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Travel to the Middle East may have gotten less popular recently, but for those planning to travel for the annual pilgrimage to Makkah (Mecca) October 24-29, 2012, The National Travel Health Network has issued updated guidelines, as follows:
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Clostridium difficile infection (CDI) is a major complication associated with antibiotic usage, and its incidence continues to increase. Management of CDI remains challenging despite new therapies and many patients suffer from recurrences. Interventions to limit acquisition of the disease are therefore urgently needed.
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In this issue: Side effects of statins; effects of cannabis use; antihypertensives and lip cancer; and FDA actions.
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Three HIV-infected patients with refractory, corticosteroid-dependent and life-threatening IRIS were presented.
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Two men (one age 57 with no prior significant illnesses and one age 67 with type 2 diabetes) from northwestern Missouri presented separately to a hospital with illnesses characterized by fever, fatigue, diarrhea, thrombocytopenia and leukopenia. Hepatic transaminase levels subsequently became elevated in both patients, peaking between 8 and 10 days.
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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.