Latest & greatest articles for pneumonia

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Top results for pneumonia

21. Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest. (Abstract)

Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest. Patients who are treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm are at increased risk for ventilator-associated pneumonia. The benefit of preventive short-term antibiotic therapy has not been shown.We conducted a multicenter, double-blind, randomized, placebo-controlled trial involving adult patients (>18 years of age) in intensive care units (ICUs) who were being (...) was early ventilator-associated pneumonia (during the first 7 days of hospitalization). An independent adjudication committee determined diagnoses of ventilator-associated pneumonia.A total of 198 patients underwent randomization, and 194 were included in the analysis. After adjudication, 60 cases of ventilator-associated pneumonia were confirmed, including 51 of early ventilator-associated pneumonia. The incidence of early ventilator-associated pneumonia was lower with antibiotic prophylaxis than

2019 NEJM

22. The DRIP Score to Evaluate or Drug Resistant Organisms in Pneumonia

The DRIP Score to Evaluate or Drug Resistant Organisms in Pneumonia The DRIP Score to Evaluate or Drug Resistant Organisms in Pneumonia | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette You are moonlighting in your busy local community emergency department one afternoon when you encounter Mrs. P, a 67-year-old patient who (...) was sent in from her nursing home with concern for pneumonia. She reports three days of a productive cough, fever to 38.4 °C, and mild shortness of breath with exertion. She denies chest pain, vomiting, or diarrhea. She has a history of end-stage renal disease, for which she has been on hemodialysis three days a week for the last five years. In addition, she has a history of hypertension and non-insulin dependent diabetes. Her last hospital admission was for leg cellulitis after minor trauma

2019 Washington University Emergency Medicine Journal Club

23. Lefamulin (Xenleta) - community-acquired bacterial pneumonia

Lefamulin (Xenleta) - community-acquired bacterial pneumonia Drug Approval Package: XENLETA U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: XENLETA Company: Nabriva Therapeutics Application Number: 211672, 211673 Approval Date: 08/19/2019 (211672) (211673) Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF

2019 FDA - Drug Approval Package

24. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America (Abstract)

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development (...) and additional management decisions.Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.

2019 EvidenceUpdates

25. Pneumonia (hospital-acquired): antimicrobial prescribing

Pneumonia (hospital-acquired): antimicrobial prescribing Pneumonia (hospital-acquired): Pneumonia (hospital-acquired): antimicrobial prescribing antimicrobial prescribing NICE guideline Published: 16 September 2019 www.nice.org.uk/guidance/ng139 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after (...) be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Pneumonia (hospital-acquired): antimicrobial prescribing (NG139) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

26. Pneumonia (community-acquired): antimicrobial prescribing

Pneumonia (community-acquired): antimicrobial prescribing Pneumonia ( Pneumonia (community-acquired): community-acquired): antimicrobial prescribing antimicrobial prescribing NICE guideline Published: 16 September 2019 www.nice.org.uk/guidance/ng138 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived (...) be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Pneumonia (community-acquired): antimicrobial prescribing (NG138) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

27. Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? Full Text available with Trip Pro

Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 74, Issue 1, Pages e1–e3 Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? x Thomas Seagraves , MD (EBEM Commentator) , x Michael Gottlieb , MD (EBEM Commentator (...) ) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: | Publication History Published online: June 21, 2018 Expand all Collapse all Article Outline Take-Home Message For adult patients with severe community-acquired pneumonia, corticosteroids reduce morbidity and mortality. For pediatric patients and adults with nonsevere community-acquired pneumonia, corticosteroids appear to reduce morbidity, but not mortality. Methods Data Sources The authors searched the Cochrane Acute

2019 Annals of Emergency Medicine Systematic Review Snapshots

28. Pneumonia in the Immunocompetent Child.

Pneumonia in the Immunocompetent Child. New 2019 ACR Appropriateness Criteria ® 1 Pneumonia in the Immunocompetent Child American College of Radiology ACR Appropriateness Criteria ® Pneumonia in the Immunocompetent Child Variant 1: Child. 3 months of age and older. Immunocompetent. Suspected uncomplicated community- acquired pneumonia in a well-appearing child who does not require hospitalization. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography chest (...) Usually Not Appropriate ? CT chest with IV contrast Usually Not Appropriate ???? CT chest without and with IV contrast Usually Not Appropriate ???? CT chest without IV contrast Usually Not Appropriate ???? MRI chest without and with IV contrast Usually Not Appropriate O MRI chest without IV contrast Usually Not Appropriate O US chest Usually Not Appropriate O Variant 2: Child. 3 months of age and older. Immunocompetent. Community-acquired pneumonia that does not respond to initial outpatient treatment

2019 American College of Radiology

29. Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With Community-Acquired Bacterial Pneumonia: The LEAP 2 Randomized Clinical Trial. (Abstract)

Oral Lefamulin vs Moxifloxacin for Early Clinical Response Among Adults With Community-Acquired Bacterial Pneumonia: The LEAP 2 Randomized Clinical Trial. New antibacterials are needed to treat community-acquired bacterial pneumonia (CABP) because of growing antibacterial resistance and safety concerns with standard care.To evaluate the efficacy and adverse events of a 5-day oral lefamulin regimen in patients with CABP.A phase 3, noninferiority randomized clinical trial conducted at 99 sites (...) in 19 countries that included adults aged 18 years or older with a Pneumonia Outcomes Research Team (PORT) risk class of II, III, or IV; radiographically documented pneumonia; acute illness; 3 or more CABP symptoms; and 2 or more vital sign abnormalities. The first patient visit was on August 30, 2016, and patients were followed up for 30 days; the final follow-up visit was on January 2, 2018.Patients were randomized 1:1 to receive oral lefamulin (600 mg every 12 hours for 5 days; n = 370

2019 JAMA

30. Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. (Abstract)

Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study. Randomized trials demonstrate no benefit from antibiotic treatment exceeding the shortest effective duration.To examine predictors and outcomes associated with excess duration of antibiotic treatment.Retrospective cohort study.43 hospitals in the Michigan Hospital Medicine Safety Consortium.6481 general care medical patients with pneumonia.The primary outcome (...) was the rate of excess antibiotic treatment duration (excess days per 30-day period). Excess days were calculated by subtracting each patient's shortest effective (expected) treatment duration (based on time to clinical stability, pathogen, and pneumonia classification [community-acquired vs. health care-associated]) from the actual duration. Negative binomial generalized estimating equations (GEEs) were used to calculate rate ratios to assess predictors of 30-day rates of excess duration. Patient outcomes

2019 Annals of Internal Medicine

31. Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients With Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial (Abstract)

Effectiveness of a Bundled Intervention Including Adjunctive Corticosteroids on Outcomes of Hospitalized Patients With Community-Acquired Pneumonia: A Stepped-Wedge Randomized Clinical Trial Community-acquired pneumonia remains a leading cause of hospitalization, mortality, and health care costs worldwide. Randomized clinical trials support the use of adjunctive corticosteroids, early progressive mobilization, antibiotic switching rules, and dietary interventions in improving outcomes. However (...) hospitals in Melbourne, Australia, among a consecutive sample of patients with community-acquired pneumonia. The primary analysis and preparation of results took place between May 14 and November 25, 2018.Treating clinical teams were advised to prescribe prednisolone acetate, 50 mg/d, for 7 days (in the absence of any contraindication) and de-escalate from parenteral to oral antibiotics according to standardized criteria. Algorithm-guided early mobilization and malnutrition screening and treatment were

2019 EvidenceUpdates

32. Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study. Full Text available with Trip Pro

Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study. Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings.We did a multi-site, international case-control study in nine study sites in seven countries (...) : Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1-59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted

2019 Lancet

33. Validity of SMART-COP score in prognosis and severity of community acquired pneumonia in the emergency department (Abstract)

Validity of SMART-COP score in prognosis and severity of community acquired pneumonia in the emergency department Determining prognosis in community acquired pneumonia (CAP), is very important. Many scores are introduced up to now for prediction of pneumonia prognosis like SMART-COP.To evaluate validity of SMART-COP score in prognosis and severity of CAP in emergency department (ED).All patients older than 18 years old with clinical suspicion of CAP (meeting the inclusion criteria), were

2019 EvidenceUpdates

34. Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial (Abstract)

Guideline-Based Clinical Assessment Versus Procalcitonin-Guided Antibiotic Use in Pneumonia: A Pragmatic Randomized Trial Efforts to reduce unnecessary and unnecessarily long antibiotic treatment for community-acquired pneumonia have been attempted through use of procalcitonin and through guidelines based on serial clinical assessment. Our aim is to compare guideline-based clinical assessment- and procalcitonin algorithm-guided antibiotic use among patients with community-acquired pneumonia.We (...) performed a pragmatic, randomized, multicenter trial from November 2012 to April 2015 at 12 French hospitals. We included emergency department (ED) patients older than 18 years with community-acquired pneumonia. Patients were randomly assigned to either the procalcitonin-guided or clinical assessment group. In accordance with past studies, we hypothesized that serial clinical assessment would be superior to procalcitonin-guided care. The primary outcome was antibiotic duration, and secondary outcomes

2019 EvidenceUpdates

35. XueBiJing Injection Versus Placebo for Critically Ill Patients With Severe Community-Acquired Pneumonia: A Randomized Controlled Trial Full Text available with Trip Pro

XueBiJing Injection Versus Placebo for Critically Ill Patients With Severe Community-Acquired Pneumonia: A Randomized Controlled Trial To investigate whether XueBiJing injection improves clinical outcomes in critically ill patients with severe community-acquired pneumonia.Prospective, randomized, controlled study.Thirty-three hospitals in China.A total of 710 adults 18-75 years old with severe community-acquired pneumonia.Participants in the XueBiJing group received XueBiJing, 100 mL, q12 hours (...) , and the control group received a visually indistinguishable placebo.The primary outcome was 8-day improvement in the pneumonia severity index risk rating. Secondary outcomes were 28-day mortality rate, duration of mechanical ventilation and total duration of ICU stay. Improvement in the pneumonia severity index risk rating, from a previously defined endpoint, occurred in 203 (60.78%) participants receiving XueBiJing and in 158 (46.33%) participants receiving placebo (between-group difference [95% CI], 14.4

2019 EvidenceUpdates

36. Should HIV-uninfected patients with Pneumocystis pneumonia be treated with corticosteroids?

Should HIV-uninfected patients with Pneumocystis pneumonia be treated with corticosteroids? Chiefs’ Inquiry Corner – March 17th, 2019 – Clinical Correlations Search Chiefs’ Inquiry Corner – March 17th, 2019 March 18, 2019 3 min read Propofol is a short-acting, intravenous sedative-hypnotic that is metabolized by the liver and excreted in the urine as conjugates of 2,6-diisopropyl-1,4 quinol. The pharmacokinetics of propofol favor its use for the induction/maintenance of anesthesia (...) with other causes of immunocompromise, especially in those with solid organ or liquid transplants, chronic steroid use, chemotherapeutics, and other immunosuppressive medications. As the use of immunosuppressive agents has increased in recent years, so has the rate of non-HIV associated Pneumocystis pneumonia (PCP). The use of steroids in HIV-infected patients with PCP has been well established, but the role of steroids in HIV-uninfected patients is much less clear. Patients with PCP who are not infected

2019 Clinical Correlations

37. Community-acquired pneumonia

Community-acquired pneumonia Community-acquired pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Community-acquired pneumonia Last reviewed: February 2019 Last updated: February 2019 Summary Risk factors relate to environment, lifestyle factors, patient status, and comorbidities. Typically characterised by a new lung infiltrate on chest x-ray, together with one or more of the following: fever, chills, cough (...) , sputum production, dyspnoea, myalgia, arthralgia, pleuritic pain. Diagnosis should include a chest x-ray, although this has been challenged by studies using CT scanning. Initial treatment is empirical with antibiotics, following international guidelines and local epidemiology. Definition Community-acquired pneumonia (CAP) is defined as pneumonia acquired outside hospital or healthcare facilities. Clinical diagnosis is based on a group of signs and symptoms related to lower respiratory tract infection

2019 BMJ Best Practice

38. Omadacycline for Community-Acquired Bacterial Pneumonia. Full Text available with Trip Pro

Omadacycline for Community-Acquired Bacterial Pneumonia. Omadacycline, a new once-daily aminomethylcycline antibiotic agent that can be administered intravenously or orally, reaches high concentrations in pulmonary tissues and is active against common pathogens that cause community-acquired bacterial pneumonia.In a double-blind trial, we randomly assigned (in a 1:1 ratio) adults with community-acquired bacterial pneumonia (Pneumonia Severity Index risk class II, III, or IV) to receive (...) reported in 41.1% of the patients in the omadacycline group and 48.5% of the patients in the moxifloxacin group; the most frequent events were gastrointestinal (10.2% and 18.0%, respectively), and the largest difference was for diarrhea (1.0% and 8.0%). Twelve deaths (8 in the omadacycline group and 4 in the moxifloxacin group) occurred during the trial.Omadacycline was noninferior to moxifloxacin for the treatment of community-acquired bacterial pneumonia in adults. (Funded by Paratek Pharmaceuticals

2019 NEJM Controlled trial quality: predicted high

39. Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV Full Text available with Trip Pro

Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV Some opioids are known immunosuppressants; however, the association of prescribed opioids with clinically relevant immune-related outcomes is understudied, especially among people living with HIV.To assess the association of prescribed opioids with community-acquired pneumonia (CAP) by opioid properties and HIV status.This nested case-control study used data from patients

2019 EvidenceUpdates

40. Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report Full Text available with Trip Pro

Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to help physicians investigate and treat acute cough due to suspected pneumonia and influenza are needed.A systematic search was carried out with eight patient, intervention, comparison, outcome questions related to acute cough due to suspected pneumonia (...) or influenza.There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza who were not hospitalized. Both clinical suggestions and research recommendations were made on the evidence available and CHEST Expert Cough Panel advice.For outpatient adults with acute cough due to suspected pneumonia, we suggest the following clinical symptoms and signs are suggestive of pneumonia: cough; dyspnea; pleural pain; sweating, fevers

2019 EvidenceUpdates