Collaborative Antimicrobial Stewardship for Surgeons.

Antimicrobial stewardship efforts that include surgeons rely on healthy and open communications between surgeons, infectious diseases specialists, and pharmacists. These efforts most frequently are related to surgical prophylaxis, the management of surgical infections, and surgical critical care. Policy should be based on best evidence and timely interactions to develop consensus on how to develop appropriate guidelines and protocols.

Usefulness of laboratory values in predicting effectiveness of recombinant factor VIIa in surgical patients with bleeding.

Purpose: The results of a study to determine whether certain laboratory values can predict the effectiveness of recombinant factor VIIa (rFVIIa) therapy to control postoperative bleeding in surgical patients are presented.

Methods: In a retrospective observational study at a large university hospital, the records of all adult patients on the cardiothoracic surgery (CTS) and general or trauma surgery (GTS) units who received rFVIIa for treatment-refractory nonsurgical bleeding episodes (an off-label use) during a 17-month period were reviewed. Collected data included blood product requirements before and after administration of rFVIIa, selected periadministration laboratory values (e.

Antibiotics in the intensive care unit: focus on agents for resistant pathogens.

Antibiotic resistance is increasing faster than the drug industry can develop and market new antibiotics. Medical personnel commonly must deal with the resistant gram-positive pathogens including MRSA and VRE, in addition to the problem gram-negative bacteria, Pseudomonas, Acinetobacter, and ESBL producing strains of Klebsiella and E. coli.