Complicated intra-abdominal infection is a common case on the units admitting general surgical patients. By definition it is infection that extends beyond the viscus of origin into the peritoneal space, and is associated with abscess or peritonitis. The traditional management approach has been to do the source control and then soak in antibiotics until signs …
SSC international data from more than 28,000 patients with severe sepsis or septic shock emphasises early source control is paramount (closely followed by BP management). Get antibiotics in within 1 hour (2 at the very most) – the clock is ticking! Here, this was timed from the moment of triage or, on the wards, the …
Safdar et al have combined 9 studies and found an NNT of 77 which may not seem fantastic but where the complication is a quality indicator… Time to add them to the line pack for non-tunnelled catheters at least? The varied but often high background CLABSI rate may make you hesitate though.
Chavez confirms the great predictive value of ultrasound in detecting pneumonia. We know more than 80% of pneumonia patients have disease extending to the pleura so this is no real surprise. How well trained do you need to be though?
Cochranized in the past, macrolides (usually azithromycin) seem more convincingly beneficial regarding mortality and treatment failure in pneumonia (especially in the elderly). This large but retrospective VA registry analysis supports this suggestion. The finding of more MIs but fewer ‘cardiac events’ is confusing. First line for everyone, include it in the initial antimicrobials, continue it …
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