New guideline recommendations indicate that the only unequivocal indications for screening and treatment of asymptomatic bacteriuria are pregnancy and undergoing endoscopic urologic procedures associated with mucosal injury.
A multicenter, retrospective, cohort study from southern and eastern Europe identified predictive factors for multidrug-resistant complicated urinary tract infections (cUTI), which included male sex, cUTI acquisition in a healthcare facility, presence of a Foley catheter, having a UTI in the previous year, and receiving an antibiotic in the preceding 30 days.
Researchers compared outcomes in patients with aspiration pneumonitis who received prophylactic antibiotics during the first two days after macro-aspiration to patients who received only supportive care during this time. Among the 200 patients meeting the acute aspiration pneumonitis case definition, antimicrobial prophylaxis was not associated with improvement in mortality. However, patients receiving prophylactic antibiotics required more frequent escalation of antibiotics and received more days of antibiotics than those who were managed initially with supportive care alone.
There are many emerging infections for which the emergency physician must remain clinically vigilant. Although many infections may not represent true emergencies, it is important for ED providers to understand the epidemiology, presentation, and treatment of some of today’s common and life-threatening infections.
A work group in the Veterans Administration determined that the necessary staffing of antimicrobial stewardship programs dealing with inpatients (including long-term care) is 1.0 clinical pharmacy specialist with infectious disease knowledge and 0.25 physician (preferably trained in infectious disease) per 100 occupied beds. Needs for outpatient stewardship, which is now mandated, were not included in the assessment.