Top Myths of Diagnosis and Management of Infectious Diseases in Hospital Medicine

Johnson, Melissa D.; Davis, Angelina; Dyer, April; Jones, Travis M; Spires, S Shaefer; Ashley, Elizabeth Dodds

doi:10.1016/j.amjmed.2022.03.019

Cited by 4 publications

(3 citation statements)

References 66 publications

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“…In most cases, the second antibiotic used was a glycopeptide (vancomycin) or oxazolidinone (linezolid) as empirical coverage against E. faecium. Although the evaluation of antibiotic use is not the subject of this study, the data are congruent with other articles in which it is preferred to avoid antibiotic combinations, except in specific situations [24,25].…”

Section: Combination Antibiotic Therapy Versus Monotherapysupporting

confidence: 80%

Mortality Risk Prediction in Abdominal Septic Shock Treated with Polymyxin-B Hemoperfusion: A Retrospective Cohort Study

García-Ramos

Caamaño

Benítez

et al. 2023

JPM

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Endotoxin, a component of the cell membrane of gram-negative bacteria, is a trigger for dysregulated inflammatory response in sepsis. Extracorporeal purification of endotoxin, through adsorption with polymyxin B, has been studied as a therapeutic option for sepsis. Previous studies suggest that it could be effective in patients with high endotoxin levels or patients with septic shock of moderate severity. Here, we perform a retrospective, single-centre cohort study of 93 patients suffering from abdominal septic shock treated with polymyxin-B hemoperfusion (PMX-HP) between 2015 and 2020. We compared deceased and surviving patients one month after the intervention using X2 and Mann-Whitney U tests. We assessed the data before and after PMX-HP with a Wilcoxon single-rank test and a multivariate logistic regression analysis. There was a significant reduction of SOFA score in the survivors. The expected mortality using APACHE-II was 59.62%, whereas in our sample, the rate was 40.9%. We found significant differences between expected mortality and real mortality only for the group of patients with an SOFA score between 8 and 13. In conclusion, in patients with abdominal septic shock, the addition of PMX-HP to the standard therapy resulted in lower mortality than expected in the subgroup of patients with intermediate severity of illness.

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Section: Combination Antibiotic Therapy Versus Monotherapysupporting

confidence: 80%

Mortality Risk Prediction in Abdominal Septic Shock Treated with Polymyxin-B Hemoperfusion: A Retrospective Cohort Study

García-Ramos

Caamaño

Benítez

et al. 2023

JPM

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“…Symptoms like fever, rapid heart rate, confusion, and rapid breathing were frequently misinterpreted or overlooked. This lack of awareness could potentially delay timely medical intervention, leading to increased morbidity and mortality rates given the high incidence of sepsis in the region [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Public Awareness and Knowledge of Sepsis: A Cross-Sectional Survey of Adults in the Western Region of Saudi Arabia

Alnofaiey,

Alharthi,

Alhulayfi

et al. 2023

Cureus

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Background: Sepsis is a condition in which the body responds improperly to harmful microorganisms and infections, which triggers a chain reaction throughout the body. It is a life-threatening medical emergency. Infections that lead to sepsis, in most cases, start in the lungs, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis rapidly leads to multi-organ failure and death. The risk factors for sepsis include a weakened immune system, being 65 years of age or older, and chronic medical conditions including diabetes, lung disease, and kidney disease. A thorough understanding of the warning signs and symptoms, as well as prompt medical attention, are required for successful sepsis management. Early detection, antimicrobial therapy, and intensive supportive care are the cornerstones of the best sepsis management. Aim: This study aimed to assess the public awareness and knowledge of sepsis in the Western region of Saudi Arabia. Methods: This was a cross-sectional study conducted from the beginning of June till the end of August 2023, among 425 Saudi adults in the Western region above the age of 18 years. Data collection was carried out by administering a questionnaire through an online platform. The questionnaire included demographic information, risk factors, symptoms, protective factors, and the source of information about sepsis. The data collected were reviewed, coded, and then fed into IBM SPSS Statistics software for Windows, Version 21 (released 2012; IBM Corp., Armonk, NY). Results: The study found that almost half (47.8%) of participants were aware of bacterial septicemia, with the most common sources of awareness being the internet (48.3%) and healthcare professionals (47.8%). Low immunity (75.9%) and infection (39.4%) have been the most frequently reported risk factors. Fever (31.5%) was the most commonly reported symptom. Participants from Yanbu and Jeddah and those in the healthcare sector had significantly higher awareness levels. The majority of participants (93.1%) had poor knowledge about the risk factors and symptoms of septicemia, with only 3.4% having fair or good knowledge. Sociodemographic characteristics did not significantly affect knowledge about septicemia (P>0.05). Conclusion: In summary, this study reveals that while awareness of bacterial septicemia is relatively high among the sample population, knowledge about the risk factors and symptoms of the condition is low. The internet, healthcare professionals, and social media play significant roles in raising awareness about bacterial septicemia. Participants from Yanbu and Jeddah, students, and healthcare sector workers had higher awareness levels compared to other groups. However, overall knowledge levels regarding bacterial septicemia were poor across various demographic characteristics. This highlights the need for targeted educational interventions to improve knowledge and understanding of septicemia and its risk factors and symptoms among the general populat...

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“…In caring for patients at risk for or diagnosed with infectious diseases, perpetuation of myths may lead to selection of inferior antimicrobial agents or receipt of unnecessary antimicrobials. Recent articles have been published debunking some of the most frequently encountered myths relating to the diagnosis and treatment of infectious diseases [ 1 , 2 ]. Management of infectious diseases in the solid organ transplant (SOT) population poses unique challenges with a broader array of potential pathogens and associated antimicrobial therapies, in addition to limited evidence.…”

mentioning

confidence: 99%

Therapeutic Myths in Solid Organ Transplantation Infectious Diseases

Goodlet,

McCreary,

Nailor

et al. 2024

Open Forum Infectious Diseases

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Infection management in solid organ transplant poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic “myths” may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss six therapeutic myths with particular relevance to solid organ transplant and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population.

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Top Myths of Diagnosis and Management of Infectious Diseases in Hospital Medicine

Cited by 4 publications

References 66 publications

Mortality Risk Prediction in Abdominal Septic Shock Treated with Polymyxin-B Hemoperfusion: A Retrospective Cohort Study

Mortality Risk Prediction in Abdominal Septic Shock Treated with Polymyxin-B Hemoperfusion: A Retrospective Cohort Study

Public Awareness and Knowledge of Sepsis: A Cross-Sectional Survey of Adults in the Western Region of Saudi Arabia

Therapeutic Myths in Solid Organ Transplantation Infectious Diseases

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