No abstract

When teaching first-time ostomy patients postoperative self-care, a Nurse Instruction plus DVD method is as effective as Nurse Instruction alone.

Appropriate early management of infectious emergencies is essential to preventing adverse outcomes. Clinicians in acute-care settings must be prepared to provide appropriate empiric antibiotics, as failure to do so has been associated with an increased risk of mortality. Empiric treatment of these infections requires knowledge of the disease state, most common pathogens, and patient-specific risk factors. Additionally, regional and institutional patterns of antibiotic resistance must be taken into consideration. At the same time, inappropriate use of broad-spectrum antibiotics should be avoided to prevent emergence of antimicrobial resistance. It is also essential that initial antibiotic therapy be de-escalated and redirected once the causative pathogen has been identified and antibiotic susceptibilities determined. Bacterial infection with pneumonia, meningitis and sepsis severe enough to warrant hospitalization are included in this review. The most common bacterial pathogens and empiric antibiotic recommendations for immunocompetent adults will be discussed. In addition, circumstances that may influence the selection of certain antibiotics are reviewed.

Various mechanisms account for resistance of bacteria to antibiotics. The appropriate use of pharmacokinetics and pharmacodynamics can guide antibiotic therapy and enhance the likelihood of success.