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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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8 results found

Clostridium difficile

Status: Current

A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on

A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis. Clostridium difficile remains the most important cause of healthcare-associated diarrhea and has become the most commonly identified cause of healthcare-associated infection in adults in the United States. Moreover, C. difficile has established itself as an important community pathogen. Although the prevalence of the epidemic and virulent ribotype 027 strain has declined markedly along with overall CDI rates in parts of Europe, it remains one of the most commonly identified strains in the United States where it causes a sizable minority of CDIs, especially healthcare-associated CDIs. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management.Full text*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. The guideline was published February of 2018 and is the most current version.

Diarrhea

Status: Current

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was published in October 2017 and is the most current

*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. This guideline was published in October 2017 and is the most current version.The widening array of recognized enteric pathogens and the increasing demand for cost-containment sharpen the need for careful clinical and public health guidelines based on the best evidence currently available. Adequate fluid and electrolyte replacement and maintenance are key to managing diarrheal illnesses. Thorough clinical and epidemiological evaluation must define the severity and type of illness (e.g., febrile, hemorrhagic, nosocomial, persistent, or inflammatory), exposures (e.g., travel, ingestion of raw or undercooked meat, seafood, or milk products, contacts who are ill, day care or institutional exposure, recent antibiotic use), and whether the patient is immunocompromised, in order to direct the performance of selective diagnostic cultures, toxin testing, parasite studies, and the administration of antimicrobial therapy (the latter as for traveler's diarrhea, shigellosis, and possibly Campylobacter jejuni enteritis). Increasing numbers of isolates resistant to antimicrobial agents and the risk of worsened illness (such as hemolytic uremic syndrome with Shiga toxin-producing Escherichia coli O157:H7) further complicate antimicrobial and antimotility drug use. Thus, prevention by avoidance of undercooked meat or seafood, avoidance of unpasteurized milk or soft cheese, and selected use of available typhoid vaccines for travelers to areas where typhoid is endemic are key to the control of infectious diarrhea.Full text

HCV Guidance

Status: Current

New direct-acting oral agents capable of curing hepatitis C virus (HCV) infection have been approved for use in the United States. The initial direct-acting agents were approved in 2011, and

New direct-acting oral agents capable of curing hepatitis C virus (HCV) infection have been approved for use in the United States. The initial direct-acting agents were approved in 2011, and many more oral drugs are expected to be approved in the next few years. As new information is presented at scientific conferences and published in peer-reviewed journals, health care practitioners have expressed a need for a credible source of unbiased guidance on how best to treat their patients with HCV infection. Full text

Healthcare-Associated Ventriculitis and Meningitis

Status: Current

The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel

The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with healthcare-associated ventriculitis and meningitis (American Academy of Neurology, American Association of Neurological Surgeons, and Neurocritical Care Society). The panel reviewed articles based on literature reviews, review articles and book chapters, evaluated the evidence and drafted recommendations. Questions were reviewed and approved by panel members. Subcategories were included for some questions based on specific populations of patients who may develop healthcare-associated ventriculitis and meningitis after the following procedures or situations: cerebrospinal fluid shunts, cerebrospinal fluid drains, implantation of intrathecal infusion pumps, implantation of deep brain stimulation hardware, and general neurosurgery and head trauma. Recommendations were followed by the strength of the recommendation and the quality of the evidence supporting the recommendation. Many recommendations, however, were based on expert opinion because rigorous clinical data are not available. These guidelines represent a practical and useful approach to assist practicing clinicians in the management of these challenging infections. Full text*Every 12 to 18 months following publication, IDSA reviews its guidelines to determine whether an update is required. The guideline was published February of 2017 and is the most current version.

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

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.

Encephalitis

Status: Current

Guidelines for the diagnosis and treatment of patients with encephalitis were prepared by an Expert Panel of the Infectious Diseases Society of America. The guidelines are intended for use by

Guidelines for the diagnosis and treatment of patients with encephalitis were prepared by an Expert Panel of the Infectious Diseases Society of America. The guidelines are intended for use by health care providers who care for patients with encephalitis. The guideline includes data on the epidemiology, clinical features, diagnosis, and treatment of many viral, bacterial, fungal, protozoal, and helminthic etiologies of encephalitis and provides information on when specific etiologic agents should be considered in individual patients with encephalitis. Full text*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 07/2011.

Bacterial Meningitis

Status: Under Review

The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Patients with bacterial meningitis are usually treated by primary care

The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. In contrast to many other infectious diseases, the antimicrobial therapy for bacterial meningitis is not always based on randomized, prospective, double-blind clinical trials, but rather on data initially obtained from experimental animal models of infections. A model commonly utilized is the experimental rabbit model, in which animals are anesthetized and placed in a stereotactic frame. In this procedure, the cisterna magna can be punctured for frequent sampling of CSF and injection of microorganisms. Frequent sampling of CSF permits measurement of leukocytes and chemical parameters and quantitation of the relative penetration of antimicrobial agents into CSF and the effects of meningitis on this entry parameter, the relative bactericidal efficacy (defined as the rate of bacterial eradication) within purulent CSF, and CSF pharmacodynamics. Results obtained from these and other animal models have led to clinical trials of specific agents in patients with bacterial meningitis. Full text*The 2004 Practice Guidelines for the Management of Bacterial Meningitis has been split into two guidelines. The nosocomial guideline was published in 2017. For recommendations on community acquired, please see the original guideline in 2004.*This guideline is being either under reviewed to determine if it requires updating or is on the slate to be updated. Please use this version with discretion, as it possible that some information may be outdated.

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