1,721,055 research outputs found
Antimicrobial treatment for Intensive Care Unit (ICU) infections including the role of the infectious disease specialist
No full textBetween 5 and 10% of patients admitted to acute care hospitals acquire one or more infections, and the risks have steadily increased during recent decades. Three types of infection account for more than 60% of all nosocomial infections: pneumonia, urinary tract infection and primary bloodstream infection, all of them associated with the use of medical devices. Nearly 70% of infections are due to micro-organisms resistant to one or more antibiotics (multidrug resistant or MDR).
A higher incidence of inappropriate antibiotic therapy is expected when infections are caused by antibiotic-resistant micro-organisms and initial inappropriate empirical therapies, and the further need to modify them substantially increases the mortality risk.
Despite new antibacterial agents such as linezolid, and also tigecycline and daptomycin, now being available for the treatment of infections due to MDR micro-organisms, the best strategy for improving the cure rate and minimising the development of resistance, probably remains the infectious disease specialist consultation
Severe bacterial infections in haemodialysis patients
No full textInfections are today by far the most common complication affecting patients with chronic kidney disease and particularly those undergoing chronic haemodialysis. Numerous antimicrobial-resistant pathogens have emerged among patients with chronic kidney disease. These patients are hospitalized with greater frequency than the general population and the number of hospitalizations has been shown to correlate with higher infection rates. This review will briefly discuss the most common infections in patients undergoing chronic haemodialysis, the clinical relevance of antimicrobial resistance in these patients, and their therapeutic options
Management of serious bacterial infections: general considerations
No full textMany efforts have been made in the recent years to improve the prognosis of severe bacterial infections by reducing the risk of treating the patients inadequately. The reasons responsible for inadequate treatment have been intensively studied and antibiotic resistance has been identified as one of the main risks. Currently different strategies are considered to optimize antibiotic therapy, such as the adoption of local guidelines, de-escalation, rotation and association therapies. Each appears to prove efficacy in the containment of resistance and improvement of outcome; however, further studies, continuous monitoring of the epidemiology of severe infections and antibiotic resistance, and finally, availability of new drugs are needed. It is the authors' opinion that, despite the importance of guidelines for the optimal treatment and most appropriate management of severe infections, closer collaboration should be established between the medical staff in the wards and IDS, who can bridge the gap between the guidelines and the individual needs of the patient, thereby improving the decision-making process. The IDS, as consultant in different medical and surgical wards and as a member of the Infectious Diseases Control local Committees, can interact at different levels and can improve the management of severe bacterial infections
Retrocardiac pneumonia mimicking acute abdomen: a diagnostic challenge
No full textWe present the case of a child who showed acute abdominal pain and fever due to retrocardiac pneumonia by Streptococcus pneumoniae without respiratory signs and symptoms. Acute abdominal pain is a common presenting symptom of children seen in pediatric emergency rooms. Basilar pneumonia is an uncommonly known cause of pediatric abdominal pain; it may go unrecognized on a patient's initial evaluation. Our case suggests that the clinical manifestations of a retrocardiac pneumonia can be atypical with abdominal pain as the principal complaint, mimicking acute abdomen
Considerations on antibiotic therapy duration in community- and hospital-acquired bacterial infections
No full text[Current guidelines for the treatment of intra-abdominal infections]
No full textIntra-abdominal infections (IAIs) are a frequent cause of mobility and mortality. These infections can be caused by a wide variety of microorganisms, including both aerobes and anaerobes, and are often polymicrobial. Several studies observed that mortality depends on initiating early appropriate antimicrobial therapy. Moreover, the inappropriate choice of initial antibiotic therapy result in a longer hospital stay and higher costs of hospitalization compared with appropriate initial antibiotic therapy. The aim of current review is that of summarize the recommendations of several guidelines on the management of IAIs
Dalbavancina nel trattamento delle infezioni batteriche acute della cute e delle strutture cutanee
No full text[Therapeutic options in chronic HBV infection]
No full textA durable suppression of viral replication in chronic HBV infection decreases the risk of liver disease progression. Treatment is recommended for patients in the immune-active phases of chronic HBV infection (HBeAg positive or HBeAg negative patients with serum HBV-DNA and elevated ALT). Licensed HBV therapies include interferon (sIFN, pegylated-IFN alfa-2a) and nucleoside/nucleotide analogues (lamivudine, adefovir, entecavir) allowing for two different treatment strategies: a finite treatment course of IFN that provides sustained off-treatment response in about one third of patients, or an indefinite treatment with nucleoside/nucleotide analogues that provides a therapy maintained response. IFN has the advantage of a defined treatment duration and of lacking resistance selection; disadvantages are the subcutaneous route of administration and poor tolerability. Nucleoside/nucleotide analogues are orally administered and well tolerated; their drawback is the risk of developing antiviral resistance which increases with duration of treatment. A finite course of IFN should be tried as first-line therapy; a long-term treatment with nucleoside/nucleotide analogues should be used for patients not responding or intolerant to interferon
[Skin and soft tissue infections: current therapeutic options]
No full textIn the present review, the authors focus on skin and soft tissue infections (SSTIs), a set of commonly observed pathologies which can present different features in terms of site and localization, clinical characteristics, and the aetiological agent responsible; their severity is related to the depth of the affected sites. After a brief introduction to the diverse classification criteria which are currently adopted by various authors, the aetiology and role of the most frequently occurring pathogen, Staphylococcus aureus, often methicillin-resistant is discussed, as well as the possible therapeutic options. We first present the internationally recommended guidelines, and stress that SSTI management has to conform to different criteria, in accordance with the different clinical settings: mild infections require simple and cost-saving treatments while severe infections make timely and aggressive treatments mandatory. The review then reports the recent data concerning the efficacy of new antimicrobials for treating SSTIs. In particular, results observed with linezolid, tigecycline, and daptomycin are discussed
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