Archive

Medical Category: Infectious Disease

Clinical Conundrum: What is the Utility of Procalcitonin in the ED?

Procalcitonin is a protein that is upregulated during inflammatory states. An elevation in procalcitonin should be specific to bacterial infections. Viral infections should result in decreased procalcitonin levels thus allowing us to differentiate bacterial from viral and help guide antibiotic ...

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Infectious Disease

The ADAPT-Sepsis Trial: Biomarker-Guided Antibiotic Duration for Hospitalized Patients with Suspected Sepsis

Antibiotic stewardship entails delivering the most appropriate antimicrobial therapy for the most appropriate duration of time to help provide the best outcome for patients with sepsis. An unnecessarily extended course of antibiotics leads to adverse effects, greater cost, medication utilization ...

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Infectious Disease

Is 7 Days Enough? Rethinking Antibiotic Duration in Sepsis — The BALANCE Trial

Current IDSA guidelines for sepsis recommend individualized durations of antibiotic therapy based on source control and clinical response, but definitive guidance remains limited. Three small noninferiority RCTs suggested that 7 days of antibiotics may be sufficient for patients with gram-negative ...

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Infectious Disease

Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

Bottom Line Up Top: There doesn’t appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. Only treat fever if it causes the patient distress. Clinical Scenario: A 45-year-old woman ...

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Infectious Disease

Is Pip-Tazo Harming Sepsis Patients?

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. Literature ...

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Infectious Disease

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