Swiss medical weekly
-
Swiss medical weekly · Apr 2019
Impact of co-amoxicillin-resistant Escherichia coli and Pseudomonas aeruginosa on the rate of infectious complications in paediatric complicated appendicitis.
Choice of antibiotics for complicated appendicitis should address local antibiotic resistance patterns. As our local data showed a less than 15% resistance of Escherichia coli to co-amoxicillin (amoxicillin + clavulanic acid), we opted for this antibiotic in 2013. Subsequently, the increasing prevalence of Pseudomonas aeruginosa challenged this choice. ⋯ Results of the multivariable analysis of this small, retrospective study revealed a statistically significant increase in the risk of postoperative complications in the presence of co-amoxicillin-resistant E. coli. The choice of antibiotic should be adapted accordingly. More data are needed to justify the systematic coverage of P. aeruginosa in children with complicated appendicitis. .
-
Swiss medical weekly · Apr 2019
Outcome of inter-hospital transfer of patients on extracorporeal membrane oxygenation in Switzerland.
An extracorporeal membrane oxygenation system (ECMO), as a bridge to either recovery, a ventricular assist device (VAD), or heart or lung transplantation, may be the only lifesaving option for critically ill patients suffering from refractory cardiac, respiratory or combined cardiopulmonary failure. As peripheral hospitals may not offer ECMO treatment, tertiary care centres provide specialised ECMO teams for on-site implantation and subsequent patient transfer on ECMO to the tertiary hospital. This study reports the results of the largest ECMO transportation programme in Switzerland and describes its feasibility and safety. ⋯ The first results of our ECMO transportation programme show its feasibility, safety and efficacy without on-site implant or on-transport complications or mortality. The favourable early survival may justify the large effort with respect to logistics, costs and manpower. With rising awareness, referring centres may increasingly consider this lifesaving option at an early stage, which may further improve outcomes.