Infectious Disease Issues in the Emergency Department

Talan, David A.

doi:10.1093/clinids/23.1.1

Cited by 22 publications

(8 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Early chest radiography should then be performed and implementation of full airborne precautions should be established for any patients with suggestive findings on radiographs or high clinical suspicion of disease. High-risk clinical procedures that will aerosolize M tuberculosis should be minimized as much as possible in the ED unless isolation facilities with proper ventilation are available [33].…”

Section: Public Health Interventionsmentioning

confidence: 99%

Communicable Respiratory Threats in the ED: Tuberculosis, Influenza, SARS, and Other Aerosolized Infections

Rothman

Hsieh

Yang

2006

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

Respiratory infections are the most common communicable infectious diseases. EDs are the front line for patients with respiratory infections because of their acute nature and because the ED is the principal site of health care for those at highest risk. These diseases include influenza, tuberculosis, and measles, together accounting for 25% of infectious causes of death worldwide. These are emerging and biothreat agents that follow the same route of transmission, such as pneumonic plague. We discuss epidemiology, pathogenesis, diagnosis, and treatment of each agent. Emphasis is on the ED's role as a public health prevention arena, with attention to education and disease prevention, early identification of disease in patients at risk, and reduction of illnesses.

show abstract

Section: Public Health Interventionsmentioning

confidence: 99%

Communicable Respiratory Threats in the ED: Tuberculosis, Influenza, SARS, and Other Aerosolized Infections

Rothman

Hsieh

Yang

2006

Emergency Medicine Clinics of North America

View full text Add to dashboard Cite

show abstract

“…In this respect, the decision of whether to treat a patient in the hospital or as an outpatient-a decision often made in the emergency department-is perhaps one of the most critical. 2 An analysis based on 1994 costs documented the dramatic difference between the costs of inpatient versus outpatient care for CAP (about $7500 and $264, respectively). 3 Outcomes-based research identified several strategies for decreasing the cost of treating patients with CAP, including more cost-efficient delivery of antimicrobial therapy and identification of low-risk patients who can be treated on an outpatient basis.…”

Section: (Pharmacotherapy 2001;21(7 Pt 2):95s-99s)mentioning

confidence: 99%

“…3 Outcomes-based research identified several strategies for decreasing the cost of treating patients with CAP, including more cost-efficient delivery of antimicrobial therapy and identification of low-risk patients who can be treated on an outpatient basis. 2,3 Optimizing Antimicrobial Delivery…”

Section: (Pharmacotherapy 2001;21(7 Pt 2):95s-99s)mentioning

confidence: 99%

“…In the emergency department, results of cultures and antimicrobial susceptibility tests are rarely available; therefore, a presumptive diagnosis and the initiation of therapy on an empiric basis are the rule rather than the exception with many infectious diseases. 2 Further, CAP symptoms, physical findings, and laboratory test results are poorly correlated with a specific etiology. 4,5 Whereas it is known that the most common etiologic agent in CAP is Streptococcus pneumoniae, a literature review of large-scale CAP studies (those involving more than 100 patients) suggests that the causative pathogen remains uncertain in about one-third of all patients.…”

Section: Empiric Therapy Is the Rulementioning

confidence: 99%

See 1 more Smart Citation

New Directions in Antiinfective Therapy for Community‐Acquired Pneumonia in the Emergency Department

Moran

2001

Pharmacotherapy

View full text Add to dashboard Cite

The emergency department is becoming an increasingly important setting for the management of community-acquired pneumonia (CAP). This trend reflects the shortened hospital stays and decreased mortality among elderly hospitalized patients resulting from rapid administration of antimicrobials. In addition, decisions about the site of care (inpatient vs outpatient) and antimicrobial therapy frequently are made in the emergency department. Recent research and subsequent clinical guidelines may help with these decisions. For example, recently issued guidelines, such as those of the Infectious Diseases Society of America and the American Thoracic Society, suggest that selection of antimicrobials for CAP (which is typically empiric) should be based on the potential pathogens and likelihood of antimicrobial resistance. Macrolides and tetracyclines are recommended in younger patients with mild-to-moderate disease. Patients with more severe disease and those at risk for drug-resistant pathogens should be treated with broad-spectrum therapy, such as a newer fluoroquinolone or a cephalosporin plus a macrolide. When hospitalization is required, early switch from intravenous to oral therapy, followed by early discharge, can be a highly successful strategy. Antimicrobials that are available in both intravenous and oral formulations, such as the newer fluoroquinolones (e.g., levofloxacin and gatifloxacin), can simplify switch therapy For outpatients, an initial long-acting parenteral dose of azithromycin, ceftriaxone, or levofloxacin followed by oral therapy is an effective protocol. In addition, use of a prediction rule to identify low-risk patients with CAP may help guide decisions about the need for hospital admission.

show abstract

“…Si tenemos en cuenta que la mayoría de estudios microbioló gicos no proporcionan resultados inmediatos, se establece un período de incertidumbre ante el cual los clínicos de los SUH se plantean el ingreso hospitalario y el inicio de un tratamiento antibió tico empírico 4 . Sabemos que el inicio precoz del tratamiento antimicrobiano mejora el pronó stico de los pacientes con sepsis, aunque por otro lado cabe recordar los importantes costes econó micos y ecoló gicos asociados al uso indiscriminado de antibió ticos.…”

Section: Introduccció Nunclassified