Cardiology
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Longer Antibiotic Courses for Pneumonia Do Not Improve Outcomes, But Cause More Adverse Effects
Two-thirds of general medicine patients with pneumonia received excess antibiotic therapy, with 93.2% of the unnecessary duration occurring after hospital discharge. Excess antibiotic therapy did not improve mortality or morbidity outcomes, although each additional antibiotic day was associated with 3% increased odds of antibiotic-associated adverse drug events.
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Antimicrobial Stewardship in Critical Care
Antimicrobial stewardship is the responsibility of everyone involved in the care of critically ill and hospitalized patients. This review discusses some of the key principles and practices of successful antimicrobial stewardship programs, particularly as they relate to critical care.
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Optimal Antithrombic Therapy After PCI for Atrial Fibrillation Patients
In three subgroups of coronary artery disease patients with atrial fibrillation, apixaban plus a P2Y12 inhibitor provided superior safety and similar efficacy outcomes as treatment with warfarin, aspirin, or both for six months.
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The Risk of Endocarditis With Bacteremia
Interrogation of the Danish National Patient Registry revealed bacteremia due to Enterococcus faecalis was most likely to be associated with infective endocarditis; thus, echocardiography is warranted in these patients.
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Aggressive Afterload Reduction Does Not Improve Outcomes in Acute Decompensated Heart Failure
The authors of the GALACTIC trial found no benefit from an aggressive vasodilation approach for patients hospitalized with acute decompensated heart failure.
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Subclinical Atrial Fibrillation Detected By Implanted Loop Recorders: Common, But How Burdensome?
In older patients with risk factors for stroke drawn from the general population, previously undiagnosed and asymptomatic episodes of atrial fibrillation are detected frequently via implantable loop recorder monitoring, allowing for early initiation of anticoagulation therapy.
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Stenting Nonculprit Lesions After STEMI: Long-Term Data Support Complete Revascularization
Data from the CvLPRIT trial of complete vs. culprit-only percutaneous coronary intervention in ST-segment elevation myocardial infarction (MI) show a significantly lower rate of major adverse cardiovascular events, all-cause mortality, and lower composite MI in the complete revascularization group at a median follow-up of 5.6 years.
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Can You Interpret This Rhythm?
The long lead II rhythm strip in the figure was obtained from a middle-aged woman with syncope and hypotension. What can you say about the rhythm?
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Minocycline Topical Foam (Amzeeq)
Minocycline topical foam is indicated to treat inflammatory lesions of non-nodular moderate-to-severe acne vulgaris in patients ≥ 9 years of age.
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Anticoagulation Decisions in Atrial Fibrillation
Using the Delphi method of arriving at a consensus among clinicians concerning for which patients with atrial fibrillation should oral anticoagulants be recommended, the risk of stroke, the risk of hemorrhage, and patient-specific factors emerged. Many of these factors are not included in the guidelines and should be studied further.