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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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11 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

Intra-abdominal Infections

Status: Update in Progress

A Panel of International Experts was convened by the Infectious Diseases Society of America (IDSA) in collaboration with the European Society for Microbiology and Infectious Diseases (ESCMID) to update the

A Panel of International Experts was convened by the Infectious Diseases Society of America (IDSA) in collaboration with the European Society for Microbiology and Infectious Diseases (ESCMID) to update the 1999 Uncomplicated Urinary Tract Infection Guidelines by the IDSA. Co-sponsoring organizations include the American Congress of Obstetricians and Gynecologists, American Urological Association, Association of Medical Microbiology and Infectious Diseases–Canada, and the Society for Academic Emergency Medicine. The focus of this work is treatment of women with acute uncomplicated cystitis and pyelonephritis, diagnoses limited in these guidelines to premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities. The issues of in vitro resistance prevalence and the ecological adverse effects of antimicrobial therapy (collateral damage) were considered as important factors in making optimal treatment choices and thus are reflected in the rankings of recommendations. Full text*Projected Publication, Winter 2018

Management of Catheter-Related Infections

Status: Update in Progress

These updated guidelines replace the previous management guidelines published in 2001. The guidelines are intended for use by health care providers who care for patients who either have these infections

These updated guidelines replace the previous management guidelines published in 2001. 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. Full text Projected publication, Winter 2019

Influenza

Status: Update in Progress

Guidelines for the treatment of persons with influenza virus infection were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence‐based guidelines encompass diagnostic issues, treatment

Guidelines for the treatment of persons with influenza virus infection were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence‐based guidelines encompass diagnostic issues, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal (interpandemic) influenza. They are intended for use by physicians in all medical specialties with direct patient care, because influenza virus infection is common in communities during influenza season and may be encountered by practitioners caring for a wide variety of patients. Full text*Projected publication, Summer 2018Statement by the Infectious Disease Society of America (IDSA) on the recent publication on “Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children"- April 2014

Vancomycin

Status: Update in Progress

Vancomycin is a glycopeptideantibiotic that has been in clinical use for nearly 50 years as a penicillin alternative to treat penicillinase-producing strains of Staphylococcus aureus. It is one of the most

Vancomycin is a glycopeptideantibiotic that has been in clinical use for nearly 50 years as a penicillin alternative to treat penicillinase-producing strains of Staphylococcus aureus. It is one of the most widely used antibiotics in the United States for the treatment of serious gram-positive infections involving methicillin-resistant S.aureus (MRSA). Early use of vancomycin was associated with a number of adverse effects, including infusion-related toxicities, nephrotoxicity, and possible ototoxicity. Upon further investigation, it appears that the impurities in early formulations of vancomycin caused many of these adverse events. Its overall use was curtailed significantly with the development of semisynthetic penicillins (e.g., methicillin, oxacillin, nafcillin) that were considered less toxic. However, the steady rise in the number of MRSA infections since the early 1980s has once again brought vancomycin into the forefront as the primary treatment for infections caused by this organism.Full text*For information on the timing of this update, please contact the ASHP.

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

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.

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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