IgG4ward’s Post

Daily Critical Care Pearls #141: Cytomegalovirus Reactivation in Immunocompetent Adult Patients 📌CMV reactivation is associated with higher morbidity and mortality in immunocompetent patients 📌If a critically ill patient is somehow tested and found to be CMV seropositive, there is no indication to provide prophylactic treatment to attempt to prevent reactivation 📌There is no role for routine treatment of CMV reactivation in critically ill immunocompetent patients 📌Treat CMV-infected patients who meet the following criteria: 1. Clinical signs of infection (this is almost always going to be lung infiltrates but in theory could also be retinitis, colitis, or hemophagocytic syndrome) AND 2. At least two risk factors: - leukopenia - hemophagocytosis - no bacteria infection - prolonged ventilation (at least 2 weeks) - SGOT at least 1.5-3x ULN - bilirubin at least 1.5-3x ULN - fever - diarrhea 📌The recommended treatment is a 2 week course of IV ganciclovir. The only reason the suggest not to use oral valganciclovir is due to presumed unpredictable oral absorption during critical illness. #criticalcare #pharmacy #medicine #clinicalpharmacy #pearls

#Treatment #Mpox As per Information available on US CDC site: Currently there is no treatment approved specifically for monkeypox virus (MPXV) infections. For most patients with mpox who have intact immune systems and don’t have a skin disease, supportive care and pain control will help them recover without medical treatment. However, for patients who experience severe manifestations of mpox, interim clinical guidance developed by CDC may assist clinicians in managing such patients. For full details, visit CDC Mpox Treatment. https://lnkd.in/gMmnBndG Summary is as below: - Tecovirimat (TPOXX): The main antiviral for treating mpox, approved under an expanded access protocol. - Brincidofovir (Tembexa) and Cidofovir: Both antivirals are also available for use in severe cases of mpox. - Vaccinia Immune Globulin Intravenous (VIGIV): May be used in certain situations, especially in immunocompromised patients. Treatment algorithm 👇🏻

Case study of an 80-year-old patient, illustrating successful management of dual #Hpylori and #Cdiff infections #CDI with quadruple therapy. https://lnkd.in/e4dC9Nxk

(Benefit-Risk Management / Diabetic Foot Infections / FINAL FDA Guidance) What's the importance of DFI? For those who have suffered down the path of poorly-controlled diabetes, the development of a superficial, poorly-healing foot ulcer followed by repeated foot trauma, then infection (with subsequent joint infection, osteomyelitis, leading to amputation), this is an unfortunate morbid situation. This guidance represents a clinical development framework for developing treatments for mono- and polymicrobial DFI (while acknowledging the poor perfusion in the extremities) [I have wrapped many Unna boots in past surgical clinics]. #cder #infections #diabetes #drugs #diabeticfootinfections #dfi #diabeticneuropathy #footinfections #antibiotics #staphylococcus #ABSSSI (P.S. picks up where ABSSSI guidance does not cover); wiki: https://lnkd.in/eA4sRpWt

🔬 Spotlight on Meropenem: A Versatile Antibiotic for Serious Infections Meropenem is a powerful, broad-spectrum antibiotic frequently used in the treatment of a variety of severe infections. Here's a closer look at its applications and what healthcare professionals should be aware of: Indications for Meropenem: Pneumonia and Nosocomial Pneumonia Urinary Tract Infections (UTIs) Intra-abdominal Infections Gynecological Infections Skin and Soft Tissue Infections Meningitis Septicaemia Empiric Treatment of Presumed Infections in Adults with Febrile Neutropenia Important Consideration: While meropenem is highly effective, clinicians should be aware of potential adverse reactions. One notable rare reaction is Acute Generalized Exanthematous Pustulosis (AGEP), a severe skin reaction characterized by rapid onset of pustules and fever. Stay Informed: Healthcare professionals should closely monitor patients for signs of AGEP and other adverse effects to ensure prompt management and the best possible outcomes. #Healthcare #InfectionControl #Antibiotics #Meropenem #PatientSafety #MedicalUpdates #thepharmacistworld

Do supplements work for treating urinary tract infections (UTIs)? One supplement has been taken off the list after a clinical trial found that d-mannose, which had been touted for its prevention potential, did not live up to its promise. The supplement was shown to make no significant difference to women who had experienced a medically attended UTI, or to symptoms or recurrence of the infection. Read more about the study here: https://hubs.la/Q02yq2mK0 #UTI #UrinaryTract

💉Meropenem: A Versatile Antibiotic for Serious Infections Meropenem is a powerful, broad-spectrum antibiotic frequently used in the treatment of a variety of severe infections. Here's a closer look at its applications and what healthcare professionals should be aware of: Indications for Meropenem: Pneumonia and Nosocomial Pneumonia Urinary Tract Infections (UTIs) Intra-abdominal Infections Gynecological Infections Skin and Soft Tissue Infections Meningitis Septicaemia Empiric Treatment of Presumed Infections in Adults with Febrile Neutropenia Important Consideration: While meropenem is highly effective, clinicians should be aware of potential adverse reactions. One notable rare reaction is Acute Generalized Exanthematous Pustulosis (AGEP), a severe skin reaction characterized by rapid onset of pustules and fever. Stay Informed: Healthcare professionals should closely monitor patients for signs of AGEP and other adverse effects to ensure prompt management and the best possible outcomes. #Healthcare #InfectionControl #Antibiotics #Meropenem #PatientSafety #medicalupdates #thepharmacistworld

March is #LiverHealthMonth: the perfect time to think about how you can show your liver some love! For people who inject drugs, getting screened regularly for Hepatitis C (a potentially deadly liver infection) is extremely important. In fact, 3 out of 4 new cases of Hepatitis C are in people who share injection equipment. Symptoms of infection don’t appear at first, leaving 40% of people living with Hep C unaware they have it. After 6 months left undetected the symptoms become much more severe, which is why early screening is critical. That’s why our rapid access opioid use disorder treatment program includes quick, easy and painless Hepatitis C screening and referrals to care! Hep C is one of the few chronic conditions that can be cured. Current treatments are over 95% effective, take only 8-12 weeks, and cause very few side-effects. Visit any of our walk-in clinics for same day Hep C testing with a quick and pain-free prick of the finger and rapid results! canatc.ca/locations #hepatitisc #opioidusedisorder Canadian Liver Foundation

Hepatitis B crash course # 1 1. Hepatitis B is a DNA virus and is transmitted by exposure to the blood or body fluids of an infected person. 2. The common possibilities include injection drug use, sexual contact, or vertical transmission from a mother to the fetus. 3. Acute hepatitis B virus infection causes symptoms like fatigue, malaise, nausea, vomiting, jaundice, and anorexia. 4. AST and ALT levels are characteristically elevated. 5. Patients can develop acute liver failure. 6. Treatment is recommended for those patients who have acute liver failure, or cirrhosis, infection in the immune active phase, or reactivation phase, or those patients who are immunosuppressed, or planning to take immunosuppressive therapy. 7. Treatment usually consists of entecavir or tenofovir. Please like, follow, share, repost, and comment if you like my content. I try my best to respond to every comment personally. If you want to see all of my future posts, hit the bell icon next to my profile. If you want to see all of my videos, please subscribe to my YouTube channel here. https://lnkd.in/gGg7KuBt

#858 A 77-year-old female with a history of atrial fibrillation, hypertension (HTN), and heart failure with reduced ejection fraction (HFrEF) who is admitted to the hospital for a total prosthetic-hip-associated infection. Vancomycin and rifampin are initiated for empiric antimicrobial therapy. The team would also like to start oral anticoagulation for stroke prevention. Which of the following oral anticoagulants may be recommended in this patient? A. Warfarin plus therapeutic enoxaparin B. Dabigatran C. Rivaroxaban D. Edoxaban Answer:A Concomitant use of dabigatran, rivaroxaban, or edoxaban with strong dual p-glycoprotein and cytochrome P450 3A4 (CYP3A4) inducers, such as rifampin, should be avoided due to decreased levels of the anticoagulant; it is also unfeasible to determine the extent of reduction of the anticoagulant due to a lack of monitoring assays to test for efficacy. Rifampin may also decrease the effect of warfarin; however, this may be monitored closely through international normal- ized ratio (INR) readings, and doses may be adjusted accordingly. #cardilogy #cardiac_drug