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.