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10.1097/QCO.0000000000000767

http://scihub22266oqcxt.onion/10.1097/QCO.0000000000000767
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34751185!ä!34751185

suck abstract from ncbi


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pmid34751185      Curr+Opin+Infect+Dis 2021 ; 34 (6): 718-727
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  • Current opinion in management of septic shock due to Gram-negative bacteria #MMPMID34751185
  • Tabah A; Buetti N; Barbier F; Timsit JF
  • Curr Opin Infect Dis 2021[Dec]; 34 (6): 718-727 PMID34751185show ga
  • PURPOSE OF REVIEW: The COVID-19 pandemic has caused multiple challenges to ICUs, including an increased rate of secondary infections, mostly caused by Gram-negative micro-organisms. Worrying trends of resistance acquisition complicate this picture. We provide a review of the latest evidence to guide management of patients with septic shock because of Gram-negative bacteria. RECENT FINDINGS: New laboratory techniques to detect pathogens and specific resistance patterns from the initial culture are available. Those may assist decreasing the time to adequate antimicrobial therapy and avoid unnecessary broad-spectrum antibiotic overuse. New antimicrobials, including beta-lactam/beta-lactamase inhibitor combinations, such as ceftolozane-tazobactam, imipenem-relebactam or meropenem-vaborbactam and cephalosporins, such as cefiderocol targeted to specific pathogens and resistance patterns are available for use in the clinical setting. Optimization of antibiotic dosing and delivery should follow pharmacokinetic and pharmacodynamic principles and wherever available therapeutic drug monitoring. Management of sepsis has brought capillary refill time back to the spotlight along with more reasoned fluid resuscitation and a moderate approach to timing of dialysis initiation. SUMMARY: Novel rapid diagnostic tests and antimicrobials specifically targeted to Gram-negative pathogens are available and should be used within the principles of antimicrobial stewardship including de-escalation and short duration of antimicrobial therapy.
  • |*COVID-19[MESH]
  • |*Gram-Negative Bacterial Infections/diagnosis/drug therapy[MESH]
  • |*Shock, Septic/drug therapy[MESH]
  • |Anti-Bacterial Agents/therapeutic use[MESH]
  • |Cephalosporins[MESH]
  • |Diagnostic Tests, Routine[MESH]
  • |Gram-Negative Bacteria[MESH]
  • |Humans[MESH]
  • |Microbial Sensitivity Tests[MESH]
  • |Pandemics[MESH]


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