In this IDSA policy paper, we review the current diagnostic landscape, including unmet needs and emerging technologies, and assess the challenges to the development and clinical integration of improved tests. To fulfill the promise of emerging diagnostics, IDSA presents recommendations that address a host of identified barriers. Achieving these goals will require the engagement and coordination of a number of stakeholders, including Congress, funding and regulatory bodies, public health agencies, the diagnostics industry, healthcare systems, professional societies, and individual clinicians.
Infectious diseases (ID) specialists have played a major role in patient care, infection control, and antibiotic management for many years. With the rapidly changing nature of health care, it has become necessary for ID specialists to articulate their value to multiple audiences. This article summarizes the versatile attributes possessed by ID specialists and delineates their value to patients, hospitals, and other integral groups in the health care continuum.
The Infectious Diseases Society of America (IDSA) conducted a survey in 1998 to characterize its membership and to determine their needs. The response rate was 39%. Although only 23% of the respondents spent most of their time in the field of teaching and research, 62% of the respondents listed an academic institution as their primary employer. According to survey results, 17% of respondents indicated that care of HIV-infected patients comprised one-half or more of their practices. Respondents noted shortcomings in their training as a result of recent changes in the clinical practice arena and the health care system; more than one-fourth of the respondents identified deficits in their preparation for administration, infection control, pharmacoeconomics, quality assurance, transplantation, and outcomes research. This survey discloses that the IDSA membership perceives a need for changes in IDSA-sponsored fellowship training programs and graduate educational activities.
Ceforanide administered parenterally twice daily was used as the sole agent to treat 17 patients with right-sided endocarditis due to Staphylococcus aureus or nonenterococcal streptococci. Fifteen patients were cured of their original infection. Two patients were withdrawn from the study. One patient was transferred to another hospital 4 days after ceforanide therapy was initiated, and the other was changed to a different antibiotic regimen when his viridans streptococcus proved tolerant to ceforanide. The intramuscular form of ceforanide was well tolerated. It was stopped in two patients after week 3 of therapy because of adverse effects, possibly related to the study drug. These findings resolved with discontinuation of the ceforanide, and no additional antimicrobial therapy was necessary. Two patients who continued to abuse drugs intravenously during the study developed bacteremia with new organisms and required additional antimicrobial therapy. Ceforanide proved to be a useful agent in the treatment of right-sided endocarditis due to susceptible S. aureus and nonenterococcal streptococci.
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