Learn More
Pseudomonas aeruginosa bloodstream infection is a serious infection with significant patient mortality and health-care costs. Nevertheless, the relationship between initial appropriate antimicrobial treatment and clinical outcomes is not well established. This study was a retrospective cohort analysis employing automated patient medical records and the(More)
BACKGROUND Pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa now cause pneumonia in patients presenting to the hospital. The concept of health care-associated pneumonia (HCAP) attempts to capture this, but its predictive value is unclear. METHODS We examined patients admitted with pneumonia; infection with a(More)
Vancomycin remains the reference standard for the treatment of systemic infection caused by methicillin-resistant Staphylococcus aureus (MRSA). However, as a result of limited tissue distribution, as well as the emergence of isolates with reduced susceptibility and in vitro resistance to vancomycin, the need for alternative therapies that target MRSA has(More)
Pneumonia occurring outside of the hospital setting has traditionally been categorized as community-acquired pneumonia (CAP). However, when pneumonia is associated with health care risk factors (prior hospitalization, dialysis, residing in a nursing home, immunocompromised state), it is now more appropriately classified as a health care-associated pneumonia(More)
OBJECTIVE To evaluate a standardized hospital order set for the management of septic shock in the emergency department. DESIGN Before-after study design with prospective consecutive data collection. SETTING Emergency department of a 1,200-bed academic medical center. PATIENTS A total of 120 patients with septic shock. INTERVENTIONS Implementation of(More)
OBJECTIVE To evaluate an antibiotic discontinuation policy for clinically suspected ventilator-associated pneumonia (VAP). DESIGN Prospective, randomized, controlled clinical trial. SETTING A medical ICU from a university-affiliated urban teaching hospital. PATIENTS Between April 2002 and July 2003, 290 patients completed the clinical trial. (More)
BACKGROUND Recent studies have suggested that early goal-directed resuscitation of patients with septic shock and conservative fluid management of patients with acute lung injury (ALI) can improve outcomes. Because these may be seen as potentially conflicting practices, we set out to determine the influence of fluid management on the outcomes of patients(More)
OBJECTIVE The goal of this investigation was to determine whether more aggressive vancomycin dosing is associated with greater risk for renal toxicity in patients with health care-associated pneumonia (HCAP) attributed to methicillin-resistant Staphylococcus aureus (MRSA). METHODS This was a retrospective, single-center, observational cohort study. The(More)
BACKGROUND Candida represents the most common cause of invasive fungal disease, and candidal blood stream infections (CBSI) are prevalent in the ICU. Inappropriate antifungal therapy (IAT) is known to increase a patient's risk for death. We hypothesized that in an ICU cohort it would also adversely affect resource utilization. METHODS We retrospectively(More)
OBJECTIVES Classically, infections have been considered either nosocomial or community-acquired. Healthcare-associated infection represents a new classification intended to capture patients who have infection onset outside the hospital, but who, nonetheless, have interactions with the healthcare system. Regarding bloodstream infection (BSI), little data(More)