Infectious Disease
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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.
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Trends in Supplemental Vitamin D Intake
Researchers investigated the trends in daily supplemental vitamin D intake of ≥ 1,000 IU and ≥ 4,000 IU and found increasing use of vitamin D supplementation.
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Influenza Cases Rising: What Clinicians Need to Know
The burden of influenza is significant. So far in the current 2018-2019 season, about 7 million Americans have been affected, with half of those people seeing a physician. Between 69,000 and 84,000 people have been hospitalized for flu-related illness.
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The Joint Commission Warns of ‘Silos’ in CDC Guidelines
While lauding the CDC for its efforts to protect healthcare workers from occupational infections, The Joint Commission took the agency to task for draft guidelines that may have the unintended effect of limiting collaboration and creating “silos” in the work culture.
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The Zombie as a Metaphor for Pandemics
The Centers for Disease Control and Prevention is drawing attention to emerging infectious disease outbreaks and other mass casualty events through creatures often depicted with voracious appetites and a relentless, limping pursuit of the living: zombies. -
Almost One-Third of Homecare Workers Think Flu Vaccine Unsafe
We continue to be beset with misinformation that undermines uptake of the annual flu vaccine, and that may explain why almost one-third of homecare nurses report that they think the shot is unsafe.