ABSTRACT
Febrile neutropenia is common in cancer patients managed with chemotherapy. Many published international guidelines have included detailed recommendations on the management of various aspects of febrile neutropenia seen in this population. Various factors play a role in the management of febrile neutropenia in cancer patients including, local microbiology epidemiology, availability of diagnostic tests and available antimicrobial agents on the local market. On behalf of the Lebanese Society of Infectious Diseases and Clinical Microbiology, the panel members hope that the guidelines on the management of infections in patients with febrile neutropenia in an era of rising antimicrobial resistance will help health care providers standardize the care of these patients
ABSTRACT
Urinary tract infection [UTI] is a common condition affecting men and women of all ages. It can have different presentations and can be acute, recurrent or chronic. It mandates prompt management to avoid complications and improve patient's outcome. In an era of increasing antimicrobial resistance and an urgent need for antimicrobial stewardship, national guidelines to standardize care of various infectious diseases have become a priority. Members of the Lebanese Society of Infectious Diseases and Clinical Microbiology [LSIDCM] drafted guidelines for the management of the various forms of UTI. These guidelines serve as a guide for health care workers, specifically primary care practitioners, family physicians, and emergency medicine physicians. They constitute an appropriate starting point before specialist consultation. They take into consideration the available local epidemiological data and the resistance profile of common urinary pathogens in Lebanon. This document includes the following sections: 1. Rationale and scope of the guidelines; 2. Definition of UTI; 3. Clinical presentation and diagnostic work-up of UTI; 4. Microbiological data of UTI; 5. Management and prevention strategies based on the latest Infectious Diseases Society of America [IDSA] and the European Society of Clinical Microbiology and Infectious Diseases [ESCMID] guidelines, tailored to the microbiological data in Lebanon. It addresses UTI in women [uncomplicated and complicated] and men [acute and chronic]. In addition, it covers management of asymptomatic bacteriuria and catheter related UTI. The recommendations in this document were graded based on the strength of the evidence as in the IDSA guidelines
ABSTRACT
Invasive Candida infections contribute to significant morbidity and mortality in patients with healthcare-associated infections. They represent a major burden on the public health system, and are challenging to diagnose and treat. A multidisciplinary expert panel critically reviewed available evidence to provide consensus recommendations for the management of invasive Candida infections in the Middle East. Based on diagnosis, recommendations were provided for the management of Candida infections in non-neutropenic and neutropenic patients. Polyenes [amphotericin B-deoxycholate [AmB-d] and lipid formulations amphotericin B [LFAmB]], triazoles [fluconazole, itraconazole and voriconazole], echinocandins [caspofungin, anidulafungin, and micafungin] and flucytosine are the recommended categories of antifungal agents for treatment of Candida infections. Echinocandins are preferred for treatment of proven and suspected Candida infections, especially in critically ill patients or those with previous exposure to azoles. Recommendations were also provided for infections caused by specific Candida species as well as management of different disease conditions. The experts highlighted that the guidelines should be used along with clinical judgment. Given the paucity of published data from the region, research in the form of randomized clinical trials should be given priority
Subject(s)
Humans , Candida , Adult , Practice Guidelines as Topic , Disease ManagementABSTRACT
Trauma-related infections remain a concerning and potentially avoidable complication of conflict-related injuries. During the Israeli conflict in South Lebanon, more than four million sub-munitions were dropped over South Lebanese soil. In this study, we will explore the different types of infection caused by sub-munitions and penetrating agents. This prospective study took place from 2006 to 2012 at the Lebanese University within the Faculty of Medical Sciences' departments. This study sample consisted of 350 injured casualties. Patients suffered from blast injuries with fragmentations targeting the head, face, torso, abdomen, pelvis and extremities. Of the 350 causalities studied, 326 [93.1%] were males, and 24 [6.9%] were females. Ages varied between 10 and 70 years, with the average age being 27 years. Of the 350 patients studied, 68 [19.4%] developed infections. Infections varied between pseudomonas, Escherichia coli, Candida and fungus and sometimes led to necrosis. Vaccinations, antibiotic therapies and proper wound irrigation must be performed at appropriate emergency units. Excision and complete debridement of necrotic and contaminated tissue should also be performed. The Convention on Cluster Munitions of 2008 should be adhered to, as these weapons indiscriminately and disproportionately harm civilians, thereby violating the well-established international principles governing conflict