162 research outputs found
Visualizing Clinical Evidence: Citation Networks for the Incubation Periods of Respiratory Viral Infections
Simply by repetition, medical facts can become enshrined as truth even when there
is little empirical evidence supporting them. We present an intuitive and clear
visual design for tracking the citation history of a particular scientific fact
over time. We apply this method to data from a previously published literature
review on the incubation period of nine respiratory viral infections. The
resulting citation networks reveal that the conventional wisdom about the
incubation period for these diseases was based on a small fraction of available
data and in one case, on no retrievable empirical evidence. Overall, 50%
of all incubation period statements did not provide a source for their estimate
and 65% of original sources for incubation period data were not
incorporated into subsequent publications. More standardized and widely
available methods for visualizing these histories of medical evidence are needed
to ensure that conventional wisdom cannot stray too far from empirically
supported knowledge
Effect of daily chlorhexidine bathing on hospital-acquired infection
BACKGROUND
Results of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs).
METHODS
We conducted a multicenter, cluster-randomized, nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections. Nine intensive care and bone marrow transplantation units in six hospitals were randomly assigned to bathe patients either with no-rinse 2% chlorhexidine– impregnated washcloths or with nonantimicrobial washcloths for a 6-month period, exchanged for the alternate product during the subsequent 6 months. The incidence rates of acquisition of MDROs and the rates of hospital-acquired bloodstream infections were compared between the two periods by means of Poisson regression analysis.
RESULTS
A total of 7727 patients were enrolled during the study. The overall rate of MDRO acquisition was 5.10 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.03), the equivalent of a 23% lower rate with chlorhexidine bathing. The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1000 patient-days with chlorhexidine bathing versus 6.60 cases per 1000 patient-days with nonantimicrobial washcloths (P=0.007), a 28% lower rate with chlorhexidine-impregnated washcloths. No serious skin reactions were noted during either study period.
CONCLUSIONS
Daily bathing with chlorhexidine-impregnated washcloths significantly reduced the risks of acquisition of MDROs and development of hospital-acquired bloodstream infections. (Funded by the Centers for Disease Control and Prevention and Sage Products; ClinicalTrials.gov number, NCT00502476.
Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140217/1/sur.2013.9999.pd
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