Hospital Medicine Alert – March 1, 2010
March 1, 2010
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Continuing Low-dose Aspirin with Peptic Ulcer Bleeding
Recurrent peptic ulcer bleeding was increased in patients with known cardiovascular or cerebrovascular disease when daily low-dose aspirin was continued along with proton-pump inhibitors, but overall mortality was significantly less during the 8-week follow-up. -
Prevention of Surgical-site Infections
In total, 6,771 patients underwent screening for Staphylococcus aureus nasal colonization using real-time polymerase chain reaction (PCR). Of those, 1,251 patients were positive, 917 were enrolled in the trial, and 808 subsequently underwent a surgical procedure. The enrolled patients were treated with nasal mupirocin ointment plus body chlorhexidine baths (or placebo). Rates of S. aureus infection were 3.4% in the mupirocin-chlorhexidine group vs. 7.7% in the placebo group. -
Lending a (Clean) Hand: Improving Hand-hygiene Practices
When ICU practitioners worked under senior clinicians who modeled good hand-hygiene practices, their own behavior with respect to hand hygiene improved. -
Intensive Lipid Lowering in ACS Patients Undergoing PCI
Intensive lipid lowering with statin therapy (atorvastatin 80 mg) in patients presenting with acute coronary syndromes (ACS) resulted in improved outcomes compared to treatment with moderate lipid lowering (pravastatin 40 mg) in the PROVE-IT TIMI-22 study (Cannon et al. N Engl J Med. 2004;350:1495-1504), which included patients treated conservatively, as well as those treated with percutaneous coronary intervention (PCI). -
Pharmacokinetics of IV Immunoglobulins and Outcome in GBS
Fixed dose of IVIg may not be effective in all patients with GBS.