Sanford guide: Sanford Guide provides clinicians with the tools they need to ensure the appropriate use of antibiotics. This is an essential resource for your Antimicrobial Stewardship program.
Johns Hopkins Antibiotic Guide Free Downloads
Johns Hopkins Point of Care Information Technology (POC-IT) Antibiotic (ABX) GuideThis free evidence-based, peer-reviewed resource is produced by the Division of Infectious Diseases at The Johns Hopkins University. Recommended treatment regimens (including prophylaxis) can be located by searching the database by disease or pathogen. Searching by antibiotic drug class leads to individual drug monographs that include study/clinical trial citations and treatment of major drug interactions. The guide also includes vaccines.
ResourcesClinical PharmacologyW:www.gsm.comeFactsW:www.factsandcomparisons.comSkycapeW:www.skyscape.comEpocratesW:www.epocrates.comLexi-CompW:www.lexi.comMICROMEDEX Healthcare SeriesW:www.micromedex.comAHFS Drug InformationW:www.ashp.org/ahfsDrugs in Pregnancy and LactationW:www.lww.comThe Harriet Lane HandbookW:www.hopkinschildrens.org/pages/residency/harrietlane.cfmJohns Hopkins Point of Care Information Technology (POC-IT) Antibiotic (ABX) GuideW:hopkins-abxguide.orgTarascon Pocket PharmacopoeiaW:www.tarascon.comHONcodeW:www.hon.ch/honcode/conduct.htm
The type of organism that causes VAP usually depends on the duration of mechanical ventilation. In general, early VAP is caused by pathogens that are sensitive to antibiotics, whereas late onset VAP is caused by multi-drug resistant and more difficult to treat bacteria. However, this is by no means a rule and merely a guide to initiate antibiotic therapy until further clinical information is available.
Respiratory samples can be obtained using several techniques: The ATS/IDSA guidelines note that use of a bronchoscopic bacteriologic strategy has been shown to reduce 14-day mortality when compared with a clinical strategy (16.2 % vs. 25.8 %, p = 0.02) [1]. When samples are obtained by BAL techniques (BAL, mini-BAL or PSB), the diagnostic threshold is 103 colony forming units (cfu)/ml for protected specimen brushing and 104 cfu/ml for BAL. In one multicenter study, BAL-and PSB-based diagnosis was associated with significantly more antibiotic-free days (11.5 9.0 vs. 7.5 7.6, p
Despite therapy, if no response is observed, it may be prudent to reconsider the diagnosis, reassess the organism being treated or search for other reasons for signs and symptoms. Because of the challenges associated with diagnosing VAP, especially early in the course, the IDSA/ATS guidelines highlight the importance of reassessing patients at 48-72 hours once pertinent data are available to determine whether the patient should continue antibiotic therapy for VAP or whether an alternative diagnosis should be pursued. In one study, Swoboda et al. [42] found that half of the empiric antibiotic use for VAP in two surgical ICUs was prescribed for patients without pneumonia.
This full-price app version of the John Hopkins guides is available for Apple devices & Android devices. It may be used offline and offers antibiotic, diabetes, HIV, and psychiatry guides that provide authoritative, evidence-based information to help answer questions and make point-of-care decisions. 2ff7e9595c
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