Hospital Medicine Alert – July 1, 2007

July 1, 2007

• Can Procalcitonin Distinguish Sepsis from other Causes of SIRS?

  A meta-analysis of 18 studies that have examined the usefulness of procalcitonin measurement in the diagnosis of sepsis finds that the diagnostic performance of this measurement is low and that the test cannot reliably distinguish sepsis from other causes of the systemic inflammatory response syndrome.

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• New Guidelines for Antibiotic Prophylaxis of Endocarditis

  The new guidelines recommend antibiotic prophylaxis of infective endocarditis in a much more restricted group of patients than did previous guidelines.

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• MRI or CT: Which is Best for Acute Stroke Imaging?

  MRI is more sensitive than CT for detecting acute ischemia and can detect acute hemorrhage with equal sensitivity to CT.

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• Managing ARDS: Steroid Saga Sequel

  This multicenter, randomized, double-blind, placebo-controlled trial finds that early initiation of low-dose, prolonged glucocorticosteroid therapy for ARDS results in improved lung injury scores and a greater likelihood of successful extubation by day 7.

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• Sequential Therapy vs Standard Triple-Drug Therapy

  Standard 10-day triple therapy for Helicobacter pylori may result in relatively low eradication rates.

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