Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Gram-negative bacteremia secondary to focal infection such as skin and soft-tissue infection, pneumonia, pyelonephritis, or urinary tract infection is commonly encountered in hospital care. Current practice guidelines lack sufficient detail to inform evidence-based practices. Specifically, antimicrobial duration, criteria to transition from intravenous to oral step-down therapy, choice of oral antimicrobials, and reassessment of follow-up blood cultures are not addressed. ⋯ After appropriate initial treatment with an intravenous antimicrobial, transition to highly bioavailable oral agents should be considered for total treatment duration of 7 days. Routine follow-up blood cultures are not cost-effective and may result in unnecessary healthcare resource utilization and inappropriate use of antimicrobials. Clinicians should incorporate these principles into the management of gram-negative bacteremia in the hospital.
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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 RELEASE DATE: October 2019 PRIOR VERSION: 2007 Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults DEVELOPER: American Thoracic Society and Infectious Diseases Society of America FUNDING SOURCE: American Thoracic Society and Infectious Diseases Society of America TARGET POPULATION: Immunocompetent adult patients with community-acquired pneumonia.