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One of the unintended consequences of the Centers for Medicare and Medicaid Services (CMS) performance measures for CAP was that clinicians often started antibiotics too quickly in patients without infection. Subsequently, the requirement that antibiotics be initiated within 6 hours of patient presentation was retired as of January 1, 2012.
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In the first report (Newland et al), a quasi-experimental study with a control group (also known as a nonrandomized, postintervention design) was performed from 20042010 to determine the impact of an antimicrobial stewardship program (ASP) implemented in March, 2008 in a tertiary care children's hospital that was based on prospective-audit-with-feedback.
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There are very little data on antibiotic stewardship in LTCF. This work (Jump et al.) came from a Geriatric Research Education and Clinical Center (GRECC) demonstration project at the Cleveland VA Medical Center. The LID was a LTCF Infectious Disease team that provided on site consultations.
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A remarkably large number of presentations at IDWeek held in San Diego October 17-21, 2012, dealt directly with issues of antimicrobial stewardship. These included aspects such as documenting the frequency of inappropriate antibiotic use in various settings together with descriptions of successful interventions.
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The different drug formulations of menopausal hormone therapy (HT) may determine the risk of venous thromboembolism (VTE), according to a new study. It is known that combined estrogen-progesterone therapy has a higher risk of VTE than estrogen-only therapy, and oral therapy has a higher risk than transdermal therapy.
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Effective antimicrobial stewardship is of particular importance in the developing world. In many developing countries, inappropriate antimicrobial use has led to widespread drug resistance among not only bacterial isolates, but also among parasites and other infectious agents.
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The authors conclude that in patients hospitalized with myocardial infarction, women were more likely than men to present without chest pain and had higher mortality than men within the same age group.
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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.