Publications by authors named "G Eschenauer"
Article Synopsis
- In March 2020, the White House Coronavirus Task Force identified the need for expert treatment guidelines for managing COVID-19 due to its life-threatening nature and lack of known effective treatments.
- The NIH was tasked with quickly assembling a panel of experts to create "living" guidelines, which would be regularly updated as new information about the virus emerged.
- The article reflects on the Panel's experiences over four years, summarizes its final recommendations, discusses ongoing challenges, and notes that the responsibility for COVID-19 guidelines will now shift to professional organizations following the end of the public health emergency.
Article Synopsis
- Critical illness complicates medication treatment for severe diseases, as physiological changes in patients can affect how drugs are absorbed and processed in the body.
- * ECMO (extracorporeal membrane oxygenation) can further alter drug pharmacokinetics, potentially leading to reduced drug concentrations due to factors like drug sequestration and increased volume of distribution.
- * Due to these complexities, especially in selecting and dosing antimicrobials, therapeutic drug monitoring is crucial for ensuring effective treatment in critically ill patients, particularly those on ECMO support.
Background: Candidaemia is associated with poor outcomes including high mortality rates. Controversy remains regarding whether fluconazole or an echinocandin is the optimal choice for initial candidaemia treatment, particularly among high-risk patients such as the immunocompromised or critically ill.
Objectives: To understand optimal initial treatment of candidaemia.
A novel 2-step process for the management of inpatient beta-lactam allergy labels.
Ann Allergy Asthma Immunol
April 2024
Background: Inpatient beta-lactam allergy labels may increase the unnecessary use of aztreonam and non-beta-lactam antibiotics, which can then lead to more adverse events and increased health care costs, OBJECTIVE: To assess the impact of a novel 2-step process (medication history review followed by risk stratification) on rates of beta-lactam delabeling, aztreonam use, and desensitizations on pediatric, adult, and obstetrics inpatients at a tertiary academic center.
Methods: We prospectively collected data on 700 patients who received inpatient consultation from the Beta-Lactam Allergy Evaluation Service between August 2021 and July 2022. Patients were delabeled either by medication review alone, drug challenge alone if with a low-risk history, or penicillin skin test followed by drug challenge if with a high-risk history.
Antifungal Therapies for Aspergillus spp.: Present and Future.
Semin Respir Crit Care Med
February 2024
Currently available and recommended options for the treatment of pulmonary aspergillosis include the triazoles, echinocandins, and amphotericin B products. These therapies have significant limitations. Only the azoles are available orally, but their use is often limited by toxicities, drug-drug interactions, pharmacokinetic variability, and emerging resistance.
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