Most Read Articles
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
22 Aug 2018
In patients with atrial fibrillation (AF) naïve to oral anticoagulants (OACs), standard-dose nonvitamin K antagonist OACs (NOACs) provides better survival benefits than warfarin, a recent meta-analysis has shown.
Stephen Padilla, 31 Aug 2018
Treatment with rivaroxaban results in less recurrent venous thromboembolism (VTE) in frail patients with VTE, with similar good bleeding outcomes, compared with warfarin, reports a study.
Stephen Padilla, 11 Sep 2018
Use of diclofenac, a traditional nonsteroidal anti-inflammatory drug (NSAID) with cyclo-oxygenase-2 (COX-2) selectivity similar to COX-2 inhibitors, is associated with higher cardiovascular health risk compared with nonuse, paracetamol use and use of other traditional NSAIDs, a recent study has shown.

Antimicrobial administration reduces sensitivity of blood cultures

24 Sep 2019

The sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy is significantly reduced among patients with severe manifestations of sepsis, a study has shown.

A total of 3,165 participants were screened, of whom 325 were included (mean age, 65.6 years; 62.8 percent men) and had repeated blood cultures drawn after antimicrobial therapy initiation (median time, 70 minutes; interquartile range, 50–110 minutes).

In 102 of 325 patients (31.4 percent), blood cultures drawn prior to antimicrobial therapy initiation were positive for 1 microbial pathogens. Blood cultures obtained after antimicrobial therapy initiation were positive for ≥1 microbial pathogens in 63 of 325 patients (19.4 percent). Between pre- and postantimicrobial testing, the absolute difference in the proportion of positive blood cultures was 12.0 percent (95 percent CI, 5.4–18.6 percent; p<0.001).

Postantimicrobial culture had a sensitivity of 52.9 percent (42.8–62.9 percent).

When including the results of other microbiological cultures, microbial pathogens were found in 69 of 102 patients (67.6 percent, 57.7–76.6 percent).

This patient-level, single-group, diagnostic study was conducted in seven emergency department in North America and included adults with severe manifestations of sepsis, including systolic blood pressure <90 mm Hg or a serum lactate level of 4 mmol/L. Blood cultures were drawn before and within 120 minutes after antimicrobial therapy initiation. Sensitivity of postantimicrobial blood cultures was measured.

The study was limited by its small sample size.

“Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity,” the authors said.

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Most Read Articles
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
22 Aug 2018
In patients with atrial fibrillation (AF) naïve to oral anticoagulants (OACs), standard-dose nonvitamin K antagonist OACs (NOACs) provides better survival benefits than warfarin, a recent meta-analysis has shown.
Stephen Padilla, 31 Aug 2018
Treatment with rivaroxaban results in less recurrent venous thromboembolism (VTE) in frail patients with VTE, with similar good bleeding outcomes, compared with warfarin, reports a study.
Stephen Padilla, 11 Sep 2018
Use of diclofenac, a traditional nonsteroidal anti-inflammatory drug (NSAID) with cyclo-oxygenase-2 (COX-2) selectivity similar to COX-2 inhibitors, is associated with higher cardiovascular health risk compared with nonuse, paracetamol use and use of other traditional NSAIDs, a recent study has shown.