Final report of the Lyme disease review panel of the Infectious Diseases Society of America.

In April 2008, the Infectious Diseases Society of America (IDSA) entered into an agreement with Connecticut Attorney General Richard Blumenthal to voluntarily undertake a special review of its 2006 Lyme disease guidelines. This agreement ended the Attorney General's investigation into the process by which the guidelines were developed. The IDSA agreed to convene an independent panel to conduct a one-time review of the guidelines.

Soliciting patient complaints to improve performance.

Background: A study was conducted in 2000 to describe service quality problems in a large tertiary care teaching hospital and evaluate the effect of a pre-discharge program for active complaint surveillance and resolution on patient satisfaction.

Methods: The pre-post intervention study with temporal controls was conducted at a tertiary care teaching hospital in St Louis. Eighty-four percent (1,023 of 1,218) of patients admitted to a general medical unit between October 2, 2000, and December 22, 2000, were interviewed by a patient advocate to identify and address patient complaints about service quality.

A pilot study of the management of uncomplicated candidemia with a standardized protocol of amphotericin B.

We evaluated an amphotericin treatment strategy on the basis of duration of candidemia and clinical findings. Patients without neutropenia who had uncomplicated candidemia received 200 mg of amphotericin B over 5-7 days if they had had 1 day of positive cultures (PC group). The clinical cure rate was 93% (95% confidence interval [CI], 77%-99%; n=29 episodes) in the SC group, with no relapses (median follow-up, 272 days).

New challenges to the therapy of systemic fungal infections.

In summary, the recent increase in frequency of systemic fungal infections has stimulated the development of new antifungal agents which are easier to use and which have decreased toxicity. This has resulted in increase in use, and along with this, the appearance of fungi resistant to antifungal agents. The medical community will have to come to terms with this newly emerging problem.