To assess the impact of a dedicated musculoskeletal infection team, 70 musculoskeletal infections (traumatic and non-traumatic chronic osteomyelitis, Cierny-Mader Type III or IV) in 58 patients with were treated in two groups. Group I (43 infections) was treated with the assistance of an on-call infectious disease specialist. Group II (27 infections) was treated with the assistance of a dedicated musculoskeletal infectious disease specialist. Overall, there was a 42% success in Group I compared with 78% success in Group II. When stratified by infection type, in patients with Type III infections, there was a 56% success in Group I and a 90% success rate in Group II. For patients with Type IV infections, there was a 25% success rate in Group I and a 71% success rate in Group II. The participation of the dedicated musculoskeletal infectious disease specialist significantly improved patient outcomes.

The primary outcome was the mortality within 30 days. Since the clinical characteristics of patients can affect the selection of antibiotics, basic analysis including all subjects who met inclusion and exclusion criteria as well as an analysis using "stabilized Inverse Probability of Treatment Weighting (stabilized IPTW)" that adjusted patient clinical characteristics were conducted. Results: We identified 554 patients who met the eligibility criteria. There was no statistically significant difference in thirty day survival rate between the groups both prior and post to propensity score weighting in empirical treatment. Multivariate analysis of thirty day survival rate conducted after the adjustment of confounding variables affecting mortality rate such as age, infection route, transfer to ICU within 48 hours, infection sites, APACHE II, liver diseases, lung diseases, renal disease and diabetes also revealed that there was no significant difference (HR= 1.01, 95%CI 0.27-3.76). After propensity score weighting, the statistical difference remained insignificant (weighted HR= 0.76, 95%CI 0.23-2.58). There was no statistically significant difference in thirty day survival rate between the groups when carbapenems and BL/BLIs were used as empirical treatment (weighted HR= 0.99, 95%CI 0.29-3.30). cOnclusiOns:The results from this study show that there was no difference in mortality when carbapenems were compared with BL/BLIs alone or with all alternative antibiotics as empirical therapy. Although the role of carbapenems as definitive treatment should be evaluated, considering an increasing carbapenem resistance, alternative antibiotics, such as BL/BLIs, can be used as alternatives for the empirical treatment of patients with ESBL-positive enterobacteriaceae bacteraemia.

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the corticosteroid found in the evidence was prednisolone in a dose of 0.5 to 1mg/ kg a day, administered orally, with a maximum dose of 60mg a day. The use of corticosteroids in triquinolose is based only on expert opinion and the treatment cycle is 10-15 days. Base II) The hydrocortisone sodium succinate is indicated for treatment of triquinolose presenting neurological or infarct involvement. In adults, the usual dosage is 100mg to 8g daily, and its initial therapy is 100-500mg every 2-10 hours as needed. Base III) Found evidence synthesis demonstrates that the treatment of patients with trichinosis presenting neurologic or infarct involvement should be performed with antiparasitic therapy (anthelmintic) associated with corticosteroids (prednisolone, 30-60mg a day for 10-15 days). Base IV) Hydrocortisone sodium succinate can be used in adults to treat trichinosis presenting neurologic and/or infarct involvement. ConClusions: According to the synthesis of selected evidence hydrocortisone can be used in the treatment of trichinosis presenting neurological or infarction involvement.