Hospital-Acquired (HAP) and Ventilator-Associated (VAP) Pneumonia Updates

Pearls from presentation 3/21/17 in FMTS by Amber, PharmD: Risk factors for MDR HAP, MRSA or Pseudomonas HAP/VAP:  IV abx within 90 d. Risk factors for MDR VAP:  prior abx within 90 d, septic shock at time of VAP, ARDS preceding VAP, ≥5 d hospitalization prior to VAP, dialysis prior to VAP onset. Antibiotic regimens: Add… Continue reading Hospital-Acquired (HAP) and Ventilator-Associated (VAP) Pneumonia Updates

The Heckerling Score – H&P predictor of CXR findings

The Heckerling score:  1 point each for T > 37.8 C HR > 100/min crackles on auscultation diminished breath sounds absence of asthma Score of 4 or 5 highly suggestive of pneumonia (+LR = 8.2, increasing pre-test probability around 45%) Score of 0 or 1 suggestive of NO pneumonia (-LR = 0.3, decreasing pre-test probability… Continue reading The Heckerling Score – H&P predictor of CXR findings

Inhaled Steroids of Minimal Benefit in Mild Asthma

Lancet 2016 Nov 29 - the START study. Researchers examined benefit of low-dose inhaled budesonide given within 2 years of mild asthma diagnosis in children and adults. n = 4098 patients with symptoms ≤3 days weekly randomized to budesonide or placebo Doses:  400 mcg in adults, 200 mcg in children Budesonide recipients had fewer severe asthma-related… Continue reading Inhaled Steroids of Minimal Benefit in Mild Asthma

Summary of New Sepsis Guidelines – JAMA

​Guideline title Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 Developers Surviving Sepsis Campaign (SSC), Society of Critical Care Medicine (SCCM), and European Society of Intensive Care Medicine (ESICM) Release date January 18, 2017 Prior versions 2012, 2008, 2004 Target population Adults with sepsis or septic shock Selected major recommendations Managing infection: Antibiotics: Administer broad-spectrum… Continue reading Summary of New Sepsis Guidelines – JAMA