Bacteriologic and clinical failures in adults with Streptococcal tonsillopharyngitis are twice as likely with oral penicillin therapy as with cephalosporin treatment. But, what is the significance of this finding?
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Cockerill and colleagues examined the effects of the volume of blood, the number of consecutive blood culture specimens, and the incubation time on the recovery of pathogens from 37,568 blood cultures obtained from adults. The study was performed at the Rochester, MN Mayo Clinic from 1996 to 1997, and used the automated BACTEC 9240 instrument.
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Musher and colleagues in Houston examined the usefulness of examination of Gram-stained sputum specimens and of sputum culture for the diagnosis of pneumococcal pneumonia. They included all 105 patients with bacteremic pneumococcal pneumonia seen over 6 years at their VA hospital, and examined the results of the first sputum specimen submitted to the laboratory.
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The FDA has approved Telithromycin, the first Ketolide antibiotic. Ketolides are semisynthetic derivatives of the macrolide erythromycin that have activity against a wide spectrum of respiratory bacterial pathogens including multi-drug resistant Streptococcus pneumoniae. Telithromycin, which is a once-a-day oral tablet, is marketed by Aventis as Ketek.
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Ventilator-associated pneumonia (VAP) is nosocomial pneumonia occurring in a mechanically ventilated patient > 48 hours after intubation. It is categorized as early-onset (defined by most experts as 48-96 hours after intubation) and late-onset (> 2-96 hours after intubation): these differ with respect to responsible bacterial agents as well as outcomes.
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