In a single academic medical center, changing from a strategy of prior authorization to prospective audit with feedback led to significantly increased total antibiotic use and use of agents with a broad spectrum of gram-negative activity.
Accidental laboratory exposure to Coccidioides species is the major cause of clinical laboratory-acquired fungal infection, and coccidiodomycosis is thought to be the least responsive deep mycosis to treatment.
In a case-control study, older patients who received an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker along with co-trimoxazole had an increased risk of sudden death (unadjusted odds ratio 1.83, 95% confidence interval 1.50 to 2.24). Hyperkalemia is hypothesized to be the underlying mechanism.
Meningitis is very unlikely in otherwise healthy-appearing febrile infants older than 21 days of age. Thus, cerebrospinal fluid analysis might not be needed as part of a “routine” evaluation of these babies.
Nationally, nonblack children with otitis media more frequently receive broad-spectrum antibiotics than black children do. The majority of children with otitis media in the United States receive inappropriate treatment with broad-spectrum antibiotics.
A 46-year-old man was admitted to our hospital due to progressive dyspnea, non-productive cough and fever. Two months prior to admission, he started to develop sustained weight loss and dyspnea associated with exertion. Ten-days prior to his presentation, dyspnea progressed to minimal exertion significantly limiting his functional status.
147 patients on stable antiretroviral therapy (ART) were randomized to receiving rosuvustatin 10 mg daily or placebo. After 24 weeks rosovustatin both reduced cystatin C and slowed kidney function decline as assessed by a serum creatinine-based equation.