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IDSA Practice Guidelines

Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]

Attributes of good guidelines include validity, reliability, reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process, review of evidence, and documentation. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]

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Latest Guidelines

New Fever in Critically Ill Patients

Status: Update in Progress

In some intensive care units (ICUs), the measurement of a newly elevated temperature triggers automatic orders for many tests that are time-consuming, costly, and disruptive. Moreover, the patient may experience

In some intensive care units (ICUs), the measurement of a newly elevated temperature triggers automatic orders for many tests that are time-consuming, costly, and disruptive. Moreover, the patient may experience discomfort, be exposed to unneeded radiation, or experience considerable blood loss as a result of this testing, which is often repeated several times within 24 hours and daily thereafter. In an era when use of hospital and patient resources is under intensive scrutiny, it is appropriate to assess how such fevers should be evaluated in a prudent and cost-effective manner. *For information on the timing of future updates to this guideline, contact SCCM

Sporotrichosis

Status: Current

Guidelines for the management of patients with sporotrichosis were prepared by an Expert Panel of the Infectious Diseases Society of America and replace the guidelines published in 2000... They include

Guidelines for the management of patients with sporotrichosis were prepared by an Expert Panel of the Infectious Diseases Society of America and replace the guidelines published in 2000... They include evidence-based recommendations for the management of patients with lymphocutaneous, cutaneous, pulmonary, osteoarticular, meningeal, and disseminated sporotrichosis. Recommendations are also provided for the treatment of sporotrichosis in pregnant women and in children.*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was last reviewed and deemed current as of 04/2013

Endocarditis Prevention

Status: Current, Endorsed

Infective endocarditis (IE) is an uncommon but life-threatening infection. Despite advances in diagnosis, antimicrobial therapy, surgical techniques, and management of complications, patients with IE still have high morbidity and mortality

Infective endocarditis (IE) is an uncommon but life-threatening infection. Despite advances in diagnosis, antimicrobial therapy, surgical techniques, and management of complications, patients with IE still have high morbidity and mortality rates related to this condition. Since the last American Heart Association (AHA) publication on prevention of IE in 1997, many authorities and societies, as well as the conclusions of published studies, have questioned the efficacy of antimicrobial prophylaxis to prevent IE in patients who undergo a dental, gastrointestinal (GI), or genitourinary (GU) tract procedure and have suggested that the AHA guidelines should be revised. Full text*For information on the timing of future updates of this guideline, please contact the AHA.

Histoplasmosis

Status: Current

Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was last reviewed and deemed current as of 06/2011.These updated

Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was last reviewed and deemed current as of 06/2011.These updated guidelines replace the previous treatment guidelines published in 2000. The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. Since 2000, several new antifungal agents have become available, and clinical trials and case series have increased our understanding of the management of histoplasmosis. Advances in immunosuppressive treatment for inflammatory disorders have created new questions about the approach to prevention and treatment of histoplasmosis.  Full text

Community-Acquired Pneumonia (CAP)

Status: Update in Progress

Improving the care of adult patients with community-acquired pneumonia (CAP) has been the focus of many different organizations, and several have developed guidelines for management of CAP. Two of the

Improving the care of adult patients with community-acquired pneumonia (CAP) has been the focus of many different organizations, and several have developed guidelines for management of CAP. Two of the most widely referenced are those of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS). In response to confusion regarding differences between their respective guidelines, the IDSA and the ATS convened a joint committee to develop a unified CAP guideline document. Full text*Projected Publication, Summer 2018

Nontuberculous Mycobacterial (NTM) Diseases

Status: Update in Progress

The minimum evaluation of a patient suspected of nontuberculous mycobacterial (NTM) lung disease should include the following: (1) chest radiograph or, in the absence of cavitation, chest high-resolution computed tomography

The minimum evaluation of a patient suspected of nontuberculous mycobacterial (NTM) lung disease should include the following: (1) chest radiograph or, in the absence of cavitation, chest high-resolution computed tomography (HRCT) scan; (2) three or more sputum specimens for acid-fast bacilli (AFB) analysis; and (3) exclusion of other disorders, such as tuberculosis (TB). Clinical, radiographic, and microbiologic criteria are equally important and all must be met to make a diagnosis of NTM lung disease. *For information on the timing of future updates to this guideline, contact the ATS.

Antimicrobial Stewardship

Status: Retired

This document presents guidelines for developing institutional programs to enhance antimicrobial stewardship, an activity that includes appropriate selection, dosing, route, and duration of antimicrobial therapy. The primary goal of antimicrobial

This document presents guidelines for developing institutional programs to enhance antimicrobial stewardship, an activity that includes appropriate selection, dosing, route, and duration of antimicrobial therapy. The primary goal of antimicrobial stewardship is to optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, including toxicity, the selection of pathogenic organisms (such as Clostridium difficile), and the emergence of resistance. Thus, the appropriate use of antimicrobials is an essential part of patient safety and deserves careful oversight and guidance. Full text *Information contained in the following guideline is outdated or superseded by another publication and should be used for historical purposes only. For recommendations on Implementing an Antimicrobial Stewardship Program, please see the new guidelines.

The Practice of Travel Medicine

Status: Retired

Travel medicine is devoted to the health of travelers who visit foreign countries. It is an interdisciplinary specialty concerned not only with prevention of infectious diseases during travel but also

Travel medicine is devoted to the health of travelers who visit foreign countries. It is an interdisciplinary specialty concerned not only with prevention of infectious diseases during travel but also with the personal safety of travelers and the avoidance of environmental risks.Full text *Information contained in the following guideline is outdated or superseded by another publication and should be used for historical purposes only. For other information related to travel medicine visit the following:CDC Travel HealthCDC YellowbookISTM Global Travel Clinic Directory

Lyme Disease

Status: Update in Progress

Lyme disease is the most common tick-borne infection in both North America and Europe. In the United States, Lyme disease is caused by Borrelia burgdorferi, which is transmitted by the

Lyme disease is the most common tick-borne infection in both North America and Europe. In the United States, Lyme disease is caused by Borrelia burgdorferi, which is transmitted by the bite of the tick species Ixodes scapularis and Ixodes pacificus. Clinical manifestations most often involve the skin, joints, nervous system, and heart. Full textApproximately every 12 – 18 months following publication, IDSA evaluates its guidelines for the need for update.  Because several years have passed since the last update, IDSA determined that a new undertaking for Lyme disease guidelines was needed. In order to develop a more focused and manageable guideline than the previous guideline which had a very broad scope, the IDSA has decided to approach this guideline topic differently by separating the topic into distinct guidelines.  This is a practice that IDSA has implemented across many of its guidelines where the scope has been expansive. The first of these guideline topics to be addressed will be on the prevention, diagnosis, and treatment of Lyme disease.  This guideline is being developed jointly with the American Academy of Neurology and the American College of Rheumatology.  Other collaborators on the guideline include panel members from the following: American Academy of Family Physicians (AAFP), American Academy of Pediatrics – Committee on Infectious Diseases (AAP-COID), American Academy of Pediatrics – Section on Emergency Medicine (AAP-EM), American College of Physicians (ACP), Association of Medical Microbiology and Infectious Diseases – Canada (AMMI-CA), Child Neurology Society (CNS), Pediatric Infectious Diseases Society (PIDS), Entomological Society of America (ESA), European Society of Clinical Microbiology and Infectious Diseases (ESCMID).  Individuals from the disciplines of cardiology, microbiology and pathology as well as a consumer representative and a methodologist with expertise in GRADE are also among the members of the guideline development panel. In contrast to the 2006 IDSA guidelines, this guideline will not provide comprehensive coverage of Anaplasma phagocytophilum and Babesia microti outside the context of co-infections. Those pathogens will be treated more comprehensively in separate, forthcoming clinical guidelines. Information on the status of these updates can be found here, within the Practice Guidelines/Infections by Organism/Bacteria section of the IDSA website. *Projected publication, Fall 2018

Asymptomatic Bacteriuria

Status: Update in Progress

The purpose of this guideline is to provide recommendations for diagnosis and treatment of asymptomatic bacteriuria in adult populations 18 years of age. The recommendations were developed on the basis

The purpose of this guideline is to provide recommendations for diagnosis and treatment of asymptomatic bacteriuria in adult populations 18 years of age. The recommendations were developed on the basis of a review of published evidence, with the strength of the recommendation and quality of the evidence graded using previously described Infectious Diseases Society of America (IDSA) criteria (table 1) [1]. Recommendations are relevant only for the treatment of asymptomatic bacteriuria and do not address prophylaxis for prevention of symptomatic or asymptomatic urinary infection. This guideline is not meant to replace clinical judgment.Screening of asymptomatic subjects for bacteriuria is appropriate if bacteriuria has adverse outcomes that can be prevented by antimicrobial therapy [2]. Outcomes of interest are short term, such as symptomatic urinary infection (including bacteremia with sepsis or worsening functional status), and longer term, such as progression to chronic kidney disease or hypertension, development of urinary tract cancer, or decreased duration of survival. Treatment of asymptomatic bacteriuria may itself be associated with undesirable outcomes, including subsequent antimicrobial resistance, adverse drug effects, and cost. If treatment of bacteriuria is not beneficial, screening of asymptomatic populations to identify bacteriuria is not indicated, unless performed in a research study to further explore the biology or clinical significance of bacteriuria. Thus, there are 2 topics of interest: whether asymptomatic bacteriuria is associated with adverse outcomes, and whether the interventions of screening and antimicrobial treatment improve these outcomes.Full textA correction has been published: Clin Infect Dis (2005) 40 (10): 1556. *Projected publication, Fall 2018

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