Med
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Comparative Study
Resistance Patterns of Escherichia coli in Women with Uncomplicated Urinary Tract Infection Do Not Correlate with Emergency Department Antibiogram.
Urine cultures are not always performed for female Emergency Department (ED) patients with uncomplicated urinary tract infection (UTI). Accordingly, hospital, and even ED-specific, antibiograms might be skewed toward elderly patients with many comorbidities and relatively high rates of antimicrobial resistance, and thus do not accurately reflect otherwise healthy women. Our ED antibiogram indicates Escherichia coli resistance rates for ciprofloxacin, levofloxacin, and trimethoprim-sulfamethoxazole (TMP-SMX) of 42%, 26%, and 33%, respectively. ⋯ ED antibiograms may overestimate resistance rates for uropathogens causing uncomplicated UTIs. In cases where nitrofurantoin cannot be used, fluoroquinolones and possibly TMP-SMX may remain viable options for treatment of uncomplicated UTI and pyelonephritis in women.
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Review Case Reports
Acute Limb Ischemia: A Case Report and Literature Review.
Acute limb ischemia (ALI), although uncommon, can present with profound symptoms, including disabling pain in the setting of acute vascular and neurologic deficits. The most appropriate diagnostic and therapeutic strategy has evolved with emerging technologies inclusive of less-invasive endovascular diagnostic and therapeutic options. ⋯ We present a case of ALI to illustrate the diagnostic and therapeutic approach with a summary of the most current literature. Emergency physicians should be aware of optimized clinical outcomes with the use of time-sensitive enhanced endovascular therapies as a recommended option for the best outcomes for the treatment of ALI.