Category: Infectious Disease

Necrotizing fasciitis and limb salvage represent serious complications of gas-producing infections that require timely and critical intervention to prevent catastrophic outcomes. These conditions are both limb- and life-threatening, demanding rapid recognition and coordinated management. This review provides valuable guidance on empiric antibiotic selection that can be initiated in the emergency department, along with the importance […]

Starting antibiotics in sepsis is always a clinical dilemma; however, timely administration is one of the few interventions clearly shown to reduce mortality in septic patients. A recent study published in Clinical Infectious Diseases demonstrated that initiating treatment with a β-lactam antibiotic followed by vancomycin had a modest impact on reducing in-hospital mortality. Link to […]

JAMA published a retrospective cohort study among septic patients who received vasopressor (norepinephrine) and hydrocortisone to show if adding fludrocortisone was more effective to this regimen compare with only giving hydrocortisone. 88275 patients reviewed and in hospital mortality and discharge to hospice as a primary outcome measured. Patients treated with combination of hydrocortisone-fludrocortisone (47.2%) had […]

There are growing body of literature recommending antibiotics for small skin abscess after incision and drainage. Antibiotics after incision and drainage was area of interest for many reseacrhers.   N Engl J Med Annals of EM BMJ

Is Dexamethasone an option to treat sore throat ? A JAMA study on 565 patients in a randomized  clinical trial showed “a single dose of oral dexamethasone(10 mg) compared with placebo did not increase the proportion of patients with resolution of symptoms at 24 hours. However, there was a significant difference at 48 hours.” Link […]

When we reviewed 3 previous studies here, here and here. We mentioned that should we really treat simple Skin abscess? NEJM published “Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess” in March 2016. Patients were randomised to TMP-SMZ 320-1600 mg twice a day for 7 days versus Placebo in patients greater than 12 years old with […]

We discussed this in 2015, but new study in Clinical Infectious Dis. again recommends antibiotic use in uncomplicated wound infection. They do not give an exact meaning of uncomplicated wound infection but we can say whenever physician meant to treat wound infection! This is a randomized, double-blind study at 5 US emergency departments. Patient  received […]

This maybe an old study, but will give you a sense of what antibiotics will be less favorite for your patients. Among antibiotics Amxicillin and Cefixime have the best taste.   Link to article

Sounds like we have to move from Bactrim and Cipro to other agents for uncomplicated cystitis. AJEM published an article in Sept and recommends using more local agent for uncomplicated cystitis , instead of systemic antibiotics. The antibiogram in this study showed sensitivity to Trimethoprim-Sulfamethoxazole 75%, Ciprofloxacin  80%, Nitrofurantoin99%, and Cefazolin 96%.   AJEM Abstract […]

New guideline by MMWR in June 2015, reviewing most important topics in STD. This guideline is very comprehensive and answers several critical questions regarding current and future therapy and focuses on STD.

NEJM published this article for antibiotic choice in uncomplicated skin infection. Patients were categorized as having cellulitis, abscess or both (if lesions of both cellulitis and abscess were present).

This is a very routine practice in ED, “I’ll be more comfortable to give one dose of Abx and then send him/her home” I did not know where this quote came from. I searched Pubmed and found this article: Antibiotic use in the emergency department. IV: Single-dose therapy and parenteral-loading dose therapy. J Emerg Medicine […]

NEJM published The ProCESS study. Basically, this study aimed to challenge EGDT by Manny Rivers in 2001, a very prestigious and novel approach to septic patient in ED. The EGDT was ED based approach. although some of the components were very difficult to acheived in ED such as Scvo2. The EGDT study showed 16% reduction […]

MMWR in latest Grand round section discussed the options for gonorrhea treatment and their recommendation in case of  cephalosporin allergy,

IDSA (Infectious Diseases Society of America) published a new guideline this year for treatment of soft tissue infections and MRSA.