REPAIRS Delphi: A UK and Ireland Consensus Statement on the Management of Infected Arterial Pseudoaneurysms Secondary to Groin Injecting Drug Use.

Objective: Consensus guidelines on the optimal management of infected arterial pseudoaneurysms secondary to groin injecting drug use are lacking. This pathology is a problem in the UK and globally, yet operative management options remain contentious. This study was designed to establish consensus to promote better management of these patients, drawing on the expert experience of those in a location with a high prevalence of illicit drug use.

The Needle and the Damage Done: A Retrospective Review of the Health Impact of Recreational Intravenous Drug Use and the Collateral Consequences for Vascular Surgery.

Background: The UK has one of the highest rates of recreational drug use and consequent deaths in Europe. Scotland is the "Drug deaths capital of Europe." Intravenous drug use can result in limb- and life-threatening pathology.

Toward microelimination of hepatitis C and HIV coinfection in NHS Tayside, Scotland: Real-world outcomes.

Background And Aims: NHS Tayside is a health board in Scotland which serves around 400 000 residents. Approximately, 2761 are estimated to be persons who inject drugs (PWID), and therefore at risk of infections such as hepatitis C (HCV) and HIV. There are few studies exploring mechanisms and success of eliminating HCV in HIV co-infected PWID using real-world data.

Fungal diseases at the medical front door.

Fungal diseases are an increasingly recognized cause of mortality worldwide and often pose diagnostic challenges. This article focuses on common fungal diseases as they may present in the acute medical unit, looking at the initial investigation and management of four common diseases: Pneumocystis jirovecii pneumonia, cryptococcal meningitis, candidaemia and allergic bronchopulmonary aspergillosis. There is an increase in morbidity and mortality if these conditions are not correctly diagnosed and thus appropriate therapy is delayed.

Can intravenous antifungal therapy be safely used in the outpatient parenteral antimicrobial therapy (OPAT) setting?

Outpatient parenteral antimicrobial therapy (OPAT) is an established treatment option for patients with a variety of infections who require a period of intravenous therapy, are clinically stable, and do not require continuous monitoring. Many patients with fungal infections require prolonged therapy due to resistance or intolerance to oral antifungal agents. Despite the widespread use of OPAT by infection specialists, antifungal agents appear infrequently used in this setting.

Oral versus intravenous clarithromycin in moderate to severe community-acquired pneumonia: an observational study.

Objectives: British Thoracic Society guidelines recommend clarithromycin in addition to beta-lactam antibiotics for patients with community-acquired pneumonia and CURB-65 score 2-5. Intravenous therapy is commonly used but there are few data on whether oral therapy is equally effective.

Methods: This observational study used propensity matching to compare two groups of patients with moderate to severe community-acquired pneumonia (CURB-65 score 2-5) treated with oral ( = 226) or intravenous ( = 226) clarithromycin on admission.

Cardiovascular disease as a complication of community-acquired pneumonia.

Purpose Of Review: Here, we review the incidence, prognosis, potential mechanisms and therapeutic implications of cardiovascular disease in community-acquired pneumonia (CAP).

Recent Findings: Recent evidence suggests that a large proportion of deaths from CAP are attributable to cardiovascular disease, including sudden cardiac death, acute myocardial infarction (MI), arrhythmias and cardiac failure. Up to one-third of patients with CAP may experience cardiovascular complications within 30 days of hospital admission, while data also suggest that CAP managed in the community is associated with increased risk of acute MI.

MRSA: treating people with infection.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) has a gene that makes it resistant to methicillin, as well as to other beta-lactam antibiotics, including flucloxacillin, beta-lactam/beta-lactamase inhibitor combinations, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but it can cause infection, particularly in people with prolonged hospital admissions, with underlying disease, or after antibiotic use. About 8% of S aureus in blood cultures in England, Wales, and Northern Ireland is resistant to methicillin.

Outcomes from global adult outpatient parenteral antimicrobial therapy programmes: a review of the last decade.

Outpatient parenteral antimicrobial therapy (OPAT) has become a global treatment modality since its advent in 1974. The multicentre outcome registries that were employed at the turn of the century to demonstrate the benefits and challenges in this treatment setting have been discontinued. In the intervening years, trends in clinical, patient satisfaction, programmatic and economic outcomes have been shown in sporadic cohort analyses from around the globe.

What is the evidence for the duration of antibiotic therapy in Gram-negative bacteraemia caused by urinary tract infection? A systematic review of the literature.

The frequency of secondary bacteraemia is variable depending on the site of infection but is often associated with significant morbidity and mortality. The most common source of Gram-negative bacteraemia is urinary tract infection (UTI). Current guidelines on the treatment of UTI provide no clear guidance on whether the presence of bacteraemia influences the duration or choice of therapy.

Prospective study of severity assessment and management of acute medical admissions with skin and soft tissue infection.

Background: Several severity scoring systems have been proposed for skin and soft tissue infections (SSTIs), but none has been tested prospectively.

Methods: We prospectively enrolled adult, acute medical admissions with SSTI between April 2009 and June 2010. Severity was assessed using two proposed SSTI scoring systems, one based on a generic sepsis definition.