Context: The benefit of early switching from intravenous (IV) to oral (PO) antibiotic therapy has been controversial during the last few decades. Aims: To evaluate the effect of early switching from IV to PO antibiotics on treatment outcomes in surgical patients at one of the largest public hospitals. Methods: Two hundred and nine patients admitted for a therapeutic antibiotic to orthopedic and general surgery conditions were randomly assigned into three groups: control (non-switching) (n = 69), early switching within 48-72 hours (n = 66), and late switching after 72 hours (n = 74). The rate of effectiveness, length of hospital stay, and cost were recorded and analyzed. Results: Treatment effectiveness was not significantly different among the three groups. However, the length of stay and cost were found reduced in early switching group, with a decrease of 2-3 days of hospital stay and 30-40% of total healthcare spending compared to late or non-switching protocol (p<0.001). Conclusions: Early switching does not compromise the outcome of antibiotic treatment while this protocol is superior to non-switching and late-switching in terms of length of hospital stay and cost of treatment. Early switching should be considered for surgery patients to optimize the treatment.
Noble transition metals, like palladium (Pd) and platinum (Pt), have been well-known for their excellent catalytic and electrochemical properties. However, they have been considered non-active for surface enhanced Raman spectroscopy (SERS). In this work, we explore the scattering contributions of Pd and Pt for the detection of organic molecules. The Pd and Pt nanostructures were synthesized on silicon substrate using a modified galvanic displacement method. The results show Pt nanoparticles and dendritic Pd nanostructures with controlled density and size. The influence of surfactants, including sodium dodecyl sulfate and cetyltrimethylammonium bromide, on the size and morphology of the nanostructures was investigated. The Pd and Pt nanostructures with a combination of large size and high density were then used to explore their applicability for the detection of 10−5 M Rhodamine 6G and 10−2 M paraoxon.
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