Archive for January 27, 2017

Executive Summary: Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society

Clinical Infectious Diseases September 15, 2016 V.63 N.5 P. 575-582           

IDSA GUIDELINE

Andre C. Kalil, Mark L. Metersky, Michael Klompas, John Muscedere, Daniel A. Sweeney, Lucy B. Palmer, Lena M. Napolitano, Naomi P. O’Grady, John G. Bartlett, Jordi Carratalà, Ali A. El Solh, Santiago Ewig, Paul D. Fey, Thomas M. File, Jr, Marcos I. Restrepo, Jason A. Roberts, Grant W. Waterer, Peggy Cruse, Shandra L. Knight, and Jan L. Brozek

1Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha

2Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington

3Brigham and Women’s Hospital and Harvard Medical School

4Harvard Pilgrim Health Care Institute, Boston, Massachusetts

5Department of Medicine, Critical Care Program, Queens University, Kingston, Ontario, Canada

6Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego

7Department of Medicine, Division of Pulmonary Critical Care and Sleep Medicine, State University of New York at Stony Brook

8Department of Surgery, Division of Trauma, Critical Care and Emergency Surgery, University of Michigan, Ann Arbor

9Department of Critical Care Medicine, National Institutes of Health, Bethesda

10Johns Hopkins University School of Medicine, Baltimore, Maryland

11Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Spanish Network for Research in Infectious Diseases, University of Barcelona, Spain

12Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University at Buffalo, Veterans Affairs Western New York Healthcare System, New York

13Thoraxzentrum Ruhrgebiet, Department of Respiratory and Infectious Diseases, EVK Herne and Augusta-Kranken-Anstalt Bochum, Germany

14Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha

15Summa Health System, Akron, Ohio

16Department of Medicine, Division of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center at San Antonio

17Burns, Trauma and Critical Care Research Centre, The University of Queensland

18Royal Brisbane and Women’s Hospital, Queensland

19School of Medicine and Pharmacology, University of Western Australia, Perth, Australia

20Library and Knowledge Services, National Jewish Health, Denver, Colorado

21Department of Clinical Epidemiology and Biostatistics and Department of Medicine, McMaster University, Hamilton, Ontario, Canada

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances.

These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia. The panel’s recommendations for the diagnosis and treatment of HAP and VAP are based upon evidence derived from topic-specific systematic literature reviews.

PDF

http://cid.oxfordjournals.org/content/63/5/575.full.pdf+html

 

http://cid.oxfordjournals.org/content/63/5/e61.full.pdf+html

 

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January 27, 2017 at 8:14 am

IDSA GUIDELINE – Executive Summary: 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Treatment of Coccidioidomycosis

Clinical Infectious Diseases September 15, 2016 V.63 N.6 P.717-722

John N. Galgiani, Neil M. Ampel, Janis E. Blair, Antonino Catanzaro, Francesca Geertsma, Susan E. Hoover, Royce H. Johnson, Shimon Kusne, Jeffrey Lisse, Joel D. MacDonald, Shari L. Meyerson, Patricia B. Raksin, John Siever, David A. Stevens, Rebecca Sunenshine, and Nicholas Theodore

1Valley Fever Center for Excellence

2Division of Infectious Diseases, University of Arizona, Tucson

3Division of Infectious Diseases, Mayo Clinic, Scottsdale, Arizona

4Division of Pulmonary and Critical Care, University of California, San Diego

5Department of Pediatrics, Infectious Diseases, Stanford University School of Medicine, California

6Division of Sanford Health, Sioux Falls, South Dakota

7David Geffen School of Medicine at UCLA, Department of Medicine, Kern Medical Center, Bakersfield, California

8Department of Rheumatology, University of Arizona, Tucson

9Department of Neurosurgery School of Medicine, University of Utah, Salt Lake City

10Division of Thoracic Surgery, Northwestern University, Feinberg School of Medicine

11Division of Neurosurgery, John H. Stroger Jr Hospital of Cook County, Chicago, Illinois

12Arizona Pulmonary Specialists, Ltd, Phoenix

13Division of Infectious Diseases, Stanford University School of Medicine, California

14Career Epidemiology Field Officer Program, Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention

15Maricopa County Department of Public Health

16Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona

It is important to realize that guidelines cannot always account for individual variation among patients.

They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances.

Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere.

Residence in and recent travel to these areas are critical elements for the accurate recognition of patients who develop this infection. In this practice guideline, we have organized our recommendations to address actionable questions concerning the entire spectrum of clinical syndromes.

These can range from initial pulmonary infection, which eventually resolves whether or not antifungal therapy is administered, to a variety of pulmonary and extrapulmonary complications.

Additional recommendations address management of coccidioidomycosis occurring for special at-risk populations. Finally, preemptive management strategies are outlined in certain at-risk populations and after unintentional laboratory exposure.

PDF

http://cid.oxfordjournals.org/content/63/6/717.full.pdf+html

January 27, 2017 at 8:10 am

IDSA GUIDELINE – Executive Summary: Official American Thoracic Society-Centers for Disease Control and Prevention-Infectious Diseases Society of America Clinical Practice Guidelines -Treatment of Drug-Susceptible Tuberculosis

Clinical Infectious Diseases October 1, 2016 V.63 N.7 P.853-867

Payam Nahid1, Susan E. Dorman2, Narges Alipanah1, Pennan M. Barry3, Jan L. Brozek4, Adithya Cattamanchi1, Lelia H. Chaisson1, Richard E. Chaisson2, Charles L. Daley5, Malgosia Grzemska6, Julie M. Higashi7, Christine S. Ho8, Philip C. Hopewell1, Salmaan A. Keshavjee9, Christian Lienhardt6, Richard Menzies10, Cynthia Merrifield1, Masahiro Narita12, Rick O’Brien13, Charles A. Peloquin14, Ann Raftery1, Jussi Saukkonen15, H. Simon Schaaf16, Giovanni Sotgiu17, Jeffrey R. Starke18, Giovanni Battista Migliori11, and Andrew Vernon8

1University of California, San Francisco

2Johns Hopkins University, Baltimore, Maryland

3California Department of Public Health, Richmond

4McMaster University, Hamilton, Ontario, Canada

5National Jewish Health, Denver, Colorado

6World Health Organization, Geneva, Switzerland

7Tuberculosis Control Section, San Francisco Department of Public Health, California

8Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

9Harvard Medical School, Boston, Massachusetts

10McGill University, Montreal, Quebec, Canada

11WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri Care and Research Institute, Tradate, Italy

12Tuberculosis Control Program, Seattle and King County Public Health, and University of Washington, Seattle

13Ethics Advisory Group, International Union Against TB and Lung Disease, Paris, France

14University of Florida, Gainesville

15Boston University, Massachusetts

16Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa

17University of Sassari, Italy

18Baylor College of Medicine, Houston, Texas

The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association.

Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline.

This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis.

For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology.

Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions.

Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided.

The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the component drugs, optimal management of tuberculosis in special populations, identification of accurate biomarkers of treatment effect, and the assessment of new strategies for implementing regimens in the field remain key priority areas for research.

See the full-text online version of the document for detailed discussion of the management of tuberculosis and recommendations for practice.

PDF

http://cid.oxfordjournals.org/content/63/7/853.full.pdf+html

January 27, 2017 at 8:07 am


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