L Leibovici

..the present, individual patient...

..Large randomised clinical trials are needed to answer this question; they need to include about 600 patients per patient/pathogen group and thus a multicentre, probably international, effort is needed...

..Systematic reviews on antibiotic drugs that ignore the topic of resistance present readers with a skewed view, emphasizing short-term efficacy or effectiveness while ignoring long-term consequences...

..None of these solve the problem of patients' autonomy. We see no other way but to argue that the right of future patients to come to less harm outweighs the right of the present patient to share in decisions on antibiotic treatment...

..Excess activation of the sympathetic nervous system may be a risk factor for mortality in patients with the systemic inflammatory response syndrome (SIRS) or sepsis...

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..They probably induce less resistance. Pragmatic large trials are needed to answer open clinical questions on the use of aminoglycosides...

..Practitioners should familiarize themselves with the methodology of systematic reviews and meta-analyses, their interpretation, and their limitations...

..To determine whether remote, retroactive intercessory prayer, said for a group of patients with a bloodstream infection, has an effect on outcomes...

..Excessive local levels of resistance to fluoroquinolones or high local incidence of infections caused by Clostridium difficile and related to fluoroquinolones should prompt a reconsideration of this policy...

..2; 95% CI, 0.05 to 0.7). In summary, combination treatment showed no advantage over treatment with an appropriate beta-lactam drug in nonneutropenic patients with gram-negative bacteremia...

..Develop a problem-orientated and data-based decision support system (DSS) to improve empirical antibiotic treatment, and compare the performance of the system to that of the physician...

..To test whether empirical antibiotic treatment that matches the in vitro susceptibility of the pathogen (appropriate treatment) improves survival in patients with bloodstream infections; and to measure the improvement...

..The clinician-scientist should perform medical research. Investing in this paradigm wilt encourage young doctors to conduct research directly oriented to benefit their patients...

..For all the questions examined here, we have not yet passed the threshold of evidence needed to offer patients participation in randomized controlled trials...

..To look for a quantitative model linking departmental consumption of antibiotic drugs to the subsequent isolation of resistant hospital-acquired coliform pathogens...

..69 (95% confidence interval 0.32-1.48). The benefit of combination therapy versus monotherapy cannot be reliably assessed in observational studies, since the propensity to prescribe these regimens differs markedly...

..e. those who were not ventilated and those who did not present with septic shock. These results support the view that nosocomial bacteraemia due to A. baumannii is associated with increased mortality...

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..The excess mortality was concentrated in women with severe underlying disorders, suggesting that sepsis might have accentuated differences in the outcome of underlying disorders in women...

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..Because of the high mortality associated with persistent bacteremia, a thorough search for the source of infection is essential to ensure timely and appropriate therapy...

..We performed a systematic review to evaluate the efficacy of antibiotic prophylaxis in inpatients with cirrhosis, regardless of the underlying risk factors that led to hospital admission...

..These results add an important new dimension to the strategy of restricting broad-spectrum antibiotics...

..Factor analysis can be used to describe phenotypic associations between resistance to antibiotics, and the factor score used to compare groups of isolates and to demonstrate temporal and other trends...

..When shock was excluded from analysis, antifungal therapy was shown to be protective. Unlike previous concerns, infection with Candida species other than C. albicans has not been shown to result in an increased fatality rate...

..To compare the effectiveness of beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy in the treatment of patients with fever and neutropenia...

..93, 15 trials, 3,320 patients). This finding might represent biased attribution of deaths to infection or might be compatible with an anti-cancer effect of quinolone antibiotics. We present further analyses addressing these possibilities...

..1). Early surgical intervention compared with medical therapy alone is associated with increased short- and long-term survival rates in patients with IE, primarily when IE is caused by S. aureus...

..Erysipelas is a skin infection generally caused by group A streptococci. Although penicillin is the drug of choice, some physicians tend to treat erysipelas with antibiotics other than penicillin...

..Given that the use of rifampin in an outbreak setting might lead to the circulation of isolates resistant to rifampin, the use of ciprofloxacin and ceftriaxone should be considered...

..To assess the effect of quinolone prophylaxis following chemotherapy for malignancies on the emergence of resistant bacteria in neutropenic patients...

..Oral therapy could be an alternative approach for selected patients...

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..However, the methods used in the observational studies significantly affect the effect size reported. Methods of observational studies assessing the effects of antibiotic treatment should be improved and standardized...

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..Colistin has re-entered clinical use by necessity. We aimed to assess its effectiveness and safety compared with newer antibiotics...

..We observed no benefit for the antibiotic treatment of AB in the short- and long-term follow-up. A prospective observational study is needed...

..Based on this weak evidence and rough estimations of the effectiveness and cost of mass screening for cervical cancer in Israel, we conclude that the current policy should be maintained...

..Lamivudine should be administered prophylactically to HBsAg-positive patients who are about to receive immunosuppressive therapy...

..The epidemiology of bacteremic febrile neutropenia differs between locations and constitutes the basis for selection of empiric antibiotic therapy for febrile neutropenia...

..This study sought to compare the efficacy and adverse effects of any aminoglycoside as a single antibiotic with other antibiotics for the treatment of patients with infection...

..To assess the value of empirical anti-Gram-positive antibiotics for the treatment of febrile neutropenia...

..This Review provides evidence and offers possible explanations for increased mortality among patients treated with cefepime in randomised trials...

..Mortality was substantially reduced when analysis was limited to fluoroquinolones. Antibiotic prophylaxis, preferably with a fluoroquinolone, should be considered for neutropenic patients...

..To compare beta lactam monotherapy with beta lactam-aminoglycoside combination therapy for severe infections...

..Predictors of mortality were: advanced age, decreased functional capacity, and malignancies. Most common organisms recovered were Staphylococcus aureus (30%), coagulase negative Staphylococcus (15%), and polymicrobial agents (15%)...

..CONCLUSION: Antibiotic therapy for 3 days is similar to prolonged therapy in achieving symptomatic cure for cystitis, while the prolonged treatment is more effective in obtaining bacteriological cure...

..Prediction of bacterial infections and their pathogens allows for early, directed investigation and treatment. We assessed the ability of TREAT, a computerized decision support system, to predict specific pathogens...

..The clinical significance of this advantage is unclear...

..The emergence and spread of multidrug-resistant tuberculosis (MDR-TB), caused by Mycobacterium tuberculosis resistant to at least isoniazid (INH) and rifampicin, is a threat to global TB control...

..To determine and quantify differences in efficacy between treatment regimens for brucellosis...

..Early, empirical broad-spectrum antibiotic treatment is the established practice for febrile neutropenia. Several beta-lactams are accepted for monotherapy. We asked whether patients' outcomes are influenced by the chosen beta-lactam...

..72 [95% CI 0.55-0.95]. We conclude that prophylactic antibiotics are the most effective treatment within the protective environment. Randomised trials on outpatient management of haematological cancer patients are needed...

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..44; 95% CI, 0.32 to 0.61), and red man syndrome were significantly less frequent with teicoplanin. Teicoplanin is not inferior to vancomycin with regard to efficacy and is associated with a lower adverse event rate than vancomycin...

..Several beta-lactams are recommended as single agents for the treatment of febrile neutropenia...

..Appropriate antibiotic treatment decreases mortality, while superfluous treatment is associated with antibiotic resistance. We built a computerized decision support system for antibiotic treatment (TREAT) targeting these outcomes...

..Synergy with carbapenem, rifampin and other antibiotics has been reported in vitro. Randomized controlled trials are ongoing or in planning to assess this and other aspects of colistin use in clinical practice...

..This combination, soon to be generic, should be compared to the current standard of care in a large randomized trial. An effective, safe, and inexpensive alternative to current options is needed...

..Monitoring the rate of infections in individual centers that treat patients with hematological malignancies is of major importance. However, there are no uniform guidelines for infection surveillance...

..Our goal was to assess the efficacy of empirical coverage of atypical pathogens in terms of mortality and clinical and bacteriological success...

..To assess the evidence for prophylactic treatment with systemic antibiotics in burns patients...

..We aimed to evaluate the effect of maintenance treatment with rituximab on the overall survival of patients with follicular lymphoma...

..To assess the effect of prolonging antibiotic prophylaxis in cardiac surgery...

..0001). If also observed in other institutions, these findings should encourage the performance of a clinical trial of sufficient size to compare co-trimoxazole to vancomycin in treating MRSA infections...

..To assess the evidence for the current standard of practice of using empirical antifungal treatment in febrile neutropenic cancer patients...

..To evaluate the efficacy and safety of co-trimoxazole versus that of vancomycin in adults with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia...

..In the present review we discuss the advantages of using causal probabilistic models for prediction and decision support, and the various decisions that were taken in the TREAT project...

..Adverse events did not differ between regimens. CONCLUSIONS: T(4) monotherapy should remain the treatment of choice for clinical hypothyroidism...

..In this article we outline the advantages and limitations inherent in these approaches, and the features that we look for when this type of article is submitted to JAC...

..Antiviral prophylaxis is commonly prescribed to haematological cancer patients. We conducted a systematic review and meta-analysis to quantify its overall benefit in specific clinical scenarios...

..Nevertheless, randomized prospective trials are less conclusive for their real value in conserving ovarian reserve and pregnancy. Large-scale prospective randomized trials are warranted to evaluate the role of GnRHa in preventing CIOF...

..Prediction of surgical site infection and mortality after cardiac surgery might allow for interventions to reduce adverse outcomes. We sought to evaluate existing risk scores...

..Many studies have evaluated the role of antifungal prophylaxis in cancer patients, with inconsistent conclusions...

..To compare available antifungal treatments for invasive candidiasis, a leading cause of nosocomial bloodstream infections...

..Prevention of catheter-related bloodstream infections in patients undergoing hemodialysis by use of antimicrobial catheter lock solutions has been examined in several trials, but no consensus is available for clinical practice...

..Prediction of bloodstream infection at the time of sepsis onset allows one to make appropriate and economical management decisions...

..To assess the efficacy of prophylaxis for Pneumocystis pneumonia (PCP), caused by Pneumocystis jirovecii (formerly Pneumocystis carinii), for immunocompromised non-HIV-infected patients by conducting a systematic review and meta-analysis...

..006). CONCLUSION: Appropriate empirical antibiotic treatment is associated with a better survival and shortened duration of hospital stay in medical patients with bacterial infections...

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..Dyspnea is one of the most distressing symptoms experienced by terminally ill cancer patients. This study aimed to evaluate the role of interventions for the palliation of dyspnea...