- Antibiotic treatment outcomes in community-acquired pneumonia [Journal Article]
- TJTurk J Med Sci 2018 Aug 16; 48(4):730-736
- CONCLUSIONS: In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens.
- Severe community-acquired pneumonia: Current management and future therapeutic alternatives. [Journal Article]
- ERExpert Rev Anti Infect Ther 2018 Aug 17
- Despite advances in modern medicine, severe community-acquired pneumonia (CAP) continues to be a potentially deadly disease. Mortality rate reaches up to the 50% in patients requiring admission to th...
Despite advances in modern medicine, severe community-acquired pneumonia (CAP) continues to be a potentially deadly disease. Mortality rate reaches up to the 50% in patients requiring admission to the Intensive Care Unit (ICU) when developing septic shock. Areas covered: We aim to describe the optimal management of severe CAP including antibiotic therapy, future antimicrobial options, and non-antibiotic (so-called adjunctive) therapies. A literature search was performed to identify all clinical trials, observational studies, meta-analysis, and reviews about this topic from PubMed. Expert commentary: Antibiotic therapy, the cornerstone of the management of CAP, must be started prompt because the delay in the administration of antimicrobials is associated with mortality. Diverse observational studies have reported a lower adjusted mortality in patients with severe CAP treated with combined antibiotic therapy, especially those in septic shock or with pneumococcal bacteremia. We summarize the available information about new antibiotics in the pipeline for severe CAP. Finally, we review the available evidence about the role of corticosteroids, immunoglobulins, and statins as adjunctive for CAP.
- The prognostic performance of qSOFA for community-acquired pneumonia. [Journal Article]
- JIJ Intensive Care 2018; 6:46
- CONCLUSIONS: Regarding hospitalized CAP, the prognostic performance of qSOFA for in-hospital mortality and ICU admission was not significantly different from those of CURB-65 and PSI. qSOFA only requires a few items and vital signs, and, thus, may be particularly useful for emergency department or non-respiratory specialists.
- Guidelines for the Evaluation and Treatment of Pneumonia. [Review]
- PCPrim Care 2018; 45(3):485-503
- Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic ...
Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia.
- Ten-year trends in intensive care admissions for respiratory infections in the elderly. [Journal Article]
- AIAnn Intensive Care 2018 Aug 15; 8(1):84
- CONCLUSIONS: We observed a substantial increase in acute respiratory infection diagnoses associated with hospitalisation between 2006 and 2015, with a growing demand for critical care services. Both the absolute number and the percentage of elderly patient ICU admissions increased over the last decade, with the greatest increases being observed for patients 85 years and older.
- C-reactive protein and procalcitonin to discriminate between tuberculosis, Pneumocystis jirovecii pneumonia, and bacterial pneumonia in HIV-infected inpatients meeting WHO criteria for seriously ill: a prospective cohort study. [Journal Article]
- BIBMC Infect Dis 2018 Aug 14; 18(1):399
- CONCLUSIONS: CRP and procalcitonin showed limited value in discriminating between the three target infections due to widely overlapping distributions, but diagnostic accuracy was higher for discriminating PJP from CAP or tuberculosis. Our findings show limitations for CRP and procalcitonin, particularly for discriminiation of tuberculosis form CAP, however they may have greater diagnostic utility as part of a panel of biomarkers or in clinical prediction rules.
- A study of community-acquired Mycoplasma pneumoniae in Yantai, China. [Journal Article]
- CMColomb Med (Cali) 2018 Jun 30; 49(2):160-163
- CONCLUSIONS: Macrolides are not the first-line treatment for M. pneumoniae respiratory tract infections in Yantai.
- Melioidosis in acute cholangitis of diabetic patient: a forgotten diagnosis. [Journal Article]
- RRRes Rep Trop Med 2012; 3:103-106
- Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infectio...
Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infection. Hence, its diagnosis depends heavily on the clinical microbiology laboratory for culture. In this case report, we describe an atypical presentation of melioidosis in a 52-year-old man who had fever, right upper-abdominal pain, and jaundice for 15 days. Melioidosis caused by Burkholderia pseudomallei was subsequently diagnosed from blood culture. As a primary care physician, high suspicion index is of great importance. High suspicion index of melioidosis in a high-risk group patient, such as the patient with diabetes mellitus and diabetic foot, is crucial in view of atypical presentations of pseudomonas sepsis. A correct combination of antibiotic administration in the early phase of therapy will determine its successful outcome.
- Comparison between Critical-Care Pain Observation Tool and physiologic indicators for pain assessment in the critically ill, mechanically ventilated adult patients. [Journal Article]
- SJSaudi J Anaesth 2018 Jul-Sep; 12(3):384-388
- CONCLUSIONS: The present study provides evidence that the CPOT has good psychometric properties. It might prove useful for pain assessment in uncommunicative critically ill patients.
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- Incidence of multidrug resistance and extended-spectrum beta-lactamase expression in community-acquired urinary tract infection among different age groups of patients. [Journal Article]
- IJIndian J Pharmacol 2018 Mar-Apr; 50(2):69-74
- CONCLUSIONS: It was concluded that for effective treatment of UTIs, appropriate screening of ESBL and culture sensitivity must be employed instead of empiric treatment.