Abstract:
PURPOSE OF REVIEW:Recent studies suggest that contemporary antibiotic dosing is unlikely to achieve best outcomes for critically ill patients because of extensive pharmacokinetic variability and altered pharmacodynamics. Dose adaptation is considered quite challenging because of unpredictable dose-exposure relationships. Consequently, individualization of antibiotic dosing has been advocated. Herein, we describe recent developments in the optimization of antibiotic dosing in the critically ill. RECENT FINDINGS:Conventional doses of many antibiotics frequently result in sub or supratherapeutic exposures in the critically ill. Clinical studies continue to illustrate that dose-exposure relationships are highly variable in severely ill patients. Dose optimization based on pharmacokinetic/pharmacodynamic principles can effectively improve antibiotic exposure. Therapeutic drug monitoring (TDM) with adaptive feedback is likely to be the most robust approach to optimize dosing for individual patients. This more accurate approach to dosing is made possible with the user-friendly dosing software that is emerging. SUMMARY:The scope of TDM is broadening from the traditional focus on prevention of toxicity, to include optimization of antibiotic exposure thereby improving patient outcomes. However, the evidence relating TDM practice with improved clinical outcome remains limited. Well designed, multicentre, randomized controlled studies are warranted.
journal_name
Curr Opin Infect Disjournal_title
Current opinion in infectious diseasesauthors
Parker SL,Sime FB,Roberts JAdoi
10.1097/QCO.0000000000000206subject
Has Abstractpub_date
2015-12-01 00:00:00pages
497-504issue
6eissn
0951-7375issn
1473-6527journal_volume
28pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:This review examines recent literature on Chagas disease in the immunosuppressed host. RECENT FINDINGS:Chagas disease in immunosuppressed patients may represent acute transmission in an organ recipient, or reactivation of chronic infection in an HIV-infected individual or patient receiving cardiac tr...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328354f179
更新日期:2012-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Ventilator-associated pneumonia (VAP) is the most frequent cause of death among the nosocomial infections acquired in the ICU. Routine surveillance endotracheal aspirate (ETA) cultures in patients on mechanical ventilation have been proposed to predict the cause of VAP. Our aim is to review the availa...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000042
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:As physicians are confronted with a diversity of adverse events and variability in response to medication among patients, this review will focus on the available evidence regarding the impact of genetic variation on drug response. Specifically, variation in drug metabolizing enzymes such as the cytoch...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/01.qco.0000191507.48481.10
更新日期:2005-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Clostridium difficile infection and Clostridium difficile-associated diarrhea (CDAD) are growing worldwide health threats. Recent studies have identified new host risk factors, diagnostic approaches and therapies of CDAD. The present review focuses on scientific papers published in the past 18 months ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32830f9397
更新日期:2008-10-01 00:00:00
abstract::Intestinal protozoal infections cause significant disease not only in the tropics but also in immunocompromised hosts and returning travellers in the developed world. Precise diagnosis of protozoal intestinal infection by microscopy can be difficult. Enzyme immunoassays for antigen detection are being used for some pr...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200110000-00013
更新日期:2001-10-01 00:00:00
abstract:PURPOSE OF REVIEW:It is now well established that cytokines play a critical role in the regulation of the immune system. Processes such as lymphoid development, differentiation, homeostasis, tolerance and memory are all regulated by cytokines that bind the type I family of cytokine receptors. Like the interferons, whic...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200306000-00005
更新日期:2003-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights progress made in the development of vaccines aimed at the stages of malaria parasites found in mosquitoes that block the transmission of malaria within a community. RECENT FINDINGS:Substantial progress has been made on the production and characterization of the leading candidat...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3282a95e12
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The majority of hepatitis C virus (HCV) infections in the United Kingdom and many developing countries were acquired through injecting. New clinical guidance suggests that HCV treatment should be offered to people with a transmission risk - such as people who inject drugs (PWID) - irrespective of seve...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000216
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The review examines the changing causes and the investigation of infectious and noninfectious diarrhoea in individuals with HIV. RECENT FINDINGS:Despite the excellent prognosis conferred by combination antiretroviral therapy, diarrhoea is still common in HIV-positive individuals and is associated wit...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000305
更新日期:2016-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to summarize the emerging literature on nontuberculous mycobacteria outbreaks in healthcare settings. As our ability to identify mycobacterial species develops, we are better able to recognize epidemiologic connections and better understand the prevalence and importance o...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000386
更新日期:2017-08-01 00:00:00
abstract::Considerable progress has been made in the development of effective hospital infection control programs in countries with limited resources, most notably in Asia and Latin America. National nosocomial infection surveillance methods are now used in a variety of countries, particularly in Brazil, and offer a better meas...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章
doi:10.1097/00001432-199808000-00010
更新日期:1998-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The immune reconstitution inflammatory syndrome (IRIS) is an important clinical complication in HIV-infected patients initiating antiretroviral therapy. This review focuses on the latest literature pertaining to the pathogenesis of IRIS. RECENT FINDINGS:The clinical manifestations of IRIS are heterog...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328352b664
更新日期:2012-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This review addresses recent developments that relate to the pathogenesis of severe malaria and its treatment, and also highlights the increase in the global burden of malaria and provides a summary of clinical trials of malaria vaccines. RECENT FINDINGS:Malaria, one of the world's most important par...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200310000-00004
更新日期:2003-10-01 00:00:00
abstract::The implementation of surveillance systems for HIV and of large cohort studies have allowed for the construction of models that more accurately describe the HIV epidemic. This review focuses on changes in the epidemiological pattern, and the effect of changes in behaviour and of antiretroviral therapy. ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章
doi:10.1097/00001432-199802000-00004
更新日期:1998-02-01 00:00:00
abstract:PURPOSE OF THE REVIEW:Viruses are an increasingly recognized cause of community-acquired pneumonia (CAP), but their exact role in nosocomial pneumonia is still debated. This review focuses on the role of viruses as a cause of nosocomial pneumonia. RECENT FINDINGS:Respiratory viruses may be responsible for healthcare-a...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000049
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:HIV postexposure prophylaxis is often recommended following potential sexual exposure to HIV. Recent data address the effectiveness of postexposure prophylaxis and prevention counseling, cost-effectiveness, antiretroviral options, challenges with nonoccupational postexposure prophylaxis among adolesce...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328012c5e0
更新日期:2007-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Early treatment of invasive mold infections improves the outcome. Therapy is often delayed, however, because available diagnostic tools such as culture, microscopy and conventional radiology lack sensitivity; consequently, empirical initiation of antifungal therapy has been advocated, particularly for...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3280106854
更新日期:2006-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Hepatitis C virus is an RNA virus that usually establishes persistent infection in its host. As an important cause of cirrhosis and hepatocellular carcinoma worldwide, hepatitis C is a growing public health concern. Despite recent advances in therapy, most people infected with the virus can expect lif...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200406000-00004
更新日期:2004-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review summarizes key studies on the effects of major abdominal surgery on the host response to infection published during the last 18 months. RECENT FINDINGS:Surgical trauma causes stereotyped systemic proinflammatory and compensatory anti-inflammatory reactions. It is leukocyte reprogra...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32833939cb
更新日期:2010-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review describes the literature about the prevention of Staphylococcus aureus infections in surgery, published from August 2006 to January 2008, and puts it into perspective. RECENT FINDINGS:To prevent Staphylococcus aureus infections after surgical procedures, three methods were describe...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328301391d
更新日期:2008-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to assess the recent studies of therapy of pregnant women and neonates, aimed at preventing the consequences of congenital cytomegalovirus (CMV) infection. RECENT FINDINGS:A recent randomized controlled trial of treatment of CMV during pregnancy with hyperimmune globulin...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000317
更新日期:2016-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The early treatment of invasive fungal infection is critical but is hampered by the non-specific nature of clinical and radiological signs and the insensitivity of current laboratory diagnostic methods. If mortality due to invasive fungal infection is to be reduced, new, preemptive therapeutic strateg...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200312000-00002
更新日期:2003-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The success of male circumcision in reducing HIV acquisition among African heterosexuals has led to renewed interest in this biological intervention for HIV/sexually transmissible infection (STI) prevention in men who have sex with men (MSM). This review summarizes the available data on the associatio...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328334e54d
更新日期:2010-02-01 00:00:00
abstract::The subject of bacterial skin infection in the tropics has shown some significant advances in the past few years, although it is still relatively understudied. Of special interest is the emerging concern about the public health aspects of pyoderma, either primary or secondary to scabies, in developing countries. In ad...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/00001432-200104000-00002
更新日期:2001-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Illicit drug use before or during sex - known as sexualized drug use (colloquially 'chemsex' or 'party and play') - has evolved as novel psychoactive substances have entered the market in many parts of the world. Here, we review key conceptual issues in associations between illicit drug use and sexual...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0000000000000234
更新日期:2016-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic pulmonary aspergillosis (CPA) is a relatively rare, slowly progressive pulmonary syndrome due to Aspergillus spp. that requires specific knowledge in terms of disease entity, diagnosis, management and azole resistance. This review focuses on the recent understanding of CPA entity and the emerg...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32833ed694
更新日期:2010-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Nontuberculous mycobacterial disease, especially pulmonary disease, is increasingly encountered by clinicians. Therapy of the most common nontuberculous mycobacterial pathogen, Mycobacterium avium complex, improved with the introduction of macrolide-containing regimens, but treatment for this and most...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e328055d9a2
更新日期:2007-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review presents an update on the molecular epidemic patterns of HIV-1 infection and the effects of subtype-related genetic variability on transmission, disease progression, response to antiretroviral therapy and drug-resistance pathways. RECENT FINDINGS:The molecular epidemiology of HIV-1 infect...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/01.qco.0000200293.45532.68
更新日期:2006-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Several attempts have been made to combine drugs for treating visceral leishmaniasis, but only recently have effective drugs become available and combinations been tested systematically. RECENT FINDINGS:Sequential treatments with liposomal amphotericin B followed by miltefosine or paromomycin (as sho...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e32833fca9d
更新日期:2010-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Antimicrobial stewardship is now recognized as a formal strategy for curbing the upward trend in antibiotic resistance. Literature on antimicrobial stewardship has focused on areas of strategic importance and operational delivery. A number of barriers have been recognized in the implementation of succ...
journal_title:Current opinion in infectious diseases
pub_type: 杂志文章,评审
doi:10.1097/QCO.0b013e3283483262
更新日期:2011-08-01 00:00:00