Hospital Medicine Alert – December 1, 2012
December 1, 2012
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Fidaxomicin after Vancomycin for Patients with Multiple C. difficile Recurrences
Three patients with multiple recurrences of C. difficile infection who were on prolonged maintenance therapy with low-dose vancomycin were treated with a standard course of fidaxomicin. Two had no further recurrences, and one recurred three months later following a course of levofloxacin. -
Pediatric-Specific Antibiograms Improve Empiric Drug Selection
Knowledge of pediatric-specific antimicrobial susceptibility data improves prescribing selections of empiric antibiotic treatment. Providers should advocate for availability of pediatric-specific antimicrobial susceptibility data wherever practical. -
Safety of High- vs. Moderate-Intensity Exercise for Cardiac Rehabilitation
Current guidelines recommend cardiac rehabilitation using moderate exercise programs for most ischemic heart disease (IHD) patients. Also, studies have shown that the intensity of exercise is directly related to the cardioprotective effects. However, there is concern that high-intensity exercise may be dangerous in IHD patients. -
Multidisciplinary Tracheostomy Teams Shorten Time to Decannulation and Increase Speaking Valve Use
This systematic review and meta-analysis finds that the implementation of multidisciplinary tracheostomy teams leads to significant improvements in time to decannulation and in speaking valve use but not in ICU or hospital length of stay. The quality of the evidence was low. -
What HbA1c for the Very Elderly?
In a nursing home-eligible population with a mean age of 80, those with a HbA1c between 8% and 8.9% had less functional decline than those with a HbA1c of 7% to 7.9%. -
Fungal meningitis and arthritis from epidural, paraspinal and intra-articular injections with contaminated corticosteroid. Early status.
An investigation initiated after a clinician reported to the Tennessee Department of Health on Sept. 18, 2012, the case of a patient who developed meningitis due to Aspergillus fumigatus after having received an epidural corticosteroid injection at an ambulatory surgical center quickly identified a number of other suspect cases.1 -
Clinical Briefs in Primary Care Supplement