Defining International Critical Care Pharmacist Contributions to Sepsis and Exploring Variability
AbstractPurpose of ReviewTo define international clinical pharmacist contributions to managing sepsis in critically unwell patients and explore variation.Recent FindingsClinical pharmacists improve clinical outcomes and cost efficiencies. They provide pharmaceutical advice on selection, administration, plus monitoring of antimicrobials and supportive therapies. Logistical activities reduce drug administration times. Guideline production, patient/clinician education, prescribing error identification, plus therapeutic optimisation activities are also reported.SummaryA survey incorporating semi-structured interviews identifie...
Source: Current Infectious Disease Reports - January 1, 2024 Category: Infectious Diseases Source Type: research
Rebuilding for Tomorrow ’s Outbreak: The State of Special Pathogen Preparedness in the USA in the Wake of COVID-19
AbstractPurpose of ReviewSpecial pathogens require unique planning care capabilities within healthcare facilities and can pose significant public health threats. Outbreaks have continued to emerge through the COVID-19 pandemic and serve as reminders of the need to have tiered levels of readiness and resources supporting all healthcare settings.Recent FindingsRecent outbreaks of Marburg virus, Sudan virus, Lassa virus, and Nipah virus are examples of low-incidence pathogens that carry disproportionally high potential consequences for healthcare worker safety and public health. While the COVID-19 pandemic has increased aware...
Source: Current Infectious Disease Reports - December 1, 2023 Category: Infectious Diseases Source Type: research
Should We Tap That? Aspirates and Antibiotics: An Update on Septic Bursitis
AbstractPurpose of ReviewSeptic bursitis is a relatively common condition that causes substantial morbidity, but there is no universally accepted approach to management. We aim to evaluate recent literature with an eye toward recommended changes in the practice of bursal aspiration, surgical debridement, and antibiotic treatment.Recent FindingsAuthors of recent studies suggest that most patients with uncomplicated septic bursitis can be treated nonoperatively, perhaps even without aspiration of the bursal sac, and can achieve satisfactory clinical response with antibiotics alone. Surgical debridement has not been shown to ...
Source: Current Infectious Disease Reports - December 1, 2023 Category: Infectious Diseases Source Type: research
One Small Step (Down) for Antibiotics, One Giant Leap for Outpatient Therapy: The Role of Oral Antibiotics in Serious Bacterial Infections
AbstractPurpose of ReviewStepping down to oral antibiotic therapy after a period of IV lead-in would eliminate most of the untoward effects of long-term intravenous therapy, including lengthy hospital admissions, copays for ambulatory infusions, catheter-related adverse events, and missed work/school.Recent FindingsTwo randomized, controlled trials, POET and OVIVA, contribute significant support for oral stepdown regimens in endocarditis and osteomyelitis, disease states that are commonly caused by gram-positive organisms. In addition, a number of retrospective reviews comparing early oral switch to continued IV therapy fo...
Source: Current Infectious Disease Reports - December 1, 2023 Category: Infectious Diseases Source Type: research
Complex Outpatient Antimicrobial Therapy: Alternative Management Strategies and Outcomes
AbstractPurpose of ReviewOutpatient parenteral antibiotic therapy (OPAT) faces challenges requiring alternative solutions to long-term OPAT and skilled nursing facility (SNF) placement, particularly in persons who inject drugs (PWID).Recent FindingsSNF placement for antibiotic therapy is not ideal due to high rates of iatrogenic infections, social and financial burden, and poor outcomes for PWID. Hospital-at-home helps decrease length of stay and improves patient satisfaction. In many cases, IV-to-oral antibiotic transitioning and long-acting lipoglycopeptide agents are non-inferior to intravenous antibiotics, allowing for...
Source: Current Infectious Disease Reports - December 1, 2023 Category: Infectious Diseases Source Type: research
Next Steps: Studying Diabetic Foot Infections with Next-Generation Molecular Assays
AbstractPurpose of ReviewIn 2019, the International Working Group on the Diabetic Foot voiced six concerns regarding the use of molecular microbiology techniques for routine diagnosis of infection complicating diabetic foot ulcers. The purpose of this review is to evaluate contemporary evidence addressing each of these concerns and describe promising avenues for continued development of molecular microbiology assays.Recent FindingsSince 2019, the feasibility of conducting metagenomic and metatranscriptomic studies on diabetic foot ulcer samples has been shown. However, these preliminary studies used small samples with co...
Source: Current Infectious Disease Reports - December 1, 2023 Category: Infectious Diseases Source Type: research
Antibiotic Use at Hospital Discharge and Outpatient Antimicrobial Stewardship
AbstractPurpose of ReviewInappropriate and unnecessary antibiotic prescriptions are common in the outpatient setting and as patients transition from inpatient to outpatient care. This review is designed to discuss effective strategies aimed to improve appropriate antibiotic use during transitions of care and in the outpatient setting for high-priority syndrome areas including acute respiratory infections (ARI), urinary tract infections (UTI), skin and soft tissue infections (SSTI), and bone and joint infections (BJI).Recent FindingsUnlike inpatient stewardship programs, outpatient stewardship practices are currently not st...
Source: Current Infectious Disease Reports - November 20, 2023 Category: Infectious Diseases Source Type: research
Complex Outpatient Antimicrobial Therapy: Alternative Management Strategies and Outcomes
AbstractPurpose of ReviewOutpatient parenteral antibiotic therapy (OPAT) faces challenges requiring alternative solutions to long-term OPAT and skilled nursing facility (SNF) placement, particularly in persons who inject drugs (PWID).Recent FindingsSNF placement for antibiotic therapy is not ideal due to high rates of iatrogenic infections, social and financial burden, and poor outcomes for PWID. Hospital-at-home helps decrease length of stay and improves patient satisfaction. In many cases, IV-to-oral antibiotic transitioning and long-acting lipoglycopeptide agents are non-inferior to intravenous antibiotics, allowing for...
Source: Current Infectious Disease Reports - November 4, 2023 Category: Infectious Diseases Source Type: research
Rebuilding for Tomorrow ’s Outbreak: The State of Special Pathogen Preparedness in the USA in the Wake of COVID-19
AbstractPurpose of ReviewSpecial pathogens require unique planning care capabilities within healthcare facilities and can pose significant public health threats. Outbreaks have continued to emerge through the COVID-19 pandemic and serve as reminders of the need to have tiered levels of readiness and resources supporting all healthcare settings.Recent FindingsRecent outbreaks of Marburg virus, Sudan virus, Lassa virus, and Nipah virus are examples of low-incidence pathogens that carry disproportionally high potential consequences for healthcare worker safety and public health. While the COVID-19 pandemic has increased aware...
Source: Current Infectious Disease Reports - November 1, 2023 Category: Infectious Diseases Source Type: research
One Small Step (Down) for Antibiotics, One Giant Leap for Outpatient Therapy: The Role of Oral Antibiotics in Serious Bacterial Infections
AbstractPurpose of ReviewStepping down to oral antibiotic therapy after a period of IV lead-in would eliminate most of the untoward effects of long-term intravenous therapy, including lengthy hospital admissions, copays for ambulatory infusions, catheter-related adverse events, and missed work/school.Recent FindingsTwo randomized, controlled trials, POET and OVIVA, contribute significant support for oral stepdown regimens in endocarditis and osteomyelitis, disease states that are commonly caused by gram-positive organisms. In addition, a number of retrospective reviews comparing early oral switch to continued IV therapy fo...
Source: Current Infectious Disease Reports - October 31, 2023 Category: Infectious Diseases Source Type: research
The Opportunities and Challenges for Artificial Intelligence to Improve Sepsis Outcomes in the Paediatric Intensive Care Unit
AbstractPurpose of ReviewTo describe existing applications of artificial intelligence (AI) in sepsis management and the opportunities and challenges associated with its implementation in the paediatric intensive care unit.Recent FindingsOver the last decade, significant advances have occurred in the use of AI techniques, particularly in relation to medical image analysis. Increasingly, these techniques are being applied to a broad array of datasets. The availability of both structured and unstructured data from electronic health records, omics data and digital technologies (for example, portable sensors) is rapidly extendi...
Source: Current Infectious Disease Reports - October 31, 2023 Category: Infectious Diseases Source Type: research
Should We Tap That? Aspirates and Antibiotics: An Update on Septic Bursitis
AbstractPurpose of ReviewSeptic bursitis is a relatively common condition that causes substantial morbidity, but there is no universally accepted approach to management. We aim to evaluate recent literature with an eye toward recommended changes in the practice of bursal aspiration, surgical debridement, and antibiotic treatment.Recent FindingsAuthors of recent studies suggest that most patients with uncomplicated septic bursitis can be treated nonoperatively, perhaps even without aspiration of the bursal sac, and can achieve satisfactory clinical response with antibiotics alone. Surgical debridement has not been shown to ...
Source: Current Infectious Disease Reports - October 27, 2023 Category: Infectious Diseases Source Type: research
Next Steps: Studying Diabetic Foot Infections with Next-Generation Molecular Assays
AbstractPurpose of ReviewIn 2019, the International Working Group on the Diabetic Foot voiced six concerns regarding the use of molecular microbiology techniques for routine diagnosis of infection complicating diabetic foot ulcers. The purpose of this review is to evaluate contemporary evidence addressing each of these concerns and describe promising avenues for continued development of molecular microbiology assays.Recent FindingsSince 2019, the feasibility of conducting metagenomic and metatranscriptomic studies on diabetic foot ulcer samples has been shown. However, these preliminary studies used small samples with co...
Source: Current Infectious Disease Reports - October 27, 2023 Category: Infectious Diseases Source Type: research
What is New in Augmented Renal Clearance in Septic Patients?
AbstractPurpose of ReviewIn this narrative review encompassing relevant scientific publications regarding critically ill patients in the last 5 years, we discuss key questions regarding the concept, pathophysiology, identification, epidemiology, and implications of augmented renal clearance (ARC) in the treatment of sepsis.Recent FindingsMathematical estimates of renal function show low accuracy when evaluating renal function in the intensive care unit, jeopardizing the correct dosing of antimicrobials. The description of ARC in critically ill patients in several, distant geographical areas worldwide reveals that this co...
Source: Current Infectious Disease Reports - October 26, 2023 Category: Infectious Diseases Source Type: research
