Cellulitis is frequently seen in ambulatory care settings and is often responsive to empiric therapy directed against Staphylococcus aureus and group A b-hemolytic streptococcus. Ideally, blood culture susceptibility by offending pathogens should direct antimicrobial therapy, but their low yield in skin infections may render them clinically useless. We therefore reviewed the available evidence ...

the empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. the aim of the present study was to evaluate the effect of procalcitonin (pct) guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (icu) with systemic inflammatory response syndrome (sirs).  a total ...

Background. Empiric antimicrobials for critically-ill patients routinely include combination therapy for patients at risk for infection from P. aeruginosa. In 2013, in vitro susceptibility to anti-pseudomonal beta-lactams, ciprofloxacin and tobramycin among ICU isolates at of P. aeruginosa was < 85%, 70% and >90%, respectively. This prompted the question of whether an aminoglycoside should rout...

The current medical therapy for Mycobacterium avium complex is controversial. American Thoracic Society recommendations advocate empiric therapy with drug susceptibility testing only for clarithromycin. At National Jewish, where we mainly see cases complicated by treatment failure and drug intolerance, we use in vitro susceptibility testing and therapeutic drug monitoring to optimize efficacy a...

BACKGROUND To prevent inappropriate empiric antibiotic treatment in patients with bacteremia caused by third-generation cephalosporin (3GC)-resistant Enterobacteriaceae (3GC-R EB), Dutch guidelines recommend β-lactam and aminoglycoside combination therapy or carbapenem monotherapy in patients with prior 3GC-R EB colonization and/or recent cephalosporin or fluoroquinolone usage. Positive predict...

The role of cefepime for extended-spectrum β-lactamase (ESBL) bacteremia is unclear if susceptible in vitro. In a propensity score-matched study of patients with ESBL bacteremia, risk of death was 2.87 times higher for patients receiving cefepime compared with carbapenems (95% confidence interval [CI], .88-9.41). We compared 14-day mortality of patients with ESBL bacteremia receiving empiric ce...

OBJECTIVE To examine the cost-effectiveness of approaches to the diagnosis and treatment of patients with type II (non-insulin-dependent) diabetes mellitus (NIDDM) who have foot infections and suspected osteomyelitis. DESIGN Decision and cost-effectiveness analyses were performed using a Markov model. We examined the prevalence of osteomyelitis, the major complications and efficacies of long-...