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.