Posts filed under ‘GUIDELINES’

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

 

August 22, 2016 at 9:09 am

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).

World J Emerg Surg. 2016 Jul 15;11:33.

Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L, Catena F, Coccolini F, Abu-Zidan FM, Coimbra R, Moore EE, Moore FA, Maier RV, De Waele JJ, Kirkpatrick AW, Griffiths EA, Eckmann C, Brink AJ, Mazuski JE, May AK, Sawyer RG, Mertz D, Montravers P, Kumar A, Roberts JA, Vincent JL, Watkins RR, Lowman W, Spellberg B, Abbott IJ, Adesunkanmi AK, Al-Dahir S, Al-Hasan MN, Agresta F, Althani AA, Ansari S, Ansumana R, Augustin G, Bala M, Balogh ZJ, Baraket O, Bhangu A, Beltrán MA, Bernhard M, Biffl WL, Boermeester MA, Brecher SM, Cherry-Bukowiec JR, Buyne OR, Cainzos MA, Cairns KA, Camacho-Ortiz A, Chandy SJ, Che Jusoh A, Chichom-Mefire A, Colijn C, Corcione F, Cui Y, Curcio D, Delibegovic S, Demetrashvili Z, De Simone B, Dhingra S, Diaz JJ, Di Carlo I, Dillip A, Di Saverio S, Doyle MP, Dorj G, Dogjani A, Dupont H, Eachempati SR, Enani MA, Egiev VN, Elmangory MM, Ferrada P, Fitchett JR, Fraga GP, Guessennd N, Giamarellou H, Ghnnam W, Gkiokas G, Goldberg SR, Gomes CA, Gomi H, Guzmán-Blanco M, Haque M, Hansen S, Hecker A, Heizmann WR, Herzog T, Hodonou AM, Hong SK, Kafka-Ritsch R, Kaplan LJ, Kapoor G, Karamarkovic A, Kees MG, Kenig J, Kiguba R, Kim PK, Kluger Y, Khokha V, Koike K, Kok KY, Kong V, Knox MC, Inaba K, Isik A, Iskandar K, Ivatury RR, Labbate M, Labricciosa FM, Laterre PF, Latifi R, Lee JG, Lee YR, Leone M, Leppaniemi A, Li Y, Liang SY, Loho T, Maegele M, Malama S, Marei HE, Martin-Loeches I, Marwah S, Massele A, McFarlane M, Melo RB, Negoi I, Nicolau DP, Nord CE, Ofori-Asenso R, Omari AH, Ordonez CA, Ouadii M, Pereira Júnior GA, Piazza D, Pupelis G, Rawson TM, Rems M, Rizoli S, Rocha C, Sakakhushev B, Sanchez-Garcia M, Sato N, Segovia Lohse HA, Sganga G, Siribumrungwong B, Shelat VG, Soreide K, Soto R, Talving P, Tilsed JV, Timsit JF, Trueba G, Trung NT, Ulrych J, van Goor H, Vereczkei A, Vohra RS, Wani I, Uhl W, Xiao Y, Yuan KC, Zachariah SK, Zahar JR, Zakrison TL, Corcione A, Melotti RM, Viscoli C, Viale P.

Abstract

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy.

Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance.

The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally.

The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs.

The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections).

The authors hope that AGORA, involving many of the world’s leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946132/pdf/13017_2016_Article_89.pdf

August 17, 2016 at 3:19 pm

Review of the guidelines for complicated skin and soft tissue infections and intra-abdominal infections–are they applicable today?

Clin Microbiol Infect. 2008 Dec;14 Suppl 6:9-18.

Caínzos M1.

Author information

1Hospital Clínico Universitario, Medical School, Santiago de Compostela, Spain. ci28@usc.es

Abstract

Difficult-to-treat infections in surgical patients, such as serious skin and soft tissue infections (SSTIs) and complicated intra-abdominal infections (cIAIs), are the cause of significant morbidity and mortality, and carry an economic burden. These surgical site infections are typically polymicrobial infections caused by a plethora of pathogens, which include difficult-to-treat organisms and multiresistant Gram-positive and Gram-negative strains. Optimal management of SSTIs and cIAIs must take into account the presence of resistant pathogens, and depends on the administration of appropriate antimicrobial therapy (i.e. the correct spectrum, route and dose in a timely fashion for a sufficient duration as well as the timely implementation of source control measures). Treatment recommendations from the Infectious Diseases Society of America and the Surgical Infection Society are available for guidance in the management of both of these infections, yet the increased global prevalence of multidrug-resistant pathogens has complicated the antibiotic selection process. Several pathogens of concern include methicillin-resistant Staphylococcus aureus, responsible for problematic postoperative infections, especially in patients with SSTIs, extended-spectrum beta-lactamase-producing Gram-negative bacteria, including CTX-M-type-producing Escherichia coli strains, and multidrug-resistant strains of Bacteroides fragilis. New empirical regimens, taking advantage of potent broad-spectrum antibiotic options, may be needed for the treatment of certain high-risk patients with surgical site infections.

FULL TEXT

http://www.sciencedirect.com/science/article/pii/S1198743X1461260X

PDF

http://ac.els-cdn.com/S1198743X1461260X/1-s2.0-S1198743X1461260X-main.pdf?_tid=66650bd4-58c8-11e6-9a3a-00000aacb35f&acdnat=1470153021_13a0055e9d7f7f6dee0fc76a87714ee8

August 10, 2016 at 8:34 am

Practice Guidelines for the Diagnosis and Management of Aspergillosis – 2016 Update by the Infectious Diseases Society of America

Clin Infect Dis. (2016) 63 (4): e1-e60

Thomas F. Patterson, George R. Thompson III, David W. Denning, Jay A. Fishman, Susan Hadley, Raoul Herbrecht, Dimitrios P. Kontoyiannis, Kieren A. Marr, Vicki A. Morrison, M. Hong Nguyen, Brahm H. Segal, William J. Steinbach, David A. Stevens, Thomas J. Walsh, John R. Wingard, Jo-Anne H. Young, and John E. Bennett

1University of Texas Health Science Center at San Antonio and South Texas Veterans Health Care System

2University of California, Davis

3National Aspergillosis Centre, University Hospital of South Manchester, University of Manchester, United Kingdom

4Massachusetts General Hospital and Harvard Medical School

5Tufts Medical Center, Boston, Massachusetts

6University of Strasbourg, France

7University of Texas MD Anderson Cancer Center, Houston

8Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland

9Hennepin County Medical Center and University of Minnesota, Minneapolis

10University of Pittsburgh, Pennsylvania

11University at Buffalo Jacobs School of Medicine and Biomedical Sciences, and Roswell Park Cancer Institute, New York

12Duke University Medical Center, Durham, North Carolina

13California Institute for Medical Research, San Jose

14New York–Presbyterian Hospital/Weill Cornell Medical Center, New York

15University of Florida, Gainesville

16University of Minnesota, Minneapolis

17Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland

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.

abstract

http://cid.oxfordjournals.org/content/63/4/433.abstract?sid=2377ea3f-a5d8-486b-aec1-5549df830d26

PDF

http://cid.oxfordjournals.org/content/63/4/433.full.pdf+html

August 4, 2016 at 9:24 am

Executive Summary: Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America

Clin Infect Dis. (2016) 63 (4): 433-442

Thomas F. Patterson, George R. Thompson III, David W. Denning, Jay A. Fishman, Susan Hadley, Raoul Herbrecht, Dimitrios P. Kontoyiannis, Kieren A. Marr, Vicki A. Morrison, M. Hong Nguyen, Brahm H. Segal, William J. Steinbach, David A. Stevens, Thomas J. Walsh, John R. Wingard, Jo-Anne H. Young, and John E. Bennett

1University of Texas Health Science Center at San Antonio and South Texas Veterans Health Care System

2University of California, Davis

3National Aspergillosis Centre, University Hospital of South Manchester, University of Manchester, United Kingdom

4Massachusetts General Hospital and Harvard Medical School

5Tufts Medical Center, Boston, Massachusetts

6University of Strasbourg, France

7University of Texas MD Anderson Cancer Center, Houston

8Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland

9Hennepin County Medical Center and University of Minnesota, Minneapolis

10University of Pittsburgh, Pennsylvania

11University at Buffalo Jacobs School of Medicine and Biomedical Sciences, and Roswell Park Cancer Institute, New York

12Duke University Medical Center, Durham, North Carolina

13California Institute for Medical Research, San Jose

14New York–Presbyterian Hospital/Weill Cornell Medical Center, New York

15University of Florida, Gainesville

16University of Minnesota, Minneapolis

17Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland

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.

abstract

http://cid.oxfordjournals.org/content/63/4/e1.abstract?sid=2377ea3f-a5d8-486b-aec1-5549df830d26

PDF

http://cid.oxfordjournals.org/content/63/4/e1.full.pdf+html

August 4, 2016 at 9:22 am

HCV Crónica – Actualización de las Recomendaciones para el Tratamiento – Esquemas libres de Interferón Marzo 2016

Asociación Argentina para el Estudio de las Enfermedades del Hígado

Ridruejo E1,2 y Galdame O3, en representación de la Asociación Argentina para el Estudio de las Enfermedades del Hígado.

  1. Sección Hepatología, Departamento de Medicina. Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”. Ciudad Autónoma de Buenos Aires, Argentina.
  2. Unidad de Hepatología y Trasplante Hepático. Hospital Universitario Austral. Pilar, Prov. de Buenos Aires.
  3. Sección de Hepatología. Hospital Italiano. Ciudad Autónoma de Buenos Aires, Argentina.

Email: info@aaeeh.org

Dirección: San Martin 617, 1er piso A. (1004) Ciudad Autónoma de Buenos Aires, Argentina.

Reconocimiento

Estas Guías se realizaron con la colaboración de los miembros de la Comisión de Expertos en Hepatitis Virales de la Asociación Argentina para el Estudio de las Enfermedades del Hígado: Bessone F, Colombato L, Daruich J, Fainboim H, Fassio E, Frider B, Gadano A, Silva MO, Tanno H, Villamil F.

Todos los pacientes con hepatitis crónica por HCV, naïve de tratamiento o no respondedores a un tratamiento previo, que quieran ser tratados y no tengan contraindicaciones, pueden ser considerados candidatos a recibir tratamiento.

La decisión del momento de iniciar el tratamiento dependerá de la severidad de la enfermedad hepática o de las comorbilidades asociadas. Se recomiendan los siguientes criterios para establecer el momento de iniciar un tratamiento …

PDF

http://aaeeh.org.ar/neweb/docs/Actualizacion-Recomendaciones-Hep-Cronica-por-virus-C.pdf

July 28, 2016 at 3:35 pm

Hepatitis C Crónica – Actualización de las Recomendaciones para el Tratamiento

Ridruejo E1,2 y Galdame O3, en representación de la Asociación Argentina para el Estudio de las Enfermedades del Hígado.

  1. Sección Hepatología, Departamento de Medicina. Centro de Educación Médica e Investigaciones Clínicas Norberto

Quirno “CEMIC”. Ciudad Autónoma de Buenos Aires, Argentina.

  1. Unidad de Hepatología y Trasplante Hepático. Hospital Universitario Austral. Pilar, Prov. de Buenos Aires.
  2. Sección de Hepatología. Hospital Italiano. Ciudad Autónoma de Buenos Aires, Argentina.

 Dirección: San Martin 617, 1er piso A. (1004) Ciudad Autónoma de Buenos Aires, Argentina Email: info@aaeeh.org

Reconocimiento

Estas Guías se realizaron con la colaboración de los miembros de la Comisión de Expertos en Hepatitis Virales de la Asociación Argentina para el Estudio de las Enfermedades del Hígado: Bessone F, Colombato L, Daruich J, Fainboim H, Fassio E, Frider B, Gadano A, Silva MO, Tanno H, Villamil F.

Indice

Introducción …………………………………………………………………………………………………….5

¿Qué pacientes deben ser tratados? ……………………………………………………………………..5

Estándar de tratamiento 2014……………………………………………………………………………..6

Nuevas drogas ………………………………………………………………………………………………….6

Nuevos esquemas de tratamiento ………………………………………………………………………..7

Tratamiento HCV genotipo 1 naïve o con recaída al tratamientocon PEG IFN/RBV …… 8

Tratamiento HCV genotipo 1 no respondedores al tratamiento

con PEG IFN/RBV con o sin telaprevir o boceprevir ………………………………………….. 11

Tratamiento HCV genotipo 1 no respondedores al tratamiento con sofosbuvir,

simeprevir y/o daclatasvir………………………………………………………………………………… 13

Tratamiento HCV genotipo 2 naïve o tratados previamente con PEG IFN/RBV,

con o sin cirrosis compensada ………………………………………………………………………….. 14

Tratamiento HCV genotipo 3 naïve o tratados previamente con PEG IFN/RBV,

con o sin cirrosis compensada ………………………………………………………………………….. 14

Tratamiento en pacientes con enfermedad hepática severa por HCV

Cirrosis compensada……………………………………………………………………………………….. 16

Pacientes con indicación de trasplante hepático …………………………………………………….17

Recurrencia post-trasplante hepático…………………………………………………………………. 18

Tratamiento de la Confección HCV- HIV …………………………………………………………. 19

Tablas …………………………………………………………………………………………………………… 21

Referencias…………………………………………………………………………………………………….. 23

En 2012 la Asociación Argentina para el Estudio de las Enfermedades del Hígado presento las primeras guías de práctica clínicas referidas al tratamiento de la hepatitis crónica por virus C (HCV) [1]. Más recientemente su publicó en Consenso Argentino de Hepatitis C donde se revisaron todos los temas concernientes a esta enfermedad [2]. Sucesivos avances en el tratamiento de esta infección nos llevan a actualizar este tema en particular a través de una actualización de las guías publicadas en 2013. Las principales sociedades científicas dedicadas al estudio de las enfermedades hepáticas han actualizado sus guías de tratamiento en base a las aprobaciones por la FDA (Food and Drug Administration) en Estados Unidos y por la EMA (European Medicines Agency) en Europa de los últimos tratamientos disponibles para la hepatitis C: American Association for the Study of Liver Disease (AASLD) [3], European Association for Study of Liver (EASL) [4], y Asociación Latinoamericana para el Estudio del Hígado (ALEH) [5]. Dado lo dinámico del avance de la información, la guía de AASLD se publica solo online y se actualiza periódicamente [3]……

PDF

http://www.aaeeh.org.ar/neweb/docs/AAEEH-Guia-tto-Hepatitis-C-Cronica.pdf

July 28, 2016 at 3:34 pm

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