Category: Uncategorized
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How deadly is antibiotic resistance?
How can we quantify the attribution of antibiotic resistance to detrimental patient outcome? Some believe that in 2050, 10 million people will die every year because of antibiotic resistance! But is antibiotic resistance always the cause of death? And if so, how can we explain detrimental outcomes of infections treated…
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Nebulized amikacin and VAP prevention (part 2): the art of circular reasoning
Three months ago, a French investigator-initiated, multicenter, double-blind, randomized, placebo-controlled study reported that nebulized amikacin reduced the occurrence of VAP. Positive cultures of endotracheal aspirates were part of (the few) diagnostic criteria for VAP. My response was that “the possibility of artificial sterilization of microbiological cultures through nebulized amikacin is…
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Hypervirulent Klebsiella: the next pandemic?
Last week, ECDC issued a risk assessment on the emergence of hypervirulent Klebsiella pneumoniae ST23 carrying carbapenemase genes in Europe, concluding that “there is a possibility of potentially untreatable infections in previously healthy adults”.
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Does Ventilator-Associated Pneumonia really exist?
That’s a question I’ve asked myself many times. If it doesn’t, antibiotics would not be needed, attributable mortality would be absent, and VAP prevention would not increase survival. A new – and excellent – study in Lancet Respiratory Medicine provides new evidence that fits my pre-opinionated and unproven belief. In…
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Macrolides for community-acquired pneumonia: to add or not to add?
Should patients hospitalized with community-acquired pneumonia (CAP) be treated with macrolides added to a beta-lactam antibiotic? This is a long-lasting discussion.