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Hospital Medicine

General Infectious Disease   

Questions discussed in this category

What is your approach to duration of fidaxomicin in a patient receiving treatment for first C difficile infection while also receiving concurrent antibiotics for an infection? 
Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?
1 Answer available
Do you treat Stenotrophomonas maltophilia bacteremia with combination therapy and if so, what is your preferred combination of antibacterials?
2 Answers available
What workup is sufficient to determine if an aortic aneurysm is "mycotic/infectious" or not, in that you would not prescribe empiric antibiotic therapy?
1 Answer available
Which biomarkers or diagnostic tools do you prioritize to support the decision to start antifungal treatment in septic patients with no clear source of infection but at high risk for fungal infections?
4 Answers available
Do you routinely continue dual antibiotic coverage or de-escalate to monotherapy based on peritoneal fluid culture sensitivities in patients with relapsing pseudomonas aeruginosa peritoneal dialysis peritonitis after peritoneal catheter removal?
1 Answer available
What factors should be prioritized when deciding the timing of CIED extraction in patients with high surgical risk or multiple comorbidities?
1 Answer available
Are there situations where you would consider treating E faecalis or E faecium that grows from a respiratory culture?
1 Answer available
What is the preferred antibiotic treatment regimen for vancomycin-resistant Enterococcus faecium endocarditis assuming susceptibility to both daptomycin and linezolid?
1 Answer available
In addition to ampicillin, is there any benefit to the addition of either gentamicin or Bactrim when treating a patient with listeria meningitis?
3 Answers available
What additional workup would you recommend for a patient with a liver abscess caused by Fusobacterium and Aggregatibacter, who has had unrevealing endoscopies and no other abdominal masses on a CT scan?
1 Answer available
Do you routinely recommend diagnostic endoscopy for patients with persistent enterococcus bacteremia despite receiving adequate antimicrobial therapy and no clear nidus?
Rogers & Rice, PMID 38018162
2 Answers available
Does your hospital or institution have an Antimicrobial Stewardship Program (ASP), which oversees ID physicians, and if so, does the ASP have the authority to refuse an antibiotic prescribed by an ID consultant?
ASPs are common place. The studies supporting ASPs oversaw doctors, not specifically trained in Infectious Diseases. However, several institutions hav...
3 Answers available
For patients with candida species osteomyelitis who have undergone extensive surgical debridement, do you routinely still recommend 6-12 months of antifungal therapy or opt for a shorter duration?
1 Answer available
What antibiotics would you use for empiric treatment of a brain abscess in patients allergic to penicillin, metronidazole, and vancomycin?
1 Answer available
Would you still consider adding clindamycin for streptococcal toxic shock syndrome in situations where the isolate is considered to be resistant?
1 Answer available
What is your approach to treatment of patients with fulminant C difficile infection who required ileostomy creation or colectomy?
Is there a role for oral vancomycin in these patients, or is oral vancomycin redundant if other routes of administration are being used (i.e intracolo...
1 Answer available
Have you incorporated the use of linezolid in lieu of vancomycin plus clindamycin for empiric treatment of necrotizing fasciitis?
1 Answer available
Do you add gentamicin when treating prosthetic valve endocarditis secondary to viridans group Streptococcus with a penicillin-intermediate isolate (MIC >0.125 - <0.5)?
3 Answers available
Do you recommend procalcitonin to help convince other providers to stop antibiotics in patients with pneumonia in whom a non-infectious diagnosis is strongly suspected?
2 Answers available
How would you approach treatment in a patient with refractory Coccidioidal meningitis who has previously been treated with IV amphotericin B?
1 Answer available
Do you ever favor cefazolin over ceftriaxone for bacteremia with susceptible E. coli?
1 Answer available
What is your preferred agent and duration to treat an epidural abscess due to azole-resistant candida species?
1 Answer available
Do you add adjunctive gentamicin and/or rifampin for treatment of prosthetic valve Staphylococcus aureus endocarditis?
3 Answers available
How do you decide between ceftolozane/tazobactam and ceftazidime/avibactam for empiric treatment of an infection due to difficult-to-treat Pseudomonas aeruginosa while awaiting additional susceptibilities?
2 Answers available
Do you consider the use of tocilizumab in patients with COVID pneumonia who have had an improvement in supplemental O2 requirements but have significantly elevated inflammatory markers after day two of remdesivir and dexamethasone?
1 Answer available
When would you initiate exchange transfusion in babesiosis and significant hemolysis?
Is parasitemia >10% and severe hemolysis with Hb less than 7 enough to initiate this?
1 Answer available
Do you take into consideration a patient's serum albumin level in your decision to use ertapenem?
2 Answers available
How do you decide on the timing and number of blood cultures for suspected endocarditis given the differences in recommendations between the ESC guidelines and the Duke Criteria?
The ESC guidelines recommend obtaining at least three sets of blood cultures at 30-minute intervals before starting antibiotic therapy, each with 10 m...
3 Answers available
Do you routinely perform echocardiography in patients with Staphylococcus aureus bacteremia deemed low risk for metastatic infection, or do you selectively omit it based on specific clinical criteria?
Hendriks, et al., PMID 38576380
2 Answers available
Under what circumstances do you consider valacyclovir for the management of VZV disease of the CNS?
2 Answers available
Do you preferentially avoid use of piperacillin-tazobactam for empiric anti-pseudomonal coverage in hospitalized patients due to risk of nephrotoxicity?
ACORN Randomized Clinical Trial 
1 Answer available
Do you routinely check cefepime levels in patient's with suspected cefepime-induced neurotoxicity?
1 Answer available
What is your approach to management of CIED in a patient with community-acquired Staph aureus bacteremia who clears blood cultures quickly with negative follow up blood cultures within 72 hours of antimicrobial therapy and negative TEE?
Would you still routinely ask for CIED removal, or would you pursue PET/CT for further evaluation and consider keeping CIED if PET/CT negative?
2 Answers available
Do you use combination antibiotic therapy for treatment of bacterial endocarditis due to gram-negative bacilli?
1 Answer available
Do you use combination therapy for persistent MSSA bacteremia?
If yes, which combination(s)?
1 Answer available
Do you routinely ask for removal of a indwelling central line (PICC or tunneled catheter) in a patient with pseudomonal bacteremia from known source with otherwise appropriate clinical improvement on anti-pseudomonal antibiotic therapy?
1 Answer available
How long would you treat an upper urinary tract infection in a patient with acute obstructive pyelonephritis due to a kidney stone status-post urinary stenting without yet removal of the stone?
4 Answers available
Do you recommend routine ophthalmologic exam for all patients with hypervirulent Klebsiella pneumoniae bacteremia?
1 Answer available
Do you choose an antibiotic with CSF penetration, such as nafcillin over cefazolin, in the setting of MSSA endocarditis with septic emboli to the brain (assuming no concomitant meningitis or brain abscess)?
3 Answers available
How long would you treat a patient with recent history of TAVR presenting with E faecalis bacteremia with unclear source with TEE showing thickened valves but no obvious vegetation?
2 Answers available
How do you treat a patient with a gram-negative infection with resistance to imipenem but sensitivity to meropenem and negative for Carbapenem resistant organism by xpert Carba-R-assay?
1 Answer available
Have you incorporated the use of steroids for patients with severe community-acquired pneumonia?
In light of published data from the CAPE COD trial...
1 Answer available
Is there a role for chronic suppressive oral or inhaled therapy for recurrent Burkholderia cepacia pneumonia causing frequent hospitalizations in a patient with severe bronchiectasis with or without underlying cystic fibrosis?
3 Answers available
For how long do you treat uncomplicated CRE bacteremia in an immunocompetent patient?
1 Answer available
Would you consider stepping down from an echinocandin to azole therapy prior to the end of an initial six-week course for fluconazole-susceptible Candida albicans endocarditis in the absence of valve surgery?
1 Answer available


Papers discussed in this category

The Annals of thoracic surgery, 2016-06
Rifampin for Surgically Treated Staphylococcal Infective Endocarditis: A Propensity Score-Adjusted Cohort Study.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 May 04
Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study.
The Lancet. Infectious diseases, 2017 Jan 28
Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study.
Antimicrobial agents and chemotherapy, 1982-07
In vitro activities of trimethoprim and sulfamethoxazole against Listeria monocytogenes.
Antimicrobial agents and chemotherapy, 1983 Apr
Delayed bactericidal activity of beta-lactam antibiotics against Listeria monocytogenes: antagonism of chloramphenicol and rifampin.
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2023 Nov 24
Treatment guidelines for multidrug-resistant Gram-negative microorganisms.
Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia, 2023 Oct 26
In vitro activity of cefiderocol and other newly approved antimicrobials against multi-drug resistant Gram-negative pathogens recovered in intensive care units in Spain and Portugal.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024 Aug 07
Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.
EClinicalMedicine, 2022 Dec 01
Duration of antibiotic treatment for Gram-negative bacteremia - Systematic review and individual participant data (IPD) meta-analysis.
Journal of clinical pharmacy and therapeutics, 2020 Sep 27
Short-course versus long-course antibiotic treatment in patients with uncomplicated gram-negative bacteremia: A systematic review and meta-analysis.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019 Sep 13
Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023 Sep 18
Considerations and Concerns regarding the use of Ertapenem in Patients with Hypoalbuminemia: is it Truly Inappropriate?
Journal of the American College of Cardiology, 2023 Jan 31
Infective Endocarditis After Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review.
JACC. Cardiovascular interventions, 2022 Jun 13
Long-Term Follow-Up of Hypoattenuated Leaflet Thickening After Transcatheter Aortic Valve Replacement.
JACC. Cardiovascular imaging, 2017 Aug 16
Diagnosis of Infective Endocarditis After TAVR: Value of a Multimodality Imaging Approach.
The New England journal of medicine, 2018 Aug 28
Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023 Sep 11
Real-World Application of Oral Therapy for Infective Endocarditis: A Multicenter, Retrospective, Cohort Study.
N Engl J Med, 2023 Mar 21
Hydrocortisone in Severe Community-Acquired Pneumonia.
The Journal of infectious diseases, 1980 Mar
A study of cephalothin and desacetylcephalothin in cerebrospinal fluid in therapy for experimental pneumococcal meningitis.
Antimicrobial agents and chemotherapy, 1976 Sep
Pharmacological study of cefazolin during intermittent and continuous infusion: a crossover investigation in humans.
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020 May 08
Should we reconsider cefazolin for treating staphylococcal meningitis? A retrospective analysis of cefazolin and cloxacillin cerebrospinal fluid levels in patients treated for staphylococcal meningitis.
The Lancet. Infectious diseases, 2020 Dec 14
Effectiveness of adjunctive clindamycin in β-lactam antibiotic-treated patients with invasive β-haemolytic streptococcal infections in US hospitals: a retrospective multicentre cohort study.
Open forum infectious diseases, 2023 Nov 24
Comparison of Adjuvant Clindamycin vs Linezolid for Severe Invasive Group A Skin and Soft Tissue Infections.
JAMA internal medicine, 2024 May 13
Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018-05-17
Detecting Infections Rapidly and Easily for Candidemia Trial, Part 2 (DIRECT2): A Prospective, Multicenter Study of the T2Candida Panel.
The Annals of pharmacotherapy, 2023 Mar 22
Therapeutic Options for Adult Patients With Persistent Methicillin-Susceptible Bacteremia: A Narrative Review.
Circulation, 2015 Sep 15
Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.
Diagnostic microbiology and infectious disease, 2021 Jul 24
Clinical outcomes of combination versus monotherapy for gram negative non-HACEK infective endocarditis.
Open forum infectious diseases, 2023 Feb 02
Epidemiology and Clinical Outcomes of Non-HACEK Gram-Negative Infective Endocarditis.
Infection & chemotherapy, 2021 Jun
Risk of Endogenous Endophthalmitis during Bacteremia: Implications for Screening.
Retina (Philadelphia, Pa.), 2014 Sep
Endophthalmitis caused by Klebsiella species.
Eye (London, England), 2017 Jun 16
Clinical features and prognostic factors of Klebsiella endophthalmitis-10-year experience in an endemic region.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2021 Jul 22
The ERACE-PA Global Surveillance Program: Ceftolozane/tazobactam and Ceftazidime/avibactam in vitro Activity against a Global Collection of Carbapenem-resistant Pseudomonas aeruginosa.
Antimicrobial agents and chemotherapy, 2023 Jul 05
Ceftolozane-Tazobactam Versus Ceftazidime-Avibactam for the Treatment of Infections Caused by Multidrug-Resistant Pseudomonas aeruginosa: a Multicenter Cohort Study.
Circulation, 2023 Dec 04
Update on Cardiovascular Implantable Electronic Device Infections and Their Prevention, Diagnosis, and Management: A Scientific Statement From the American Heart Association: Endorsed by the International Society for Cardiovascular Infectious Diseases.
Journal of clinical microbiology, 2007-11
Detection of bloodstream infections in adults: how many blood cultures are needed?
Journal of clinical microbiology, 2011-12
Optimized pathogen detection with 30- compared to 20-milliliter blood culture draws.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2004 May 25
Optimal testing parameters for blood cultures.
Open forum infectious diseases, 2021 Dec 18
Clinical Significance of in a Single Positive Blood Culture Bottle.
Journal of the American College of Cardiology, 2019 Jul 16
Prevalence of Infective Endocarditis in Enterococcus faecalis Bacteremia.
The Medical clinics of North America, 1963 Sep
COCCIDIOIDOMYCOSIS AND AMPHOTERICIN B.
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2022 Sep 10
Use of biomarkers to individualize antimicrobial therapy duration: a narrative review.
The Lancet. Infectious diseases, 2016 Mar 02
Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial.
Experimental cell research, 1985 Jan
Cell growth, cell division and cell size homeostasis in Swiss 3T3 cells.
JAMA, 2024 Dec 09
Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial.

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