The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · Jun 2011
ReviewImpact of antimicrobial stewardship in critical care: a systematic review.
To evaluate the current state of evidence for antimicrobial stewardship interventions in the critical care unit. ⋯ More rigorous research is needed, but available evidence suggests that antimicrobial stewardship is associated with improved antimicrobial utilization in the intensive care unit, with corresponding improvements in antimicrobial resistance and adverse events, and without compromise of short-term clinical outcomes.
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J. Antimicrob. Chemother. · Jun 2011
Meta AnalysisLack of impact of selective digestive decontamination on Pseudomonas aeruginosa ventilator-associated pneumonia: benchmarking the evidence base.
The selective digestive decontamination (SDD) component antibiotics have activity against Pseudomonas aeruginosa, an important ventilator-associated pneumonia (VAP) isolate. Evaluating the relationship between the anti-pseudomonal activity of SDD towards its VAP prevention effect is complicated by postulated indirect effects of SDD mediated in the concurrent control groups. The objective here is to address these effects through a benchmarking analysis of the evidence base. ⋯ There is no evidence for either direct or indirect effects of SDD on P. aeruginosa-IP that could account for the profound effects of SDD on VAP incidence.
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J. Antimicrob. Chemother. · May 2011
ReviewClinical activity of anti-Gram-positive agents against methicillin-resistant Staphylococcus aureus.
Current concerns about multiresistance and a diminishing antibiotic pipeline are mainly addressed to Gram-negative bacteria. The greatest fear within the Gram-positive arena is vancomycin-resistant Staphylococcus aureus. Its epidemiology and clinical presentation give cause for concern, but so far its impact has been strictly limited. While this may change, the loss of glycopeptides as a treatment option may not, in fact, be all bad news.