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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده: مورد

Minimal criteria for initiation of antimicrobial use for suspected infections in nursing home residents with advanced dementia

Minimal criteria for initiation of antimicrobial use for suspected infections in nursing home residents with advanced dementia
Suspected urinary tract infection Suspected lower respiratory tract infection Suspected skin infection Febrile episode
  1. No indwelling Foley catheter
  2. Acute dysuria alone or temperature >37.9°C
  3. and
  4. ≥1 of following*:
    1. New or worse frequency
    2. Urgency
    3. Costovertebral tenderness
    4. Gross hematuria
    5. Suprapubic pain
    6. Mental status change
    7. Rigors
  1. Indwelling Foley catheter
  2. ≥1 of following:
    1. Temperature >37.9°C
    2. Rigors
    3. Change in mental status
  1. Temperature >38.9°C
  2. ≥1 of following:
    1. Respiratory rate >25 breaths/minute
    2. New productive cough
  1. Temperature <38.9°C
  2. New productive cough
  3. and
  4. ≥1 of the following:
    1. Pulse >100 beats/minute
    2. Respiratory rate >25 breaths/minute
    3. Rigors
    4. Change in mental status
  1. Afebrile with COPD
  2. New/increased cough with purulent sputum

New or increased purulent drainage

or

≥1 of the following*:

  1. Temperature >37.9°C
  2. Redness
  3. New or increased swelling
  4. Warmth
  5. Tenderness

Temperature >37.9°C

and

≥1 of the following:

  1. Change in mental status
  2. Rigors
  3. Unstable vital signsΔ
These criteria were initially proposed by the Society for Healthcare Epidemiology of America (SHEA).[1]

COPD: chronic obstructive pulmonary disease.

* Urgency, frequency, skin tenderness, costovertebral tenderness, and suprapubic pain may be difficult to evaluate in advanced dementia but are accepted criteria if present.

¶ Diagnostic criteria for delirium can be difficult to evaluate in advanced dementia; therefore, any change from baseline mental status is considered.

Δ Unstable vital signs = systolic blood pressure <90 mmHg or heart rate >100 beats/minute or respiratory rate >25 breaths/minute.

Reference:
  1. Loeb M, Bentley DW, Bradley S, et al. Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: Results of a consensus conference. Infect Control Hosp Epidemiol 2001; 22:120.
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