N-95 or Plain Mask to Prevent Flu?
There was no difference between a regular medical mask and N-95 mask worn by healthcare workers in preventing influenza or any other respiratory infection.
Does This Patient Have Pertussis? Bedside Clues to Diagnosis
Adults with cough <3weeks or 3-8 weeks with post-tussive vomiting or whooping should be treated for pertussis; those with fever or without paroxysmal cough should be considered to have an alternate diagnosis. Children with <4 weeks of cough and post-tussive vomiting may have pertussis, but it was much less clear than in adults.
Do We Write Antibiotic Rx Because It’s Just Easier?
It took an extra 67 seconds when not prescribing an antibiotic to patients with acute respiratory infection compared to visits in which an antibiotic was prescribed.
Dealing With the ESBL Threat – Extended Spectrum β-lactamase Enterobacteriaceae
Highly resistant, extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae in the urine are becoming increasingly common in unexpected patients in the ED.
Vancomycin/Piperacillin-Tazobactam and AKI
The combination of vancomycin plus piperacillin-tazobactam (VPT) was associated with increased risk of acute kidney injury (AKI) compared to either drug as monotherapy or other vancomycin - β-lactam combinations, NNH = 11.
Really Scary? Predicting Bad Outcomes in Bronchiolitis
Specific emergency department variables are strongly predictive of infants with bronchiolitis requiring escalated care.
Fluoroquinolones and Aortic Dissection – Again
Use of fluoroquinolones was associated with a 2.5-fold increase in risk of hospitalization for aortic aneurysm or aortic dissection.
Initial Parenteral then Oral Antibiotic vs Oral Alone in Pediatric UTI
There was no reduction in children 29 days - 2 months in 72-hour repeat ED visit with subsequent admission for those given a single parenteral dose of antibiotic in the ED and then outpatient oral treatment vs simply starting on oral therapy.
LRINEC Score, Physical Exam, or Imaging for Necrotizing Infection?
In this systematic review and meta-analysis, no single aspect of the physical examination, imaging, or LRINEC score had high enough sensitivity to exclude necrotizing soft tissue infections. Contrast CT performed the best, but it was only 94.3% sensitive at best. If you have a high clinical suspicion, early surgical consultation is necessary for definitive diagnosis and management.
Outpatient Antibiotic for Pyelonephritis – Ciprofloxacin, TMP/SMX, or Cephalosporins?
Outpatient treatment failure for pyelonephritis occurred more often in patients treated with fluoroquinolones or trimethoprim-sulfamethoxazole (TMP-SMX) than in patient treated with cephalosporins.