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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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6 results found

Nervous System Lyme Disease

Status: Update in Progress, Endorsed

Objective: To provide evidence-based recommendations on the treatment of nervous system Lyme disease and post–Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens

Objective: To provide evidence-based recommendations on the treatment of nervous system Lyme disease and post–Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed? Methods: The authors analyzed published studies (1983–2003) using a structured review process to classify the evidence related to the questions posed. Results: The panel reviewed 353 abstracts which yielded 112 potentially relevant articles that were reviewed, from which 37 articles were identified that were included in the analysis. Conclusions: There are sufficient data to conclude that, in both adults and children, this nervous system infection responds well to penicillin, ceftriaxone, cefotaxime, and doxycycline (Level B recommendation). Although most studies have used parenteral regimens for neuroborreliosis, several European studies support use of oral doxycycline in adults with meningitis, cranial neuritis, and radiculitis (Level B), reserving parenteral regimens for patients with parenchymal CNS involvement, other severe neurologic symptomatology, or failure to respond to oral regimens. The number of children (8 years of age) enrolled in rigorous studies of oral vs parenteral regimens has been smaller, making conclusions less statistically compelling. However, all available data indicate results are comparable to those observed in adults. In contrast, there is no compelling evidence that prolonged treatment with antibiotics has any beneficial effect in post–Lyme syndrome (Level A).   *The updated Lyme Disease Guideline will address Nervous System Lyme. Projected publication: Fall 2018

Cardiovascular Implantable Electronic Device Infections

Status: Current, Endorsed

Despite improvements in cardiovascular implantable electronic device (CIED) design, application of timely infection control practices, and administration of antibiotic prophylaxis at the time of device placement, CIED infections continue to

Despite improvements in cardiovascular implantable electronic device (CIED) design, application of timely infection control practices, and administration of antibiotic prophylaxis at the time of device placement, CIED infections continue to occur and can be life-threatening. This has prompted the study of all aspects of CIED infections. Recognizing the recent advances in our understanding of the epidemiology, risk factors, microbiology, management, and prevention of CIED infections, the American Heart Association commissioned this scientific statement to educate clinicians about CIED infections, provide explicit recommendations for the care of patients with suspected or established CIED infections, and highlight areas of needed research. Full text*For information on the timing of future updates of this guideline, please contact the AHA.

Opportunistic Infections in Stem Cell Transplant Recipients

Status: Current, Endorsed

In the past decade, modifications in HCT management and supportive care have resulted in changes in recommendations for the prevention of infection in HCT patients. These changes are fueled by

In the past decade, modifications in HCT management and supportive care have resulted in changes in recommendations for the prevention of infection in HCT patients. These changes are fueled by new antimicrobial agents, increased knowledge of immune reconstitution, and expanded conditioning regimens and patient populations eligible for HCT. Despite these advances, infection is reported as the primary cause of death in 8% of autologous HCT patients and 17% to 20% of allogeneic HCT recipients [3]. The major changes in this document, including changes in recommendation ratings, are summarized here. *For information on the timing of future updates to this guideline, contact CIBMTR.

Hepatitis B

Status: Current, Endorsed

These guidelines have been written to assist physicians and other health care providers in the recognition, diagnosis, and management of patients chronically infected with hepatitis B virus (HBV). These recommendations

These guidelines have been written to assist physicians and other health care providers in the recognition, diagnosis, and management of patients chronically infected with hepatitis B virus (HBV). These recommendations provide a data-supported approach to patients with hepatitis B. *For information on the timing of future updates of this guideline, contact the AASLD.

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.

Control of Tuberculosis (TB)

Status: Current, Endorsed

During 1993–2003, incidence of tuberculosis (TB) in the United States decreased 44% and is now occurring at a historic low level (14,874 cases in 2003)... In this statement, the American

During 1993–2003, incidence of tuberculosis (TB) in the United States decreased 44% and is now occurring at a historic low level (14,874 cases in 2003)... In this statement, the American Thoracic Society (ATS), Centers for Disease Control and Prevention (CDC), and the Infectious Diseases Society of America (IDSA) propose recommendations to improve the control and prevention of TB in the United States and to progress toward its elimination. *For information on the timing of future updates to this guideline, contact the ATS.

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