Norepinephrine, hydrocortisone, and fludrocortisone

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 […]

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Dexamethasone and Sore Throat

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 […]

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HAP and VAP not HCAP!

The new guideline by IDSA published’ 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.” There are some answered questions that previously we were practicing based on them. I. Should Patients With Suspected VAP Be Treated Based on the Results […]

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Choice of Treatment for Uncomplicated UTI

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 […]

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Single Dose Antibiotic before ED Discharge!

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 […]

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