While no attempt was made to assess formally the appro­priateness of antibiotic prescribing patterns, antibiotic usage did appear to correspond to the clinical indications for which antimicrobial therapy was prescribed, as well as to the bacte­ria isolated from patients with infection. Active involvement of pharmacy, infectious disease and microbiology personnel may have also affected the [...]

ICUs are often the target of surveillance programs and anti­microbial restrictions due to increased rates of bacterial resis­tance. Although it is difficult to make direct comparisons with other ICUs without detailed demographic information, the results of our study demonstrated a lower incidence of an­timicrobial resistance among bacterial isolates of patients re­ceiving parenteral antibiotics relative to [...]

There were 759 admissions to the CrCU during the study. One-third of patients were admitted from the emergency de­partment, 32% of patients came from the operating room and 35% were transferred to the CrCU from another ward or hospi­tal. A total of 258 (32%) patients received parenteral antimi­crobial therapy during their CrCU stay, including 75 [...]

At the time of the study, Sunnybrook Health Science Centre was a 982-bed (418 acute, 564 chronic), university-affiliated, adult tertiary care teaching hospital in Metropolitan Toronto. It is the largest level 1 trauma centre in Canada, with other major teaching programs that include aging, cardiovascular disease, oncology and trauma. At the time of the study, [...]

Microbiological surveillance and parenteral antibiotic use in a critical care unit The emergence of antimicrobial resistance over the past several decades has challenged the management of infec­tions in hospitalized patients, and has led to increased mor­bidity, higher health care costs and prolonged hospitaliza­tions. Hospitals are now frequently encountering out­breaks of resistant organisms such as vancomycin-resistant [...]

Fluconazole is one of the new imidazoles undergoing clinical trials for the treatment of fungal infections. We used fluconazole at a dose of 50 or 100 mg/day for the treatment of patients with persistent or dissemi­nated coccidioidomycosis. Twelve of 14 patients had an initial favorable response, with definite improve­ment of clinical signs and symptoms of [...]

Subsequent Course Of the 12 who initially responded, only four re­mained free of coccidioidal disease. These patients have been followed for 10, 13, 15, and 18 months. One patient died of a myocardial infarction at the end of successful treatment of his fungal infection. Six of the 11 surviving responders had a relapse nine days [...]