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Latest & greatest articles for pneumonia
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Antimicrobial prescribing: ceftolozane with tazobactam for treating hospital-acquired pneumonia, including ventilator-associated pneumonia Antimicrobial prescribing: ceftolozane with tazobactam for treating hospital-acquired pneumonia, including ventilator- associated pneumonia Evidence summary Published: 18 December 2019 www.nice.org.uk/guidance/es22 pathways K Ke ey messages y messages The content of this evidence review was up-to-date in December 2019. See summaries of product (...) /tazobactam for more information). In August 2019, the indication for ceftolozane with tazobactam was extended to include treating hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP) in adults (Zerbaxa: Procedural steps taken and scientific information after authorisation). Evidence for using ceftolozane with tazobactam for treating HAP and VAP is from 1 phase 3 randomised controlled non-inferiority trial (ASPECT-NP). ASPECT-NP found that a high dose of ceftolozane
Ceftolozane/tazobactam (Zerbaxa) - hospital acquired pneumonia, including ventilator-associated pneumonia Published 09 December 2019 1 Statement of advice SMC2256 ceftolozane / tazobactam 1g/0.5g powder for concentrate for solution for infusion (Zerbaxa®) Merck Sharp & Dohme Limited 8 November 2019 ADVICE: in the absence of a submission from the holder of the marketing authorisation ceftolozane / tazobactam (Zerbaxa®) is not recommended for use within NHSScotland. Indication under review (...) : In adults for the treatment of hospital acquired pneumonia, including ventilator-associated pneumonia. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this indication. As a result we cannot recommend its use within NHSScotland. Advice context: No part of this advice may be used without the whole of the advice being quoted in full. This advice represents the view of the Scottish Medicines Consortium and was arrived at after careful consideration
Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development (...) and additional management decisions.Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.
The DRIP Score to Evaluate or Drug Resistant Organisms in Pneumonia The DRIP Score to Evaluate or Drug Resistant Organisms in Pneumonia | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette You are moonlighting in your busy local community emergency department one afternoon when you encounter Mrs. P, a 67-year-old patient who (...) was sent in from her nursing home with concern for pneumonia. She reports three days of a productive cough, fever to 38.4 °C, and mild shortness of breath with exertion. She denies chest pain, vomiting, or diarrhea. She has a history of end-stage renal disease, for which she has been on hemodialysis three days a week for the last five years. In addition, she has a history of hypertension and non-insulin dependent diabetes. Her last hospital admission was for leg cellulitis after minor trauma
Lefamulin (Xenleta) - community-acquired bacterial pneumonia Drug Approval Package: XENLETA U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: XENLETA Company: Nabriva Therapeutics Application Number: 211672, 211673 Approval Date: 08/19/2019 (211672) (211673) Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF
Pneumonia in the Immunocompetent Child. New 2019 ACR Appropriateness Criteria ® 1 Pneumonia in the Immunocompetent Child American College of Radiology ACR Appropriateness Criteria ® Pneumonia in the Immunocompetent Child Variant 1: Child. 3 months of age and older. Immunocompetent. Suspected uncomplicated community- acquired pneumonia in a well-appearing child who does not require hospitalization. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography chest (...) Usually Not Appropriate ? CT chest with IV contrast Usually Not Appropriate ???? CT chest without and with IV contrast Usually Not Appropriate ???? CT chest without IV contrast Usually Not Appropriate ???? MRI chest without and with IV contrast Usually Not Appropriate O MRI chest without IV contrast Usually Not Appropriate O US chest Usually Not Appropriate O Variant 2: Child. 3 months of age and older. Immunocompetent. Community-acquired pneumonia that does not respond to initial outpatient treatment
Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 74, Issue 1, Pages e1–e3 Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? x Thomas Seagraves , MD (EBEM Commentator) , x Michael Gottlieb , MD (EBEM Commentator (...) ) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: | Publication History Published online: June 21, 2018 Expand all Collapse all Article Outline Take-Home Message For adult patients with severe community-acquired pneumonia, corticosteroids reduce morbidity and mortality. For pediatric patients and adults with nonsevere community-acquired pneumonia, corticosteroids appear to reduce morbidity, but not mortality. Methods Data Sources The authors searched the Cochrane Acute
Do Corticosteroids Benefit Patients With Influenza Pneumonia? Do Corticosteroids Benefit Patients With Influenza Pneumonia? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page To read this article in full, please review your options for gaining access at the bottom of the page. Article in Press Do Corticosteroids Benefit Patients With Influenza Pneumonia? x Michael Gottlieb , MD (EBEM Commentator) , x Thomas Seagraves , MD (EBEM (...) Commentator) , x Stephen R. Gore , MD (EBEM Commentator) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: Publication History Published online: July 23, 2019 To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Among patients with influenza pneumonia, corticosteroids are associated with increased mortality, longer length of stay in the ICU, and higher rates of secondary infection, although there are no data from
Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With Community-Acquired Bacterial Pneumonia: The LEAP 2 Randomized Clinical Trial. New antibacterials are needed to treat community-acquired bacterial pneumonia (CABP) because of growing antibacterial resistance and safety concerns with standard care.To evaluate the efficacy and adverse events of a 5-day oral lefamulin regimen in patients with CABP.A phase 3, noninferiority randomized clinical trial conducted at 99 sites (...) in 19 countries that included adults aged 18 years or older with a Pneumonia Outcomes Research Team (PORT) risk class of II, III, or IV; radiographically documented pneumonia; acute illness; 3 or more CABP symptoms; and 2 or more vital sign abnormalities. The first patient visit was on August 30, 2016, and patients were followed up for 30 days; the final follow-up visit was on January 2, 2018.Patients were randomized 1:1 to receive oral lefamulin (600 mg every 12 hours for 5 days; n = 370
Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. Randomized trials demonstrate no benefit from antibiotic treatment exceeding the shortest effective duration.To examine predictors and outcomes associated with excess duration of antibiotic treatment.Retrospective cohort study.43 hospitals in the Michigan Hospital Medicine Safety Consortium.6481 general care medical patients with pneumonia.The primary outcome (...) was the rate of excess antibiotic treatment duration (excess days per 30-day period). Excess days were calculated by subtracting each patient's shortest effective (expected) treatment duration (based on time to clinical stability, pathogen, and pneumonia classification [community-acquired vs. health care-associated]) from the actual duration. Negative binomial generalized estimating equations (GEEs) were used to calculate rate ratios to assess predictors of 30-day rates of excess duration. Patient outcomes
Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients With Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial Community-acquired pneumonia remains a leading cause of hospitalization, mortality, and health care costs worldwide. Randomized clinical trials support the use of adjunctive corticosteroids, early progressive mobilization, antibiotic switching rules, and dietary interventions in improving outcomes. However (...) hospitals in Melbourne, Australia, among a consecutive sample of patients with community-acquired pneumonia. The primary analysis and preparation of results took place between May 14 and November 25, 2018.Treating clinical teams were advised to prescribe prednisolone acetate, 50 mg/d, for 7 days (in the absence of any contraindication) and de-escalate from parenteral to oral antibiotics according to standardized criteria. Algorithm-guided early mobilization and malnutrition screening and treatment were
Diagnostic accuracy of lung ultrasound performed by novice versus advanced sonographers for pneumonia in children: A systematic review and meta-analysis Childhood pneumonia is a leading cause of mortality worldwide. Growing evidence suggests that lung ultrasound (LUS) may be a reliable diagnostic alternative to chest x-ray for childhood pneumonia. However, it is unclear whether sonographer experience affects the diagnostic accuracy of LUS. We summarize the diagnostic accuracy of LUS (...) for pneumonia and compare the performance between novice and advanced sonographers with a systematic review and meta-analysis.We searched PubMed and EMBASE from inception to February 2018 for eligible studies that evaluated the utility of LUS in children suspected of having pneumonia against the reference standard of either imaging results alone or a combination of clinical, laboratory, and imaging results. We reported the study using the Preferred Reporting Items for a Systematic Review and Meta-analysis
Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study. Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings.We did a multi-site, international case-control study in nine study sites in seven countries (...) : Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1-59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted
XueBiJing Injection Versus Placebo for Critically Ill Patients With Severe Community-Acquired Pneumonia: A Randomized Controlled Trial To investigate whether XueBiJing injection improves clinical outcomes in critically ill patients with severe community-acquired pneumonia.Prospective, randomized, controlled study.Thirty-three hospitals in China.A total of 710 adults 18-75 years old with severe community-acquired pneumonia.Participants in the XueBiJing group received XueBiJing, 100 mL, q12 hours (...) , and the control group received a visually indistinguishable placebo.The primary outcome was 8-day improvement in the pneumonia severity index risk rating. Secondary outcomes were 28-day mortality rate, duration of mechanical ventilation and total duration of ICU stay. Improvement in the pneumonia severity index risk rating, from a previously defined endpoint, occurred in 203 (60.78%) participants receiving XueBiJing and in 158 (46.33%) participants receiving placebo (between-group difference [95% CI], 14.4
Validity of SMART-COP score in prognosis and severity of community acquired pneumonia in the emergency department Determining prognosis in community acquired pneumonia (CAP), is very important. Many scores are introduced up to now for prediction of pneumonia prognosis like SMART-COP.To evaluate validity of SMART-COP score in prognosis and severity of CAP in emergency department (ED).All patients older than 18 years old with clinical suspicion of CAP (meeting the inclusion criteria), were
Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial Efforts to reduce unnecessary and unnecessarily long antibiotic treatment for community-acquired pneumonia have been attempted through use of procalcitonin and through guidelines based on serial clinical assessment. Our aim is to compare guideline-based clinical assessment- and procalcitonin algorithm-guided antibiotic use among patients with community-acquired pneumonia.We (...) performed a pragmatic, randomized, multicenter trial from November 2012 to April 2015 at 12 French hospitals. We included emergency department (ED) patients older than 18 years with community-acquired pneumonia. Patients were randomly assigned to either the procalcitonin-guided or clinical assessment group. In accordance with past studies, we hypothesized that serial clinical assessment would be superior to procalcitonin-guided care. The primary outcome was antibiotic duration, and secondary outcomes
Solithromycin monotherapy for treatment of community-acquired bacterial pneumonia: A meta-analysis of randomised controlled trials Solithromycin is a new monotherapy option for community-acquired bacterial pneumonia (CABP) patients. However, the efficacy and safety of solithromycin monotherapy for the treatment of CABP remains controversial. The aim of this meta-analysis was to evaluate the role that solithromycin played in the treatment of CABP.We systematically retrieved randomised controlled
Preoperative chlorhexidine mouthwash to reduce pneumonia after cardiac surgery: A systematic review and meta-analysis Postoperative pneumonia is one of the most common complications after cardiac surgery, entailing increased patient morbidity, mortality, and health care burden. The primary aim of this study was to assess whether preoperative chlorhexidine mouthwash is associated with reduced postoperative pneumonia after cardiac surgery.A comprehensive systematic search of NLM Pubmed, Embase (...) , Scopus, and Cumulative Index of Nursing and Allied Health was executed to include the studies since inception to June 27, 2017, which assessed the effects of preoperative chlorhexidine gluconate mouthwash on postoperative pneumonia. Studies were identified by 2 independent reviewers, and data were extracted using a predefined protocol. Random effects models were run to obtain risk ratios with 95% confidence intervals. Quality of evidence was evaluated using Grading of Recommendations Assessment