Time for first antibiotic dose is not predictive for the early clinical failure of moderate–severe community-acquired pneumonia

The time to first antibiotic dose (TFAD) has been mentioned as an important performance indicator in community-acquired pneumonia (CAP). However, the advice to minimise TFAD to 4 hours (4 h) is only based on database studies. We prospectively studied the effect of minimising the TFAD on the early clinical outcome of moderate–severe CAP. On admission, patients’ medical data and TFAD were recorded. Early clinical failure was expressed as the proportion of patients with clinical instability, admission to the intensive care unit (ICU) or mortality on day three. Of 166 patients included in the study, 27 patients (29.7%) with TFAD <4 h had early clinical failure compared to 23 patients (37.7%) with TFAD >4 h (odds ratio [OR] 0.69; 95% confidence interval [CI] 0.35–1.35). In multivariate analysis, the pneumonia severity index (OR 1.03; 95%CI 1.01–1.04), confusion (OR 2.63; 95%CI 1.14–6.06), Staphylococcus aureus infection (OR 7.26; 95%CI 1.33–39.69) and multilobar pneumonia (OR 2.40; 95%CI 1.11–5.22) but not TFAD were independently associated with early clinical failure. Clinical parameters on admission other than the TFAD predict early clinical outcome in moderate–severe CAP. In contrast to severe CAP necessitating treatment in the ICU directly, in the case of suspected moderate–severe CAP, there is time to establish a reliable diagnosis of CAP before antibiotics are administered. Therefore, the implementation of the TFAD as a performance indicator is not desirable

Availability of surface hydroxyl groups in <I>Valonia</I> and bacterial cellulose

International audienc

Individual, species and geographic origin influence on cooperage oak extractible content (Quercus robur L. and Quercus petraea Liebl.)

Dry extract, ellagitanins, free ellagic acid, whisky-lactone, eugenol and vanillin have been quantified for a sample set of 61 pedunculate oaks (Quercus robur L.) and 72 sessile oaks (Quercus petraea Liebl.) originating from 6 different forests. Despite a very high interindividual variability, pedunculate oak shows higher level of dry extract, ellagitanins and free ellagic acid but lower level in volatil compounds compared to sessile oak. Inside a same species, differences between forests are less marked. Extractible compounds level is poorly correlated to the grain (ring width). Regarding cambial age, it might have its significance but lack of scientific data could not permit to conclude in that sense. Our results suggest that cooperage oak selection should be based on a species-provenance combination rather than on the grain or the provenance solely

A double-blind, randomized, controlled trial of topical polysporin triple compound versus topical mupirocin for the eradication of colonization with methicillin-resistant Staphylococcus aureus in a complex continuing care population

BACKGROUND: Intranasal mupirocin or Polysporin Triple (PT) ointment (polymyxin B, bacitracin, gramicidin), in combination with chlorhexidine body washes, have been used for eradicating methicillin-resistant Staphylococcus aureus (MRSA), but no comparative studies have been done