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181. Consensus Guidelines for Evaluation and Management of Pulmonary Disease in Sjögren’s

. In Sjögren’s patients with small airway disease, time-limited empiric therapy in newly diagnosed and previously untreated disease may include: ? A short course of systemic steroids for 2-4 weeks with a repeat spirometry to determine reversibility, especially if uncontrolled asthma is suspected ? Nebulized or inhaled short or long-acting bronchodilators and/or inhaled corti- costeroids if there is physiological obstruction ? Shortcourse(ie,2-3months)ofempiricmacrolide antibiotics (mostcommonly

2021 American College of Chest Physicians

183. Breastfeeding Challenges

(this has been documented in animal studies), but this decrease usually will improve once she begins to recover, as long as she continues to breastfeed or adequately express her breast milk . Women should be reassured that the antibiotics and antiinflammatory medications used to treat mastitis are safe for her infants. Unless otherwise indicated, the patient should be encouraged to either continue breastfeeding her baby or to express her milk. If there is no clinical response to antibiotics, methicillin (...) ? Answer: The clinical definition of mastitis is a tender, hot, swollen, wedge-shaped area of the breast associated with a fever, chills, flu-like aching, and systemic illness. Most women diagnosed with mastitis can be treated with antibiotics on an outpatient basis. Preferred antibiotics are usually penicillinase-resistant penicillin, such as dicloxacillin, 500 mg four times per day. Alternatively, cephalexin 500 mg four times a day or clindamycin 300 mg four times a day may be used if the patient has

2021 American College of Obstetricians and Gynecologists

184. Reliability of nonlocalizing signs and symptoms as indicators of the presence of infection in nursing-home residents

of antibiotic use in residents of nursing homes ranges from 47% to 79%, and more than half of antibiotic courses initiated in nursing-home settings are unnecessary or prescribed inappropriately (wrong drug, dose, or duration). Inappropriate antibiotic use is associated with a variety of negative consequences including Clostridioides difficile infection (CDI), adverse drug effects, drug–drug interactions, and antimicrobial resistance. In response to this problem, public health authorities have called (...) Clostridioides difficile infection (CDI), adverse drug effects, - drug–drug interactions, and antimicrobial resistance. - In response to this problem, public health authorities have called for efforts to improve the quality of antibiotic prescribing in nursing homes. - There is increasing interest in implementing interventions to promote the deliberate application of clinical criteria as an approach to improving antibiotic decision making in nursing homes. - A consensus conference held by members

2021 Infectious Diseases Society of America

185. Anaesthesia and critical care: guidance for Clinical Directors on preparations for a possible second surge in COVID-19

(VTE) prophylaxis and treatment. Venous thromboembolism (VTE) prophylaxis and treatment. Antibiotic treatment. Antibiotic treatment. Indications for Indications for dexamethasone dexamethasone. . Indications for Indications for remdesivir remdesivir. . Indications for and management of renal replacement therapy. Indications for and management of renal replacement therapy.21 September 2020 8 Tracheostomy timing and processes. Tracheostomy timing and processes

2020 ICM Anaesthesia COVID-19

187. Renal Replacement Therapy for Critically Unwell Adult Patients: Guidelines for best practice and service resilience during COVID-19

Babu Muthuswamy Wales Critical Care and Trauma Network & Consultant in Intensive Care Medicine Julie Platten Chair, CC3N & Network Manager, North of England Critical Care Operational Delivery Network Sara Price Renal Dietetic Clinical Lead, University Hospitals Birmingham Laura Radford Senior Pharmacist Critical Care, Cambridge University Hospitals NHS Foundation Trust Reem Santos Principal Pharmacist Antimicrobial Stewardship and Infectious Diseases, Cambridge University Hospitals NHS Foundation (...) and surge scenarios 45 Appendix I: Clinical Guidance for adult critical care units – Antimicrobial drug dosing in different modalities of renal replacement therapy 59 RRT for Critically Unwell Adult Patients: Guidelines for best practice and service resilience during COVID-19 – 2020 6 Introduction Purpose The purpose of this guideline is to support implementation of the NHS England (NHSE) service specification, which describes the requirements for renal replacement therapy (RRT) as an interdependent

2020 Renal Association

189. Therapeutic Hypothermia for Neonatal Encephalopathy

coagulation accordingly. • Give vitamin K. Therapeutic Hypothermia for Neonatal Encephalopathy A BAPM Framework for Practice 27 ©BAPM 2020 Infection • Take blood cultures and give antibiotics within one hour of birth. • Consider lumbar puncture. • Physiological drop in white cell count and platelets is common in TH. • C-reactive protein rise with TH and may not be a sensitive marker of infection. (35) Seizures • Consider treating seizures which are confirmed with aEEG, particularly if they are associated

2021 British Association of Perinatal Medicine

190. ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease Full Text available with Trip Pro

with VHD. For subsets of patients with AF and VHD, anticoagulation is discussed in . 2.4.1 Secondary Prevention of Rheumatic Fever Recommendation for Secondary Prevention of Rheumatic Fever COR LOE Recommendation 1 C-EO 1. In patients with rheumatic heart disease, secondary prevention of rheumatic fever is indicated ( and ) ( ) . Table 6 Secondary Prevention of Rheumatic Fever Antibiotics for Prevention Dosage Penicillin G benzathine 1.2 million U intramuscularly every 4 wk Penicillin V potassium 200 (...) mg orally twice daily Sulfadiazine 1 g orally once daily Macrolide or azalide antibiotic (for patients allergic to penicillin and sulfadiazine) Varies Adapted from Gerber et al. ( ) ∗ In patients with documented valvular heart disease, the duration of rheumatic fever prophylaxis should be ≥10 y or until the patient is 40 y of age (whichever is longer). Lifelong prophylaxis may be recommended if the patient is at high risk of group A streptococcus exposure. Secondary rheumatic heart disease

2021 American College of Cardiology

191. The Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19: Molecular Diagnostic Testing

of Infectious Diseases, Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health McGovern Medical School, Center for Infectious Diseases, University of Texas Health School of Public Health, Houston, TX 4 Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois; Department of Pathology, Rush University Medical Center, Chicago, Illinois 5 Department of Pediatrics, University of Washington, Seattle Children’s Research Institute

2021 Infectious Diseases Society of America

192. Respiratory support for adults with severe to critical COVID-19

workers and infrastructure, ECMO should only be considered in selected patients with COVID-19 and severe ARDS. PP [Taskforce] Mechanical ventilation (cont.) ADDITIONAL MEASURES TRACHEOSTOMY In mechanically ventilated patients with COVID-19 and respiratory failure, use empiric antibacterial agents when clinically indicated. Re-evaluate the duration of therapy and spectrum of coverage based on the microbiology results and the individual’s clinical status. PP [Taskforce] In mechanically ventilated

2020 National COVID-19 Clinical Evidence Taskforce

193. Management of adults with moderate to severe COVID-19

on room air = 92%) or have pleural effusion or purulent sputum, prescribe antibiotics according to local pneumonia guidelines. If the onset of bacterial pneumonia symptoms occurs within 72 hours of hospital admission, choose antibiotics according to local CAP guidelines. If the onset of bacterial pneumonia symptoms occurs more than 72 hours after admission, choose antibiotics according to local HAP guidelines. PP [Taskforce/ASID] In people with suspected or confirmed COVID-19 with onset of symptoms

2020 National COVID-19 Clinical Evidence Taskforce

194. Clinical guide for the management of critical care for adults with COVID-19 during the Coronavirus pandemic v4

not be withheld. Other Anti-SARS-CoV-2/COVID-19 therapies should only be administered within the context of a nationally approved trial. COVID-19 related clinical trials should be supported to enable the rapid development of an evidence base for this new disease. Routine antibiotics ? Antibiotic adminstration is not recommended for uncomplicated COVID-19. COVID-19 and other infections ? Careful attention to antimicrobial stewardship is important ? Prevalence of both bacterial and fungal infection rises (...) with time on ICU. ? Antibiotics should be considered if there is suspected bacterial super-infection. ? Antifungals should be considered in patients not responding to antibacterial treatment, who are known or strongly suspected to have fungal infection. Consider Galactomannan/ ß-D-glucan testing if available. ? There is limited information available on interactions between seasonal influenza and COVID-19: - PHE analysis of data from the latter part of the 2019-20 influenza season in England found

2020 ICM Anaesthesia COVID-19

195. Advice for pregnant members of the anaesthesia and intensive care workforce during the COVID-19 pandemic

in the “UK Five-year Tackling Antimicrobial Resistance National Action Plan (2019-2024).” COVID-19: infection prevention and control guidance Uncontrolled if printed. 5 Contents 1. Explanation of the updates to infection prevention and control guidance 6 2. Introduction 7 2.1 Scope and purpose 7 3. Governance and responsibilities 9 4. Care pathways 10 4.1 Administration measures for the pathways 12 4.2 Community settings 14 4.3 Outpatient/primary/day care 14 5. Standard Infection Prevention Control

2020 ICM Anaesthesia COVID-19

196. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19

]. Azithromycin, widely utilized as an antibacterial agent, has also been shown to have in vitro antiviral activity against a variety of ribonucleic acid viruses [20-22]. While the exact mechanism of antiviral activity is unknown, possibilities include inhibiting endocytosis and limiting viral replication [23] and the induction of interferon [22, 24]. Macrolides have also been shown to have anti-inflammatory activity [25, 26]. Summary of the evidence Our search identified eight RCTs and seven comparative (...) no antibiotic or amoxicillin, respectively [56]. Given the cumulative effect on cardiac conduction seen with HCQ and AZ, if this combination was used, baseline and follow-up echocardiogram (ECG) monitoring would be indicated, as well as careful surveillance for other concomitant medications known to prolong the QT interval. Azithromycin has a low risk for cytochrome P450 interactions [57]; however, additional pharmacologic adverse events including gastrointestinal effects and QT prolongation need

2021 Infectious Diseases Society of America

197. Multisociety guideline on reprocessing flexible GI endoscopes and accessories

, evidence-based re- processing guidelines. Gaps and variation in implementing infection prevention practices are common inendoscopy units across the United States, 11 and compliance with reprocessing guidelines is inconsistent. Such variation emphasizes the need for standards and updates to infection control guidelines as it relates to GI endoscopes. Several guidelines have covered the topics of safety in endoscopy units, 12 antibiotic prophylaxis before endoscopy, 13 and standards for minimizing

2021 American Society for Gastrointestinal Endoscopy

198. Urinary Tract Infections in the Primary Care Setting – Investigation

observation. Hydrate patient and evaluate for 6,7 : New medication/drug interactions Hypoxia Hypoglycemia Trauma There is high certainty of harm (risk of antibiotic-associated diarrhea, including C. difficile infection and increased risk of antimicrobial resistance) and low certainty of benefit from treatment of asymptomatic bacteriuria in older adults. 6 With indwelling urinary catheter Catheterized patients usually do not manifest symptoms of cystitis. Instead, monitor for symptoms of complicated UTI (...) ): antimicrobial prescribing. NICE [Internet]. [cited 2019 Jul 15]. Available from: 33. Dason S, Dason JT, Kapoor A. Guidelines for the diagnosis and management of recurrent urinary tract infection in women. Can Urol Assoc J. 2011 Oct;5(5):316–22. 34. Albert X, Huertas I, Pereiró II, Sanfélix J, Gosalbes V, Perrota C. Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. Cochrane Database Syst Rev. 2004;(3

2020 Clinical Practice Guidelines and Protocols in British Columbia


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