A Comparison of Current Guidelines of Five International Societies on Clostridium difficile Infection Management

<p>Article full text</p> <p>The full text of this article can be found here</p><p> <b><u>https://link.springer.com/article/10.1007/s40121-016-0122-1</u></b></p> <p>Provide enhanced content for this article</p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p>Other enhanced features include, but are not limited to:</p> <ul> <li>Slide decks</li> <li>Videos and animations</li> <li>Audio abstracts</li> <li>Audio slides</li> </ul

A Review of Experimental and Off-Label Therapies for Clostridium difficile Infection

<p><strong>Article full text</strong></p> <p><br> The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s40121-016-0140-z"><b>here</b>.</a><br> <br> <strong>Provide enhanced content for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slides</p> <p> </p

Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia

<div><p>Background</p><p>There is only limited information on mortality over extended periods in hospitalized patients with pneumococcal community-acquired pneumonia (CAP). We aimed to evaluate the 30-day mortality and whether is changed over a 20-year period among immunocompetent adults hospitalized with pneumococcal CAP.</p><p>Methods</p><p>We conducted a retrospective observational study of data that were prospectively collected at the Hospital Clinic of Barcelona of all adult patients hospitalized with diagnosis of pneumococcal CAP over a 20-year period. To aid analysis, results were divided into four periods of 5 years each (1997–2001, 2002–2006, 2007–2011, 2012–2016). The primary outcome was 30-day mortality, but secondary outcomes included intensive care unit (ICU) admission, lengths of hospital and ICU-stays, ICU-mortality, and need of mechanical ventilation.</p><p>Results</p><p>From a cohort of 6,403 patients with CAP, we analyzed the data for 1,120 (17%) adults with a diagnosis of pneumococcal CAP. Over time, we observed decreases in the rates of alcohol consumption, smoking, influenza vaccination, and older patients (age ≥65 years), but increases in admissions to ICU and the need for non-invasive mechanical ventilation. The overall 30-day mortality rate was 8% (95% confidence interval, 6%–9%; 84 of 1,120 patients) and did not change significantly between periods (p = 0.33). Although, we observed a decrease in ICU-mortality comparing the first period (26%) to the second one (10%), statistical differences disappeared with adjustment (p0.38).</p><p>Conclusion</p><p>Over time, 30-day mortality of hospitalized pneumococcal CAP did not change significantly. Nor did it change in the propensity-adjusted multivariable analysis. Since mortality in pneumococcal pneumonia has remained unaltered for many years despite the availability of antimicrobial agents with proven in vitro activity, other non-antibiotic strategies should be investigated.</p></div

Rate of 30-day mortality per period.

<p>Rate of 30-day mortality per period.</p

Significant univariable and multivariable cox regression analyses for the prediction of icu mortality.

<p>Significant univariable and multivariable cox regression analyses for the prediction of icu mortality.</p

Significant univariable and multivariable Cox regression analyses for the prediction of 30-day mortality.

<p>Significant univariable and multivariable Cox regression analyses for the prediction of 30-day mortality.</p

Kaplan-Meier analysis on the effect of period on time to death.

<p>Kaplan-Meier analysis on the effect of period on time to death.</p

Samples for microbiological diagnosis of pneumococcal pneumonia by study period.

<p>Samples for microbiological diagnosis of pneumococcal pneumonia by study period.</p

Flow chart of study population.

<p>Flow chart of study population.</p

Outcomes by study period.

<p>Outcomes by study period.</p