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Dec 6, 2024 | 
contagionlive.com | Bruce Jones
Contagion: How soon do you assess into clinical care and what are you looking for when changing treatments or step-down? Jones: Once we start seeing clinical stability in these patients, our approach varies based on case-specific factors. For example, if a patient’s infection source is a wound and we have pending cultures, we may initially go broad due to concerns about polymicrobial infection.
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Dec 2, 2024 | 
contagionlive.com | Bruce Jones
Contagion: What do you want to see in terms of patients responding to treatment—timeframe, cultures, follow-ups? Jones: When assessing clinical response, one of the first things I look at is the white blood cell count—whether it's decreasing. If the patient was febrile initially, are they now afebrile, and have they remained afebrile for more than 24 hours?
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Nov 25, 2024 | 
contagionlive.com | Bruce Jones
Contagion: Staph aureus bacteremia remains a serious infection that can lead to infective endocarditis, and a higher mortality rate. With this in mind, what do you want to consider in treatment options? Jones: When I think of Staphylococcus aureus, I think of a pathogen with metastatic tendencies; it often spreads to distant sites and tends to form abscesses. For us, we used to assume MRSA until proven otherwise if S aureus was in our differential.
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Nov 18, 2024 | 
contagionlive.com | Bruce Jones
Contagion: What is the clinical challenges of treating Staphylococcus aureus? Jones: When considering serious infections, particularly those like bacteremia, patient outcomes can be severe. Bacteremia, for example, comes with a high mortality rate—often 25-30%, with some studies reporting even higher rates. Complications, such as dissemination or endovascular involvement, are common in these patients, and resistance profiles, such as MRSA versus MSSA, play a critical role.
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Sep 17, 2024 | 
veterinary-practice.com | Bruce Jones
While in early years there was a great use of and belief in herbal medicine to treat wounds, much of this was misleading, and real breakthroughs in modern wound care only came with the advent of microbiology and pathology Wounds can arise either accidentally or because of conflict, and can range from grazes and severe bruising to life-threatening, but there has always been a need for protection and care to aid healing. Wound care dates from prehistory, as demonstrated by several species of...
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Jul 1, 2024 | 
jdsupra.com | Abdullah Azkalany |Bruce Jones
On June 28, 2024, the Supreme Court of the United States decided City of Grants Pass, Oregon v. Johnson, No. 23-175, holding that the Cruel and Unusual Punishments Clause of the Eighth Amendment of the United States Constitution does not prohibit laws preventing overnight camping on public property from being enforced against individuals experiencing homelessness.
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Jun 20, 2024 | 
contagionlive.com | Bruce Jones
Contagion: What do you need to see from a clinical standpoint to begin thinking of discharging a patient? Jones: Often, the process isn't as complicated as we might think. The first step is understanding patient expectations, and sometimes even the expectations of their family. This can vary greatly depending on the individual patient, but it’s a good starting point. For instance, what resources does the patient have available? What is their financial situation?
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Jun 20, 2024 | 
contagionlive.com | Bruce Jones
Contagion: What are the concerns and challenges around empirical antimicrobial treatment? Jones: I work in a community health system. Many places have their protocols and pathways, but that’s something we struggle with. To be honest, our physicians haven't fully adapted to or embraced these practices. As a result, many patients are started on broad-spectrum agents, often multiple agents, covering gram-positive, gram-negative, and anaerobic bacteria, which is frequently unnecessary.
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Jun 13, 2024 | 
contagionlive.com | Bruce Jones
Contagion: What are your initial considerations when choosing an empiric therapy for these patients? Jones: From my standpoint as an ID pharmacist, whether you are an ID pharmacist, an ID physician, or someone on the inpatient side, we often inherit patients who arrive through the emergency department. Typically, these patients are started on broad-spectrum agents initially. Our role then becomes one of evaluation and adjustment.
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Jun 13, 2024 | 
contagionlive.com | Bruce Jones
Contagion: Can you talk about your clinical concerns regarding a patient population who are presenting with comorbidities such as type 2 diabetes, higher BMI, and advanced age? Jones: That's a lot of what we see on a day-to-day basis, right? And there are different levels within that. So, let me break it down. Take diabetes, for example. Because diabetes is so prevalent, it doesn't necessarily stand out as much as it used to. My first question is: what degree of diabetes are we dealing with?
