ABSTRACT
Bacterial infections are the most frequent cause of hospitalization in elderly patients. In the early eighties, the advantages of Outpatient parenteral Antibiotic therapy (OPAT) were identified in the United States, and suitable therapeutic programs were established. In order to understand the different ways of managing OPAT, a National OPAT Registry was set up in 2003 in Italy. This study analyzes data concerning bacterial infections in 176 elderly patients including demographics, therapeutic management, clinical response, and side-effects. Bone and joint infections (48.9%) and skin and soft tissue infections (27.8%) were the most common infections treated with OPAT. Teicoplanin (28.9%) and ceftriaxone (22.1%) were the top two antibiotics chosen. OPAT was mainly performed at a hospital infusion center (52.8%). The clinical success rate was high and side-effects were low (12.6% of cases). Management of bacterial infections in the elderly with an outpatient program is effective and safe.
Subject(s)
Ambulatory Care/methods , Anti-Bacterial Agents/administration & dosage , Bacterial Infections/drug therapy , Aged , Aged, 80 and over , Ceftriaxone/administration & dosage , Female , Humans , Infusions, Parenteral , Italy , Male , Teicoplanin/administration & dosageABSTRACT
The prognosis of HIV-infected patients has dramatically improved since the advent of HAART. The immune recovery associated with HAART may result in immuno-pathological reactions and clinical deterioration when HAART is initiated in patients with tuberculosis (TB). This phenomenon is defined as immune reconstitution inflammatory syndrome (IRIS). In this review, we summarise the epidemiology, clinical presentations and management of TB-associated IRIS.
Subject(s)
AIDS-Related Opportunistic Infections/immunology , Antiretroviral Therapy, Highly Active/adverse effects , Immune Reconstitution Inflammatory Syndrome/etiology , Tuberculosis, Pulmonary/immunology , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/epidemiology , Antitubercular Agents/therapeutic use , Drug Therapy, Combination , Evidence-Based Medicine , Glucocorticoids/therapeutic use , Humans , Immune Reconstitution Inflammatory Syndrome/chemically induced , Immune Reconstitution Inflammatory Syndrome/diagnosis , Immune Reconstitution Inflammatory Syndrome/immunology , Immune Reconstitution Inflammatory Syndrome/microbiology , Incidence , Prevalence , Risk Factors , Rome/epidemiology , Treatment Outcome , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/epidemiologyABSTRACT
The authors evaluated the efficacy and tolerance of low dose lymphoblastoid alpha interferon in 14 i.v. drug addicts with histologically confirmed chronic active hepatitis C. Patients were treated for 12 months; all completed the whole treatment without complaining of significant side effects. Four months after withdrawal of treatment, 13 patients were found to be in clinical and biohumoral remission with serum transaminases within the normal range already after 12 weeks.
