Abstract：
:Critical-care units can be barometers for appropriate antimicrobial use. There, life and death hang on empirical antimicrobial therapy for treatment of infectious diseases. With increasing therapeutic empiricism, triple-drug, broad-spectrum regimens are often necessary, but cannot be continued without fear of the double-edged sword: a life-saving intervention or loss of life following Clostridium difficile infection, infection from a resistant organism, nephrotoxicity, cardiac toxicity, and so on. While broadened initial empirical therapy is considered a standard, it must be necessary, dosed according to pharmacokinetic-pharmacodynamic principles, and stopped when no longer needed. Antimicrobial stewardship interventions shepherd these considerations in antimicrobial therapy. With pharmacists and physicians trained in infectious disease and critical care, clear-cut interventions can be focused on beginning or growing a stewardship program, or proposing future studies.
journal_name
Infect Dis Clin North Amjournal_title
Infectious disease clinics of North Americaauthors
Owens RC Jrdoi
10.1016/j.idc.2009.04.015subject
Has Abstractpub_date
2009-09-01 00:00:00pages
683-702issue
3eissn
0891-5520issn
1557-9824pii
S0891-5520(09)00044-0journal_volume
23pub_type
杂志文章,评审abstract：:Norovirus is the leading cause of acute gastroenteritis. In older adults, it is responsible for an estimated 3.7 million illnesses; 320,000 outpatient visits; 69,000 emergency department visits; 39,000 hospitalizations; and 960 deaths annually in the United States. Older adults are particularly at risk for severe outc...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2017.07.012
更新日期：2017-12-01 00:00:00
abstract：:Vaccine recommendations continue to evolve as a result of new vaccines, safety considerations, changing disease incidence (e.g., polio), and public health priorities. The pace of discovery is accelerating and advisory committees will need to respond accordingly. Each vaccine, new or old, will be required to earn its p...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70264-6
更新日期：2001-03-01 00:00:00
abstract：:In healthy adults and children in developed countries, most foodborne and water-borne infections are short-lived and resolve without specific treatment. In developing areas, these infections may produce acute mortality and chronic morbidity caused by developmental impairment. Immune-compromised hosts are at increased ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2013.05.006
更新日期：2013-09-01 00:00:00
abstract：:Acquired immunodeficiency syndrome (AIDS) is the lethal end stage of a sexually transmitted disease caused by a virus that is producing the major epidemic of our century. In this article we describe the history and epidemiology of AIDS and the disease states associated with infection with the human immunodeficiency vi...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-03-01 00:00:00
abstract：:The diagnostic approach to the compromised host with CNS infection depends on an analysis of the patient's clinical manifestations of CNS disease, the acuteness or subacuteness of the clinical presentation, and an analysis of the type of immune defect compromising the patient's host defenses. Most patients with CNS in...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70160-4
更新日期：2001-06-01 00:00:00
abstract：:Cytomegalovirus (CMV) may no longer be the menace that plagues stem cell transplant outcomes, owing to marked improvements in transplantation techniques and methods of prophylaxis. However, it still remains a common and morbid problem for recipients of stem cell transplant and patients with certain hematologic maligna...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2019.02.008
更新日期：2019-06-01 00:00:00
abstract：:The nature of infections after solid-organ transplantation has changed with increasingly potent immunosuppressive regimens, routine use of antimicrobial prophylaxis, and improved microbiologic diagnostic tools. New pathogens have been identified in this population including many with significant antimicrobial resistan...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2010.01.005
更新日期：2010-06-01 00:00:00
abstract：:An increasing number of HIV-infected patients will require surgical therapy. The methods of diagnosis and therapeutic planning for HIV-infected patients are the same as for all other patients. Surgery should be advised if an operation is likely to have a positive effect on the patient's life. Most patients with AIDS w...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:It appears incontestable that there is a link between genital ulcer disease and HIV infection. On the one hand the natural history and response to therapy of syphilis, HSV-2, and chancroid are all modified by the immunosuppressive effects of HIV infection. On the other hand, HIV transmission is probably facilitated by...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-06-01 00:00:00
abstract：:Mold infections carry a substantial clinical and economic burden in solid organ transplant (SOT) recipients with a high overall mortality of near 30%. The most important pathogens include Aspergillus, the Zygomycetes, Fusarium, Scedosporium/Pseudallescheria, and the dematiaceous (dark) molds. Risk factors for the infe...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2018.04.006
更新日期：2018-09-01 00:00:00
abstract：:This article reviews in brief the basic principles of echocardiography and their application in infective endocarditis. The role of echocardiography in relation to surgical decision making is emphasized. The special problems of vegetations, valve ring abscess, leaflet perforation, prosthetic valve endocarditis, and in...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-03-01 00:00:00
abstract：:The desideratum of "appropriate" antibiotic therapy include efficacy, safety, and low cost. Strategies for achieving these goals include education, control of the hospital formulary, written justification forms and automatic stop orders, ongoing utilization review, restriction, required consultation, control of labora...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-12-01 00:00:00
abstract：:HIV testing and incidence are stable, but trends for certain populations are concerning. Primary prevention must be reinvigorated and target vulnerable populations. Science and policy have progressed to improve the accuracy, speed, privacy, and affordability of HIV testing. More potent and much better tolerated HIV tr...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2014.06.002
更新日期：2014-09-01 00:00:00
abstract：:AIDS is characteristically associated with several intracellular enteric protozoan infections that often cause chronic and sometimes fatal intractable large-volume diarrhea. Until the AIDS epidemic, several of these parasitic infections were almost unknown as causes of human disease. This article reviews the diseases ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-09-01 00:00:00
abstract：:Infectious complications remain a major source of morbidity and mortality for patients with end-stage renal disease on dialysis. The majority of these complications are related to dialysis access devices, and as such represent a potentially modifiable risk factor. This article reviews the important infectious complica...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2011.09.005
更新日期：2012-03-01 00:00:00
abstract：:Zygomycosis is an increasingly common infection in immunocompromised patients. Advances in the understanding of Zygomycetes pathobiology and the introduction of new drugs with improved activity and tolerability for treatment of zygomycosis have improved the prospects of effectively controlling this devastating infecti...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2006.06.003
更新日期：2006-09-01 00:00:00
abstract：:The problem of prophylaxis in orthopedic implant surgery will become increasingly important and complex as the population ages and requires more arthroplasty procedures, and the prevalence of antimicrobial-resistant bacteria meanwhile also continues to rise. Energy spent preventing prosthetic joint infection is more e...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2005.07.002
更新日期：2005-12-01 00:00:00
abstract：:The unknowns persisting in the understanding of the mode of action of anti-core lipopolysaccharide antibodies are discussed, and a study of two anti-lipid A monoclonal antibodies is reviewed. This article also critically analyzes the results of the recent clinical trials with monoclonal antibodies. ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
abstract：:Viral hepatitis is a major global public health problem affecting hundreds of millions of people and is associated with significant morbidity and mortality. Five major biologically unrelated hepatotropic viruses cause most of the global burden of viral hepatitis. Hepatitis B and hepatitis C are associated with a signi...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2019.08.004
更新日期：2019-12-01 00:00:00
abstract：:The combination of molecular pathogen diagnostics and the biomarker procalcitonin (PCT) are changing the use of antimicrobials in patients admitted to critical care units with severe community-acquired pneumonia, possible septic shock, or other clinical syndromes. An elevated serum PCT level is good supportive evidenc...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2017.05.003
更新日期：2017-09-01 00:00:00
abstract：:Recurrent urinary tract infections (UTIs) are common, especially in women. Low-dose daily or postcoital antimicrobial prophylaxis is effective for prevention of recurrent UTIs and women can self-diagnose and self-treat a new UTI with antibiotics. The increasing resistance rates of Escherichia coli to antimicrobial age...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2013.10.001
更新日期：2014-03-01 00:00:00
abstract：:Oral mucositis is a serious complication of cancer therapy and in severely immunosuppressed patients. In immunosuppressed patients, the signs and symptoms of infection often are muted because of limited host response, and accurate diagnosis and appropriate treatment may be difficult. Prevention of mucosal breakdown, s...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2007.03.003
更新日期：2007-06-01 00:00:00
abstract：:Vancomycin and daptomycin are options for the initial treatment of patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Treatment options for persistent MRSA bacteremia or bacteremia due to vancomycin-intermediate or vancomycin-resistant strains include daptomycin, ceftaroline, and combination ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2020.04.003
更新日期：2020-12-01 00:00:00
abstract：:Changes that occur in the pharmacology of drugs in the elderly must be considered in the use of antimicrobial agents. Although absorption of orally administered drugs is not affected in a significant way, renal function decreases, drug-drug interactions increase, compliance with regimens may be decreased, and drug tox...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70252-x
更新日期：2000-06-01 00:00:00
abstract：:Infections accompanying severe pancreatitis are secondary and of three types: infected pancreatic necrosis, infected pseudocyst (including peripancreatic fluid collection), and pancreatic abscess. The first is an earlier, more morbid process, with antibiotics supportive and surgical debridement necessary. The latter t...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:At the close of the 19th century, the germ theory had generated a new understanding of the causes of acute infectious diseases and revealed new directions for study. This understanding contributed to the greatest improvements in health in the history of medicine. At the end of the 20th century, the second stage of thi...
journal_title：Infectious disease clinics of North America
pub_type： 历史文章,杂志文章,评审
doi：10.1016/S0891-5520(03)00099-0
更新日期：2004-03-01 00:00:00
abstract：:Community-acquired pneumonia (CAP) is the leading cause of death from infectious diseases in the United States. It accounts for 500,000 hospitalizations and 45,000 deaths each year, and it represents one of the most common causes of ICU admission. The mortality rate due to severe CAP has shown little improvement over ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2009.04.003
更新日期：2009-09-01 00:00:00
abstract：:Antimicrobial resistance is a common iatrogenic complication of both modern life and medical care. Certain multidrug resistant and extensively drug resistant Gram-negative organisms pose the biggest challenges to health care today, predominantly owing to a lack of therapeutic options. Containing the spread of these or...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2016.08.001
更新日期：2016-12-01 00:00:00
abstract：:Amebiasis is a widespread parasitic disease caused by Entamoeba histolytica. This protozoan organism is the third leading parasitic cause of death in the developing world and is an important health risk to travelers in endemic areas. Amebiasis most commonly results in asymptomatic colonization of the gastrointestinal ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70121-5
更新日期：2000-09-01 00:00:00
abstract：:Since the introduction of the floroquinolones for clinical use in the late 1980s, they have been used successfully for a large number of clinical situations. As experience accumulates, the indications and optimal use of these agents gradually become more clear. Unfortunately, two of the pathogens for which these agent...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-09-01 00:00:00
