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1662. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis Full Text available with Trip Pro

regarding antibiotic choices and dosing. Penicillin or amoxicillin remain the treatments of choice, and recommendations are made for the penicillin-allergic patient, which now include clindamycin. EXECUTIVE SUMMARY Group A streptococcal (GAS) pharyngitis is a significant cause of community-associated infections. This document constitutes a revision of the 2002 guideline of the Infectious Diseases Society of America (IDSA) on the treatment of GAS pharyngitis [ ]. The primary objective of this guideline (...) outcome, is very uncertain. Information is based on GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria [ ] Abbreviation: RCT, randomized controlled trial. Table 2. Antibiotic Regimens Recommended for Group A Streptococcal Pharyngitis Drug, Route Dose or Dosage Duration or Quantity Recommendation Strength, Quality a Reference(s) For individuals without penicillin allergy Penicillin V, oral Children: 250 mg twice daily or 3 times daily; adolescents and adults: 250 mg 4

2012 Infectious Diseases Society of America

1663. Effectiveness of practices to reduce blood culture contamination Full Text available with Trip Pro

, False positive reactions, Healthcare quality improvement, Laboratory medicine, Phlebotomy, Practice guideline Introduction A blood culture is the primary laboratory test for diagnosing serious blood stream infections, including septicemia or sepsis, and in directing appropriate antibiotic therapy [ – ]. Septicemia among hospitalized patients is widely prevalent and was the single most expensive condition treated in U.S. hospitals affecting nearly one of every 23 patients (4.2%) at an aggregate cost (...) diagnosis due to errors in clinical interpretation, inappropriate antibiotic treatment as well as unnecessary and longer hospital stays and costs associated with these outcomes [ , , , , ]. To reduce this important quality gap and its consequences, it is essential to identify effective practices for reducing blood culture contamination rates. Other than the use of skin antiseptics [ ] and changing needles prior to inoculation of blood culture bottles [ ], no systematic reviews of quality improvement

2012 Laboratory Medicine Best Practices

1664. Diagnosis and Treatment of Diabetic Foot Infections Full Text available with Trip Pro

or metabolic perturbations). This classification system, along with a vascular assessment, helps determine which patients should be hospitalized, which may require special imaging procedures or surgical interventions, and which will require amputation. Most DFIs are polymicrobial, with aerobic gram-positive cocci (GPC), and especially staphylococci, the most common causative organisms. Aerobic gram-negative bacilli are frequently copathogens in infections that are chronic or follow antibiotic treatment (...) , and obligate anaerobes may be copathogens in ischemic or necrotic wounds. Wounds without evidence of soft tissue or bone infection do not require antibiotic therapy. For infected wounds, obtain a post-debridement specimen (preferably of tissue) for aerobic and anaerobic culture. Empiric antibiotic therapy can be narrowly targeted at GPC in many acutely infected patients, but those at risk for infection with antibiotic-resistant organisms or with chronic, previously treated, or severe infections usually

2012 Infectious Diseases Society of America

1665. Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer

commonly utilized. [22] A discussion of locoregional staging for rectal cancer is beyond the intended scope of this guideline, but readers are referred to the Rectal Cancer Guidelines of the American Society of Colon and Rectal Surgeons. [23] IV. PREPARATION FOR OPERATION Standard guidelines have been published regarding the safety of outpatient bowel preparation [21, 22] , use of prophylactic antibiotics [24] , blood cross matching [25, 26] and venous thromboembolism prophylaxis. [27] Recommendation

2012 Society of American Gastrointestinal and Endoscopic Surgeons

1666. Aerosol delivery device selection for spontaneously breathing patients

FOR SPONTANEOUSLY BREATHING PATIENTS: 2012 616 RESPIRATORY CARE •APRIL 2012 VOL 57 NO 4other drugs such as antibiotics or corticoste- roids. 91,92 7.2 Use of proper technique in applying aerosol de- livery systems: 7.2.1Healthcareprovidersmustdemonstratecom- petencywithpropertechniqueandpatientinstruc- tion of aerosol delivery systems. 15,93–96 7.2.2 Patients and family members must demon- stratepropertechniquewithuseofprescribedaero- sol delivery systems. 93–96 7.3 Patient adherence with application of aerosol (...) and/or improper technique may result in underdosing or over- dosing. 41–43,96,113–116 9.1.5 Specific pharmacologic agents can pro- duce adverse side effects such as headache, in- somnia, tachycardia, tremor, and nervousness with adrenergic agents; local topical effects with anticholinergics; airway reactivity with antibiot- ics,hypertonicsaline,inhaledcorticosteroids,and bronchodilators; systemic/local effects with cor- ticosteroids; and bad taste with mucolytics and hypertonic saline. 14,117 9.1.6

2012 American Association for Respiratory Care

1667. Clinical Consensus Statement: Appropriate Use of Computed Tomography for Paranasal Sinus Disease

appropriately to medical management (statement 1). The panel unanimously agreed that CT imaging is indicated in patients who have been treated repeatedly with antibiotics and other medications for presumed sinusitis, with persistent complaints posttreatment, but no clinical evidence of sinusitis, to confirm that the problem is indeed not due to sinonasal pathology and thereby avoid continued inappropriate antibiotic administration (statement 2). Computed tomography imaging is not indicated for clinically (...) focused on indications for sinus CT imaging. Discussion regarding medical therapy and details of medical management are addressed in other guidelines. There is strong evidence, for example, that nasal steroid sprays and saline lavages are helpful for chronic rhinosinusitis. The presence of sinus abnormalities on CT does not necessarily indicate an infectious cause, but a sinus CT that is completely normal provides confirmation that initiation or continuation of antibiotics for sinusitis

2012 American Academy of Otolaryngology - Head and Neck Surgery

1670. Pharmacologic treatment of chorea in huntington disease

Q10 was associated with a trend toward a smaller decline in TFC at 30 months; however, chorea did not improve (adjusted coenzyme Q10 effect −0.10 units, 95% CI −1.05 to 0.86). Conclusion. Coenzyme Q10 is likely ineffective in moderately improving HD chorea (1 Class I study), but modest benefit cannot be excluded. Minocycline. Minocycline is an antibiotic with anti-inflammatory and antiapoptotic properties studied in HD on the basis of preclinical evidence. One Class I RCT studied minocycline

2012 American Academy of Neurology

1671. Radiologic Management of Benign and Malignant Biliary Obstruction

include those with a broad range of antimicrobial activity with good penetration into the bile ducts. Examples include third-generation cephalosporins, ureidopenicillins, carbapenems, and fluoroquinolones [31]. The beneficial role for antibiotics in PSC is controversial. While a high rate of positive cultures has been reported for PSC patients, antibiotic therapy for 12 weeks with rifaximin resulted in no significant effects on the clinical course of PSC [32]. Conversely, vancomycin (...) therapy, including ursodeoxycholic acid and corticosteroids, along with endoscopic and percutaneous dilatation of biliary strictures and drainage, or surgical resection of isolated biliary strictures, may improve quality of life; however, definitive evidence of prolonged survival is lacking [29,30]. Because of this, many advocate treating these patients in a tertiary hospital to facilitate a multidisciplinary approach without jeopardizing future transplantation [29,30]. Selection of antibiotics should

2012 American College of Radiology

1672. Quality-Improvement Guidelines for Hepatic Transarterial Chemoembolization     - currently under revision

saline solution is essential before the administration of other premedications, including antiemetics and steroids. Many centers also administer antibiotics for Gram-neg- ative enteric organisms, even although this practice is not universal or prospectively proven to be bene?cial for all patients [16]. In patients without an intact sphincter of Oddi from earlier surgery, sphincterotomy, or biliary drainage, the risk of infection after embolization is signi?cantly increased [17]. The risk (...) ) ? mitomycin C Doxorubicin (or epirubicin) ? cisplatin Median dosage per session [mg] Doxorubicin (20–100) Epirubicin (40–100) Cisplatin (10–120) A. Basile et al.: Quality-Improvement Guidelines for Hepatic Transarterial Chemoembolization 123Medication and Periprocedural Care Periprocedural medications, including pain medications, antibiotic prophylaxis, intra-arterial lidocaine, corticoste- roids, and proton-pump inhibitors, are all administered at the physician’s discretion. If necessary, antiemetic

2012 Cardiovascular and Interventional Radiological Society of Europe

1673. A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines on Acute Kidney Injury: Part 1: definitions, conservative management and contrast-induced nephropathy

with single-daily dosing is used for more than 48h. (2C) 2.2.5.5 We suggest using topical or local applications of aminoglycosides (e.g. respiratory aerosols, in- stilled antibiotic beads), rather than intravenous (i.v.) application, when feasible and suitable. (2B) 2.2.5.6 We recommend that patients receiving whatever formulationof amphotericinB shouldreceive adequate sodium loading and potassium suppletion (1B). We suggest balancing the presumed lower nephrotoxicity of lipid formulations against (...) - phrotoxicity, and ototoxicity, remain major concerns, these events appear to be due to cumulative exposure, and their occurrence after single shot administration is ERBP KDIGOAKIpart 1 5 by guest on October 8, 2012 http://ndt.oxfordjournals.org/ Downloaded from exceptional. On the other hand, due to their potent bac- tericidal activity, aminoglycosides can help to reverse sepsis-related haemodynamic instability, and thus risk for AKI. In the light of recent developments with progressive antimicrobial

2012 European Renal Best Practice

1674. EANM Practice Guideline-SNMMI Procedure Standard for 18F-FDG Use in Inflammation and Infection

be scheduled for late morning. Detailed instructions can befoundintheEANMguidelinesfortumorimaging. It is strongly advised that commencement of steroid treatmentbeavoidedbetweentherequestdateforthe study and the appointment. The use of steroid treat- mentcouldresultinafalse-negativeresult,especially in giant cell arteritis and other systemic vasculitides (126). Because the effect of antibiotics on 18 F-FDG uptake is unknown, it is important to be aware of ongoing antibiotic treatment, but no general recom

2012 Society of Nuclear Medicine and Molecular Imaging

1675. Quality Improvement Guidelines for Transjugular Intrahepatic Portosystemic Shunt (TIPS)

is \ 50,000 9 10 9 /L, or according to the center’s standards) should be corrected. The acutely bleeding patient has to be hemodynamically stabilized during the procedure. Cardiologic evaluation should reveal preexisting cardiac dysfunction. Silent cirrhotic cardiomyopathy may be unmasked after TIPS insertion [9]. Prophylactic broad-spectrum antibiotics should be administered. With a potentially limited effect on hepatic metabolism, antibiotics are initiated on the day of proce- dure and continued (...) for at least two additional days. (Antibiotic therapy should be included in the therapy of variceal bleeding.) Two cross-matched blood units should be available. Draining of tense ascites can be performed to decrease the angle between the hepatic veins and the inferior vena cava and have better ?uoroscopic imaging. Clinicians should be aware of hepatorenal syndrome. Monitored ascites drainage can improve respiratory comfort during the procedure. It should be determined whether patients have an allergy

2012 Cardiovascular and Interventional Radiological Society of Europe

1676. Standards of Practice: Guidelines for Thermal Ablation of Primary and Secondary Lung Tumors

abscess are reported paren- chymal complications. The risks of infectious complica- tions seem to be higher in primary tumors, in compromised lung parenchyma, and in previously irradiated lung. However, prophylactic antibiotics have not been proven to reduce infectious rates [33]. Conclusion Percutaneous thermal ablation of primary and metastatic lung malignancies is clearly feasible, is cheaper, results in a shorter recovery time, and offers reduced morbidity and mortality. Because there are still

2012 Cardiovascular and Interventional Radiological Society of Europe

1678. Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations Full Text available with Trip Pro

surgery in the abdomen or pelvis [ , ]. Summary and recommendation: Patients should wear well-fitting compression stockings, have intermittent pneumatic compression, and receive pharmacological prophylaxis with LMWH. Extended prophylaxis for 28 days should be given to patients with colorectal cancer. Evidence level: Stockings, compression, LMVH, extended prophylaxis: High Recommendation grade: Strong Antimicrobial prophylaxis and skin preparation In a Cochrane review on antimicrobial prophylaxis (...) in colorectal surgery [ ], the authors concluded that the use of antibiotic prophylaxis for patients undergoing colorectal surgery is imperative to reduce the risk of surgical-site infections. For intravenous antibiotics, it is accepted that the best time for administration is 30–60 min before the incision is made [ ]. Repeated doses during prolonged procedures may be beneficial [ ]. The timing of oral administration of antibiotics is much less certain, especially in the light of current recommendations

2012 ERAS Society

1679. Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

be considered in patients with colorectal cancer or other patients with increased risk of VTE. Evidence level : high. Recommendation grade : strong. 3.8. Antimicrobial prophylaxis and skin preparation Prophylactic antibiotics Prophylactic antibiotics are effective against aerobes and anaerobes; they have been shown to reduce the prevalence of infectious complications in colorectal surgery. x 41 Bratzler, D.W. and Houck, P.M. Antimicrobial prophylaxis for surgery: an advisory statement from the National (...) ) depending on the pharmacokinetics of the antibiotics used. x 41 Bratzler, D.W. and Houck, P.M. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis . 2004 Jun 15 ; 38 : 1706–1715 | | | The first intravenous dose should be administered before skin incision but ≤1 h before surgery. x 41 Bratzler, D.W. and Houck, P.M. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention

2012 ERAS Society

1680. Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

and skin preparation In a Cochrane review on antimicrobial prophylaxis in colorectal surgery, x 72 Nelson, R.L., Glenny, A.M., and Song, F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev . 2009 ; ( CD001181 ) the authors concluded that the use of antibiotic prophylaxis for patients undergoing colorectal surgery is imperative to reduce the risk of surgical-site infections. For intravenous antibiotics, it is accepted that the best time for administration is 30–60 min before (...) the incision is made. x 73 Steinberg, J.P., Braun, B.I., Hellinger, W.C., Kusek, L., Bozikis, M.R., Bush, A.J. et al. Timing of antimicrobial prophylaxis and the risk of surgical site infections: results from the Trial to Reduce Antimicrobial Prophylaxis Errors. Ann Surg . 2009 ; 250 : 10–16 | | | Repeated doses during prolonged procedures may be beneficial. x 74 Fujita, S., Saito, N., Yamada, T., Takii, Y., Kondo, K., Ohue, M. et al. Randomized, multicenter trial of antibiotic prophylaxis in elective

2012 ERAS Society

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