Infectious Disease
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CDC Analysis Supports Mandated Drug Stewardship in Hospitals
A new analysis of the immense societal costs of Clostridioides difficile infection may spur the Centers for Medicare & Medicaid Services to finalize a regulation requiring antibiotic stewardship in hospitals.
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Infectious Disease Alert Updates
Jump in Cocci Cases, Winter 2017; Who Knew the Ink Was Not Sterile? Homeless Population Requires Hepatitis A Vaccination
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IV to Oral Conversion of Antibiotic Therapy for Bacteremia Due to Enterobacteriaceae
Oral step-down antibiotic therapy (IV to oral conversion) is safe and effective in patients with bloodstream infection due to Enterobacteriaceae.
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Eravacycline (Xerava)
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Infection After Placement of Antibiotic Spacers in Prosthetic Joints
Researchers reviewed a case series of 51 patients who received retained “destination spacers” after resection of infected joint prostheses. The researchers noted a significant association between the presence of preoperative sinus drainage and re-infection. Longterm antimicrobial suppression after retention of a destination spacer did not result in significant prevention of re-infections.
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The Downsides of High Vancomycin Troughs: No Longer ‘Mississippi Mud,’ but Still Hazardous
A retrospective cohort study from a large healthcare system found that elevated vancomycin troughs were common and associated with a higher body mass index and reduced baseline renal function, and led to more acute kidney injury and a longer hospital length of stay.
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Pediatric Pneumonia — Evolving Diagnosis and Management
Tachypnea has long been considered to identify which children with acute fever and cough might benefit from antibiotic treatment, especially in resource-limited parts of the world. Now, with declining rates of vaccine-preventable infections with Haemophilus influenzae and pneumococcus, new data suggest that approximately 90% of febrile, tachypneic, coughing (but still well enough for outpatient treatment) preschoolers do fine without antibiotics.
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Is There RBBB, Acute Ischemia, or Both?
The ECG in the figure was obtained from a 35-year-old man with a 20-year history of smoking. He presented to the ED with new-onset chest discomfort. He was hemodynamically stable at the time this tracing was obtained. How would one interpret his ECG? Is there right bundle branch block (RBBB)? Is there evidence of acute posterior ischemia or infarction?
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Sarecycline Tablets (Seysara)
Sarecycline is indicated for the treatment of inflammatory lesions of non-nodular moderate to severe acne in patients 9 years of age and older.
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Is Sanitizer Better Than Soap?
In day care settings, the implementation of hand hygiene programs reduced respiratory illness, absenteeism, and antibiotic use in children 0-3 years of age. Using hand sanitizer was more effective than washing with soap and water.