Search

Your search keyword '"Gilbert, David N."' showing total 294 results
Start Over Author "Gilbert, David N."
294 results on '"Gilbert, David N."'

1. Infectious Diseases Society of America Position Paper: Recommended Revisions to the National Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Sepsis Quality Measure

Author

Rhee, Chanu, Chiotos, Kathleen, Cosgrove, Sara E, Heil, Emily L, Kadri, Sameer S, Kalil, Andre C, Gilbert, David N, Masur, Henry, Septimus, Edward J, Sweeney, Daniel A, Strich, Jeffrey R, Winslow, Dean L, and Klompas, Michael

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Sepsis, Hematology, Prevention, Infectious Diseases, Infection, Inflammatory and immune system, Good Health and Well Being, Aged, Anti-Bacterial Agents, Communicable Diseases, Humans, Medicare, Quality Indicators, Health Care, Reproducibility of Results, Shock, Septic, United States, sepsis, septic shock, SEP-1, severe sepsis, IDSA, Biological Sciences, Medical and Health Sciences, Microbiology, Clinical sciences
Abstract

The Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) measure has appropriately established sepsis as a national priority. However, the Infectious Diseases Society of America (IDSA and five additional endorsing societies) is concerned about SEP-1's potential to drive antibiotic overuse because it does not account for the high rate of sepsis overdiagnosis and encourages aggressive antibiotics for all patients with possible sepsis, regardless of the certainty of diagnosis or severity of illness. IDSA is also concerned that SEP-1's complex "time zero" definition is not evidence-based and is prone to inter-observer variation. In this position paper, IDSA outlines several recommendations aimed at reducing the risk of unintended consequences of SEP-1 while maintaining focus on its evidence-based elements. IDSA's core recommendation is to limit SEP-1 to septic shock, for which the evidence supporting the benefit of immediate antibiotics is greatest. Prompt empiric antibiotics are often appropriate for suspected sepsis without shock, but IDSA believes there is too much heterogeneity and difficulty defining this population, uncertainty about the presence of infection, and insufficient data on the necessity of immediate antibiotics to support a mandatory treatment standard for all patients in this category. IDSA believes guidance on managing possible sepsis without shock is more appropriate for guidelines that can delineate the strengths and limitations of supporting evidence and allow clinicians discretion in applying specific recommendations to individual patients. Removing sepsis without shock from SEP-1 will mitigate the risk of unnecessary antibiotic prescribing for noninfectious syndromes, simplify data abstraction, increase measure reliability, and focus attention on the population most likely to benefit from immediate empiric broad-spectrum antibiotics.

Published
2021

3. Improving Sepsis Outcomes in the Era of Pay-for-Performance and Electronic Quality Measures: A Joint IDSA/ACEP/PIDS/SHEA/SHM/SIDP Position Paper.

Author

Rhee, Chanu, Strich, Jeffrey R, Chiotos, Kathleen, Classen, David C, Cosgrove, Sara E, Greeno, Ron, Heil, Emily L, Kadri, Sameer S, Kalil, Andre C, Gilbert, David N, Masur, Henry, Septimus, Edward J, Sweeney, Daniel A, Terry, Aisha, Winslow, Dean L, Yealy, Donald M, and Klompas, Michael

Subjects
MORTALITY prevention, MEDICARE, HOSPITAL care, TREATMENT effectiveness, BLOOD plasma substitutes, SEPTIC shock, SEPSIS, LABOR incentives, PAY for performance, COMORBIDITY
Abstract

The Centers for Medicare & Medicaid Services (CMS) introduced the Severe Sepsis/Septic Shock Management Bundle (SEP-1) as a pay-for-reporting measure in 2015 and is now planning to make it a pay-for-performance measure by incorporating it into the Hospital Value-Based Purchasing Program. This joint IDSA/ACEP/PIDS/SHEA/SHM/SIPD position paper highlights concerns with this change. Multiple studies indicate that SEP-1 implementation was associated with increased broad-spectrum antibiotic use, lactate measurements, and aggressive fluid resuscitation for patients with suspected sepsis but not with decreased mortality rates. Increased focus on SEP-1 risks further diverting attention and resources from more effective measures and comprehensive sepsis care. We recommend retiring SEP-1 rather than using it in a payment model and shifting instead to new sepsis metrics that focus on patient outcomes. CMS is developing a community-onset sepsis 30-day mortality electronic clinical quality measure (eCQM) that is an important step in this direction. The eCQM preliminarily identifies sepsis using systemic inflammatory response syndrome (SIRS) criteria, antibiotic administrations or diagnosis codes for infection or sepsis, and clinical indicators of acute organ dysfunction. We support the eCQM but recommend removing SIRS criteria and diagnosis codes to streamline implementation, decrease variability between hospitals, maintain vigilance for patients with sepsis but without SIRS, and avoid promoting antibiotic use in uninfected patients with SIRS. We further advocate for CMS to harmonize the eCQM with the Centers for Disease Control and Prevention's (CDC) Adult Sepsis Event surveillance metric to promote unity in federal measures, decrease reporting burden for hospitals, and facilitate shared prevention initiatives. These steps will result in a more robust measure that will encourage hospitals to pay more attention to the full breadth of sepsis care, stimulate new innovations in diagnosis and treatment, and ultimately bring us closer to our shared goal of improving outcomes for patients. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

4. Improving Sepsis Outcomes in the Era of Pay-for-Performance and Electronic Quality Measures: A Joint IDSA/ACEP/PIDS/SHEA/SHM/SIDP Position Paper

Author

Rhee, Chanu, primary, Strich, Jeffrey R, additional, Chiotos, Kathleen, additional, Classen, David C, additional, Cosgrove, Sara E, additional, Greeno, Ron, additional, Heil, Emily L, additional, Kadri, Sameer S, additional, Kalil, Andre C, additional, Gilbert, David N, additional, Masur, Henry, additional, Septimus, Edward J, additional, Sweeney, Daniel A, additional, Terry, Aisha, additional, Winslow, Dean L, additional, Yealy, Donald M, additional, and Klompas, Michael, additional

Published
2023
Full Text
View/download PDF

5. Infectious Diseases Physicians : Leading the Way in Antimicrobial Stewardship

Author

Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and the Society for Healthcare Epidemiology of America, Ostrowsky, Belinda, Banerjee, Ritu, Bonomo, Robert A., Cosgrove, Sara E., Davidson, Lisa, Doron, Shira, Gilbert, David N., Jezek, Amanda, Lynch, John B., Septimus, Edward J., Siddiqui, Javeed, and Iovine, Nicole M.

Published
2018

6. Better Tests, Better Care: Improved Diagnostics for Infectious Diseases

Author

Caliendo, Angela M, Gilbert, David N, Ginocchio, Christine C, Hanson, Kimberly E, May, Larissa, Quinn, Thomas C, Tenover, Fred C, Alland, David, Blaschke, Anne J, Bonomo, Robert A, Carroll, Karen C, Ferraro, Mary Jane, Hirschhorn, Lisa R, Joseph, W Patrick, Karchmer, Tobi, MacIntyre, Ann T, Reller, L Barth, and Jackson, Audrey F

Subjects
Clinical Research, Detection, screening and diagnosis, 4.1 Discovery and preclinical testing of markers and technologies, Good Health and Well Being, Communicable Diseases, Health Policy, Health Services Needs and Demand, Humans, Microbiological Techniques, Molecular Diagnostic Techniques, Point-of-Care Systems, Public Health, Infectious Diseases Society of America, clinical microbiology, diagnostics, infectious diseases, molecular diagnostics, point-of-care testing, rapid diagnostics, Biological Sciences, Medical and Health Sciences, Microbiology
Abstract

In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians.

Published
2013

12. Better Tests, Better Care: Improved Diagnostics for Infectious Diseases

Author

Infectious Diseases Society of America (IDSA), Caliendo, Angela M., Gilbert, David N., Ginocchio, Christine C., Hanson, Kimberly E., May, Larissa, Quinn, Thomas C., Tenover, Fred C., Alland, David, Blaschke, Anne J., Bonomo, Robert A., Carroll, Karen C., Ferraro, Mary Jane, Hirschhorn, Lisa R., Joseph, W. Patrick, Karchmer, Tobi, MacIntyre, Ann T., Reller, L. Barth, and Jackson, Audrey F.

Published
2013
Full Text
View/download PDF

26. Development of new antibacterials: a laudable aim, but what is the value?

Author

Tillotson, Glenn S., Gilbert, David N., Guidos, Robert J., Boucher, Helen W., Talbot, George H., Spellberg, Brad, Edwards, John E., Jr., Scheld, W. Michael, Bradley, John S., and Bartlett, John G.

Subjects
Pharmaceutical industry -- Product development, Antibacterial agents -- Product development, Health, Health care industry, World Health Organization -- Powers and duties
Published
2010

29. CONTRIBUTORS

Author

Adkinson, N. Franklin, primary, Allen, David M., additional, Allos, Ban Mishu, additional, Amsden, Guy W., additional, Anderson, David A., additional, Andes, David R., additional, Aoki, Fred Y., additional, Apfalter, Petra M., additional, Apicella, Michael A., additional, Arias, Cesar A., additional, Augenbraun, Michael H., additional, Azar, Dimitri T., additional, Baddour, Larry M., additional, Baden, Lindsey R., additional, Baker, Carol J., additional, Ballard, Ronald C., additional, Ballow, Charles H., additional, Barnes, Scott D., additional, Baron, Miriam J., additional, Barouch, Dan H., additional, Barrett, Alan, additional, Bassin, Sarice L., additional, Batteiger, Byron E., additional, Baum, Stephen G., additional, Bayer, Arnold S., additional, Beckham, J. David, additional, Beekmann, Susan E., additional, Bell, Beth P., additional, Bennett, John E., additional, Berbari, Elie F., additional, Berman, Jonathan D., additional, Bertino, Joseph S., additional, Birdsall, Holly H., additional, Bisno, Alan L., additional, Biswas, Hope H., additional, Blackburn, Brian G., additional, Blaser, Martin J., additional, Blazes, David L., additional, Bleck, Thomas P., additional, Blijlevens, Nicole M.A., additional, Bobak, David A., additional, Bonnez, William, additional, Boothroyd, John C., additional, Borio, Luciana, additional, Bosque, Patrick J., additional, Boucher, Richard C., additional, Brause, Barry D., additional, Brown, Kevin E., additional, Brown, Patricia D., additional, Brown-Elliott, Barbara A., additional, Burd, Eileen M., additional, Burns, James E., additional, Bush, Larry M., additional, Calfee, David P., additional, Caplan, Ellis S., additional, Carael, Michel, additional, Carpenter, Charles C.J., additional, Caserta, Mary T., additional, Castagnola, Elio, additional, Chaisson, Richard E., additional, Chambers, Henry F., additional, Chapman, Stanley W., additional, Chappell, James D., additional, Chen, Sharon C-A., additional, Chopra, Sanjiv, additional, Chow, Anthony W., additional, Chroneou, Alexandra, additional, Cianciotto, Nicholas P., additional, Clark, Rebecca A., additional, Clark, Robert A., additional, Cohen, Jeffrey I., additional, Cohen, Myron S., additional, Cohen-Poradosu, Ronit, additional, Cohn, Susan E., additional, Connors, Mark, additional, Cono, Joanne, additional, Corey, Lawrence, additional, Cornett, Patricia A., additional, Cox, Heather L., additional, Craig, William A., additional, Craven, Donald E., additional, Crossley, Kent B., additional, Crump, John A., additional, Crumpacker, Clyde S., additional, Curran, James W., additional, Currie, Bart J., additional, Curry, Michael P., additional, Damon, Inger K., additional, Darouiche, Rabih O., additional, DeBiasi, Roberta L., additional, Deepe, George S., additional, del Rio, Carlos, additional, DeMuri, Gregory P., additional, Dennis, David T., additional, Densen, Peter, additional, De Pauw, Ben E., additional, Dermody, Terence S., additional, Dewar, Robin, additional, Diaz, James H., additional, Dieffenbach, Carl W., additional, Dienstag, Jules L., additional, Dolin, Raphael, additional, Donaldson, Scott H., additional, Donnelly, J. Peter, additional, Donnenberg, Michael S., additional, Donowitz, Gerald R., additional, Dormitzer, Philip R., additional, Drake, James M., additional, Dumler, J. Stephen, additional, Dummer, J. Stephen, additional, DuPont, Herbert L., additional, Durack, David T., additional, Durand, Marlene L., additional, Edelstein, Paul H., additional, Edmond, Michael B., additional, Edwards, John E., additional, Edwards, Morven S., additional, Eliopoulos, George M., additional, Engleberg, N. Cary, additional, Ernst, Joel D., additional, Fairhurst, Rick M., additional, Fairley, Jessica K., additional, Falkow, Stanley, additional, Falsey, Ann R., additional, Fauci, Anthony S., additional, Feinstone, Stephen M., additional, Fekete, Thomas, additional, Fey, Paul D., additional, Fine, Steven M., additional, Finegold, Sydney M., additional, Fishman, Neil O., additional, Fitzgerald, Daniel W., additional, Flores, Anthony R., additional, Fowler, Vance G., additional, Freedman, David O., additional, Friedlander, Arthur M., additional, Galgiani, John N., additional, Gallin, John I., additional, Gallo, Robert C., additional, Garrett, Wendy S., additional, Gelfand, Jeffrey A., additional, Gelone, Steven P., additional, Gershon, Anne A., additional, Gilbert, David N., additional, Gilligan, Peter H., additional, Glickman, Michael S., additional, Göbel, Ulf B., additional, Goldstein, Deborah, additional, Goldstein, Ellie J.C., additional, Gordin, Fred M., additional, Gotuzzo, Eduardo, additional, Graman, Paul S., additional, Graves, Margot, additional, Griffin, Patricia M., additional, Griffith, David E., additional, Guerrant, Richard L., additional, Haake, David A., additional, Haas, David W., additional, Hall, Caroline Breese, additional, Halperin, Scott, additional, Hammerschlag, Margaret R., additional, Handsfield, H. Hunter, additional, Haque, Rashidul, additional, Hartman, Barry J., additional, Hay, Roderick J., additional, Hayden, Frederick G., additional, Hedberg, Craig W., additional, Henderson, David K., additional, Henderson, Donald A., additional, Hendley, J. Owen, additional, Hewlett, Erik L., additional, High, Kevin P., additional, Hill, Adrian V.S., additional, Hill, David R., additional, Hinman, Alan R., additional, Hirsch, Martin S., additional, Hodges, Lisa S., additional, Holland, Steven M., additional, Hook, Edward W., additional, Hooper, David C., additional, Hooton, Thomas M., additional, Horsburgh, C. Robert, additional, Hospenthal, Duane R., additional, Hughes, James M., additional, Hughes, Molly A., additional, Huston, Christopher D., additional, Hynes, Noreen A., additional, Iredell, Jonathan R., additional, Janda, J. Michael, additional, Johannsen, Eric C., additional, Johnson, Warren D., additional, Kashuba, Angela D.M., additional, Kasper, Dennis L., additional, Kaye, Donald, additional, Kaye, Keith S., additional, Kaye, Kenneth M., additional, Kazura, James W., additional, Kenny, George E., additional, Keystone, Jay S., additional, Khabbaz, Rima F., additional, King, Charles H., additional, Kirchhoff, Louis V., additional, Klein, Jerome O., additional, Knoll, Bettina M., additional, Knowlton, Kirk U., additional, Kohlhoff, Stephan A., additional, Könönen, Eija, additional, Kontoyiannis, Dimitrios P., additional, Koralnik, Igor J., additional, Koshy, Anita A., additional, Kotton, Camille Nelson, additional, Kovacs, Joseph A., additional, Kozarsky, Phyllis, additional, Koziel, Margaret James, additional, Krieger, John N., additional, Kuehnert, Matthew J., additional, LeDuc, James W., additional, Lee, Laura M., additional, Leggett, James E., additional, Lescano, Andres G., additional, Levett, Paul N., additional, Levine, Donald P., additional, Levison, Matthew E., additional, Lewis, Russell E., additional, Liles, W. Conrad, additional, Lima, Aldo A.M., additional, Litman, Nathan, additional, Lorber, Bennett, additional, Lutwick, Larry I., additional, MacGregor, Rob Roy, additional, Mackowiak, Philip A., additional, Madoff, Lawrence C., additional, Magill, Alan J., additional, Maguire, James H., additional, Maldarelli, Frank, additional, Mandell, Lionel A., additional, Mann, Barbara J., additional, Markoff, Lewis, additional, Marrazzo, Jeanne M., additional, Marrie, Thomas J., additional, Marth, Thomas, additional, Martin, Gregory J., additional, Maschmeyer, Georg, additional, Masur, Henry, additional, Mawle, Alison, additional, Mayer, Kenneth H., additional, McBride, John T., additional, McCormack, William M., additional, McIntosh, Kenneth, additional, Mead, Paul S., additional, Meyer, Daniel K., additional, Meyers, Burt R., additional, Miller, Mark A., additional, Miller, Samuel I., additional, Mitchell, David H., additional, Modlin, John F., additional, Moellering, Robert C., additional, Moir, Susan, additional, Montgomery, Joel M., additional, Montoya, José G., additional, Moore, Thomas A., additional, Moreillon, Philippe, additional, Morrell, Dean S., additional, Morris, J. Glenn, additional, Morse, Caryn Gee, additional, Moseley, Robin, additional, Muder, Robert R., additional, Munford, Robert S., additional, Murphy, Edward L., additional, Murphy, Timothy F., additional, Murray, Barbara E., additional, Murray, Clinton K., additional, Murray, Patrick R., additional, Musher, Daniel M., additional, Nannini, Esteban C., additional, Nash, Theodore E., additional, Nauseef, William M., additional, Neill, Marguerite A., additional, O'Donnell, Judith A., additional, Ohl, Christopher A., additional, Okhuysen, Pablo C., additional, Onderdonk, Andrew B., additional, Opal, Steven M., additional, Orenstein, Walter A., additional, Osman, Douglas R., additional, Osterholm, Michael T., additional, Ostroff, Stephen M., additional, Oxman, Michael N., additional, Page, Andrea V., additional, Palmore, Tara N., additional, Pamer, Eric G., additional, Pappas, Peter G., additional, Pasternack, Mark S., additional, Patterson, Thomas F., additional, Pavan-Langston, Deborah, additional, Pegues, David A., additional, Penn, Robert L., additional, Perfect, John R., additional, Perlman, Stanley, additional, Peters, C.J., additional, Peterson, Phillip K., additional, Petri, William A., additional, Petti, Cathy A., additional, Pickering, Larry K., additional, Pier, Gerald B., additional, Pillai, Satish K., additional, Piot, Peter, additional, Plaeger, Susan F., additional, Polk, Ronald E., additional, Pop-Vicas, Aurora, additional, Powers, John H., additional, Punturieri, Antonello, additional, Que, Yok-ai, additional, Rabinowitz, Ronald P., additional, Rabizadeh, Shervin, additional, Ramphal, Reuben, additional, Raoult, Didier, additional, Ravdin, Jonathan I., additional, Ray, Stuart C., additional, Reboli, Annette C., additional, Reddy, Pavani, additional, Reichman, Richard C., additional, Reitz, Marvin S., additional, Relman, David A., additional, Renault, Cybèle A., additional, Restrepo, Angela, additional, Rex, John H., additional, Reynolds, Herbert Y., additional, Rhee, Elizabeth G., additional, Rhee, Kyu Y., additional, Rotz, Lisa D., additional, Ruoff, Kathryn L., additional, Rupp, Mark E., additional, Rupprecht, Charles E., additional, Russo, Thomas A., additional, Rutala, William A., additional, Salvatore, Mirella, additional, Saulsbury, Frank T., additional, Savoia, Maria C., additional, Sax, Paul E., additional, Scheld, W. Michael, additional, Schiffer, Joshua T., additional, Schlossberg, David, additional, Schneider, Thomas, additional, Schwebke, Jane R., additional, Sears, Cynthia L., additional, Seas, Carlos, additional, Sepkowitz, Kent A., additional, Septimus, Edward J., additional, Siberry, George K., additional, Sifri, Costi D., additional, Singh, Nina, additional, Singh, Upinder, additional, Sinner, Scott W., additional, Sivapalasingam, Sumathi, additional, Slater, Leonard N., additional, Smulian, A. George, additional, Sobel, Jack D., additional, Sodha, Samir V., additional, Sohail, M. Rizwan, additional, Solomon, Tom, additional, Song, Yuli, additional, Soper, David E., additional, Sorrell, Tania C., additional, Sparling, P. Frederick, additional, Stamm, Walter E., additional, Steckelberg, James M., additional, Steere, Allen C., additional, Steigbigel, Neal H., additional, Steinberg, James P., additional, Steiner, Theodore S., additional, Sterling, Timothy R., additional, Stevens, David A., additional, Stevens, Dennis L., additional, Strahilevitz, Jacob, additional, Stratton, Charles W., additional, Suffredini, Anthony F., additional, Suh, Kathryn N., additional, Sulkowski, Mark S., additional, Sullivan, Donna C., additional, Swartz, Morton N., additional, Talbot, Thomas R., additional, Tan, C. Sabrina, additional, Thielman, Nathan M., additional, Thio, Chloe Lynn, additional, Thomas, David L., additional, Thomas, Lora D., additional, Thorner, Anna R., additional, Tice, Alan D., additional, Tobón, Angela María, additional, Tramont, Edmund C., additional, Treanor, John J., additional, N. Tsibris, Athe M., additional, Tunkel, Allan R., additional, Turner, Ronald B., additional, Tyler, Kenneth L., additional, van de Beek, Diederik, additional, Vannier, Edouard G., additional, Van Schooneveld, Trevor C., additional, Vaughn, David W., additional, Viscoli, Claudio, additional, Volberding, Paul A., additional, Wald, Ellen R., additional, Walker, David H., additional, Wallace, Richard J., additional, Walsh, Edward E., additional, Walzer, Peter D., additional, Wanke, Christine A., additional, Washburn, Ronald G., additional, Wasley, Annemarie, additional, Waters, Valerie, additional, Weber, David J., additional, Weinberg, Arnold N., additional, Weinberg, Geoffrey A., additional, Weinmann, Gail G., additional, Weisdorf, Daniel J., additional, Weiss, Louis M., additional, Weiss, Michael E., additional, Welch, David F., additional, Wellems, Thomas E., additional, Wenzel, Richard P., additional, Wharton, Melinda, additional, White, A. Clinton, additional, Whitley, Richard J., additional, Wilson, Kenneth H., additional, Wilson, Walter R., additional, Witebsky, Frank G., additional, Wolfgang, Matthew C., additional, Wright, Peter F., additional, Young, Edward J., additional, Young, Jo-Anne H., additional, Zhang, Jie Lin, additional, Zinner, Stephen H., additional, and Zurlo, John J., additional

Published
2010
Full Text
View/download PDF

32. Infectious Diseases Society of America Position Paper: Recommended Revisions to the National Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Sepsis Quality Measure

Author

Rhee, Chanu, primary, Chiotos, Kathleen, additional, Cosgrove, Sara E, additional, Heil, Emily L, additional, Kadri, Sameer S, additional, Kalil, Andre C, additional, Gilbert, David N, additional, Masur, Henry, additional, Septimus, Edward J, additional, Sweeney, Daniel A, additional, Strich, Jeffrey R, additional, Winslow, Dean L, additional, and Klompas, Michael, additional

Published
2020
Full Text
View/download PDF

33. Outpatient parenteral antimicrobial-drug therapy

Author

Gilbert, David N., Dworkin, Ronald J., Raber, Susan R., and Leggett, James E.

Subjects
Intravenous catheterization -- Equipment and supplies, Drug delivery devices -- Analysis, Ambulatory medical care -- Methods
Abstract

Outpatient intravenous antimicrobial drug therapy can save on hospitalization costs. The patient must have an infectious disease that does not require hospitalization and there must be no safe oral drug. The drugs must be relatively stable and are delivered by catheters and infusion pumps. The catheters are placed in the arm or in a central vein such as the subclavian or internal jugular vein. Some can even be implanted subcutaneously so they are not visible. Complications of intravenous catheters include infection, hypersensitivity and blood clot formation.

Published
1997

39. A randomized comparison of the safety and efficacy of once-daily gentamicin or thrice-daily gentamicin in combination with ticarcillin-clavulanate

Author

Gilbert, David N., Lee, Belle L., Dworkin, Ronald J., Leggett, James L., Chambers, Henry F., Modin, Gunnar, Tauber, Martin G., and Sande, Merle A.

Subjects
Gentamicin -- Dosage and administration, Bacterial infections -- Drug therapy, Ticarcillin -- Health aspects, Clavulanate -- Health aspects, Health, Health care industry
Abstract

PURPOSE: The primary purpose of the clinical trial was to assess the safety and efficacy of once-a-day compared with three-times-a-day gentamicin in patients with serious infections who had protocol-determined peak serum aminoglycoside concentrations. PATIENTS AND METHODS: A total of 249 hospitalized patients with suspected or proven serious infections were randomized in a 2:2:1 ratio to gentamicin given three times a day with ticarcillin-clavulanate (TC), gentamicin once a day with TC, or ticarcillin-clavulanate (TC) alone. The gentamicin once-a-day dosage for patients with estimated creatinine clearance values of [is greater than or equal to] 80 mL/min was 5.1 mg/kg. With lower creatinine clearance estimates, the mg/kg dosage of gentamicin was decreased, and the dosage intervals (once daily or three times a day) were maintained. Evaluability required documentation of achievement of protocol-defined peak serum gentamicin levels. RESULTS: Of the total 175 evaluable patients, there were no significant differences found between treatment regimens with respect to clinical or microbiologic efficacy. Bedside audiometry proved impractical due to the frequency of altered mental state in ill patients. Based on the traditional increase in serum creatinine values from baseline values, no differences in renal toxicity between the treatment groups was identified. When changes in renal function were reanalyzed based on maintaining, as opposed to worsening, of renal function, preservation of renal function was better in the gentamicin once-a-day patients as opposed to the gentamicin three-times-a-day patients, P [is less than] 0.01. CONCLUSIONS: Gentamicin once a day plus TC, gentamicin three times a day plus TC, and TC alone had similar effects in seriously ill hospitalized patients. The incidence of nephrotoxicity was similar in the three treatment groups. Using a nonvalidated post-hoc analysis, renal function was better preserved in gentamicin once-a-day + TC and TC-only patients as opposed to gentamicin three-times-a-day + TC. Am J Med. 1998;105: 182-191. [C] 1998 by Excerpta Medica, Inc.

Published
1998

41. Staphylococcus aureus septic arthritis in patients on hemodialysis treatment

Author

Slaughter, Sarah, Dworkin, Ronald J., Gilbert, David N., Leggett, James E., Jones, Stephen, Bryant, Richard, and Martin, Michael A.

Subjects
Infectious arthritis -- Case studies -- Complications and side effects, Hemodialysis -- Case studies, Arthritis, Infectious -- Case studies -- Complications and side effects, Bacteremia -- Case studies -- Complications and side effects, Health
Abstract

We retrospectively reviewed hospital discharge diagnoses of septic arthritis over an 11-year period (1982 through 1992) at 3 medical centers; 11 episodes of septic arthritis were identified in patients on hemodialysis treatment. Of the 11 episodes, 9 were caused by Staphylococcusaureus, in 8 of 9, the blood cultures were positive for the organism and the infection was monoarticular. Concurrent infection of the dialysis access site occurred in 4 cases. Two patients died (22%). We postulate that repeated skin trauma and contact with health care personnel and facilities result in a high rate of nasal carriage of S aureus and, hence, an increased risk of bacteremia with its attendant complications such as septic arthritis. The use of mupirocin nasal ointment is reported to eradicate or suppress carriage in a high percentage of patients; some studies report that long-term suppressive therapy reduces the frequency of S aureus bacteremia. (Slaughter S, Dworkin RJ, Gilbert DN, et al: Staphylococcus aureus septic arthritis in patients on hemodialysis treatment. West J Med 1995; 163:128-132), A case of a patient on hemodialysis treatment in whom Staphylococcus aureus septic arthritis developed prompted inquiry into the regional frequency of this serious disorder. Only one previous article has [...]

Published
1995

42. The Effects of Monitoring the Use of Gentamicin in a Community Hospital

Author

Gilbert, David N.

Abstract

The effect of a combined education and monitoring program on the use of gentamicin in a community hospital is described. The data support the tenet that the ways antibiotics are used can be altered by an education program. (Author/LBH)

Published
1978

Catalog

Books, media, physical & digital resources
See catalog results