Infection
-
Multicenter Study
The time course of blood C-reactive protein concentrations in relation to the response to initial antimicrobial therapy in patients with sepsis.
C-reactive protein (CRP) may be a useful marker of sepsis but its use in the evaluation of response to therapy remains poorly defined. The aim of this study was to define the time course of CRP levels in septic patients according to their response to initial antimicrobial treatment, and to search for possible correlations between CRP levels and other clinical and biological variables. ⋯ Changes in CRP levels over the first 48 h of therapy can help to evaluate the response to initial antimicrobial therapy in septic patients.
-
Multicenter Study Clinical Trial
Influence of steroids on procalcitonin and C-reactive protein in patients with COPD and community-acquired pneumonia.
The induction of C-reactive Protein (CRP) may be attenuated by corticosteroids, whereas Procalcitonin (PCT) appears to be unaltered. We investigated, whether in community-acquired pneumonia (CAP) a combined antibiotic-corticosteroid therapy may actually lead to different slopes of decline of these inflammatory markers. ⋯ In patients with COPD and CAP, the time courses over 7 days of PCT and CRP showed a nearly parallel decline compared to non-COPD patients with CAP. Contrary to the induction phase, corticosteroids do not modify the time-dependent decay of PCT and CRP when the underlying infectious disease (CAP) is adequately treated.
-
Multicenter Study Comparative Study
Phlebitis rate and time kinetics of short peripheral intravenous catheters.
An observational prospective cohort study was carried out on complication rates and time kinetics of phlebitis caused by short peripheral intravenous catheters (PIVCs) in inpatients on 15 hospital wards in four hospitals in Cologne, Germany. ⋯ Linear time kinetics of PIVC phlebitis do not support CDC recommendations for an elective PIVC change after 72 hours, provided daily monitoring of the insertion site occurs.
-
Multicenter Study
Prevalence and patterns of antibiotic prescribing in Italian hospitals.
Use of antimicrobial drugs is associated with the emergence of resistant bacteria, increasing hospital expenditures and requires an assessment of appropriateness. The aim of this study was to investigate prevalence and patterns of antibiotic prescribing and expenditures in Italian hospitals. A prevalence survey was performed in 15 Italian hospitals. ⋯ High rates of antibiotic usage were observed in Italian hospitals. Areas for improvement, both for the use of diagnostic resources and the prescribing habits, were identified. The 1-day prevalence survey of antimicrobial use may be a tool of feedback to prescribers for more appropriate drug selection.
-
Although there is consensus in the international literature on the benefits of using perioperative antibiotic prophylaxis (PAP), there is still considerable scope for improving its use in many hospitals. ⋯ There is still great uncertainty regarding the point in time at which PAP should be administered and its duration. Additional efforts are necessary to improve PAP in accordance with published evidence-based guidelines.