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Article ; Online: A step towards precision medicine in management of fever and neutropenia in haematology.

Viscoli, Claudio

The Lancet. Haematology

2017 Volume 4, Issue 12, Page(s) e563–e564

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Fever/blood ; Fever/drug therapy ; Hematology ; Humans ; Neutropenia/blood ; Neutropenia/drug therapy ; Precision Medicine/methods
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2017-11-30
Publishing country	England
Document type	Editorial
ISSN	2352-3026
ISSN (online)	2352-3026
DOI	10.1016/S2352-3026(17)30217-X
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Article ; Online: Bloodstream Infections: The peak of the iceberg.

Viscoli, Claudio

Virulence

2016 Volume 7, Issue 3, Page(s) 248–251

Language	English
Publishing date	2016-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2657572-3
ISSN	2150-5608 ; 2150-5594
ISSN (online)	2150-5608
ISSN	2150-5594
DOI	10.1080/21505594.2016.1152440
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Article ; Online: Pitfalls of defining combination therapy for carbapenem-resistant Enterobacteriaceae in observational studies.

Giacobbe, D R / Maraolo, A E / Viscoli, C

European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

2017 Volume 36, Issue 10, Page(s) 1707–1709

MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Carbapenem-Resistant Enterobacteriaceae/drug effects ; Drug Therapy, Combination ; Enterobacteriaceae Infections/drug therapy ; Enterobacteriaceae Infections/microbiology ; Humans ; Observational Studies as Topic ; Randomized Controlled Trials as Topic ; beta-Lactam Resistance/drug effects
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2017-05-21
Publishing country	Germany
Document type	Editorial
ZDB-ID	603155-9
ISSN	1435-4373 ; 0934-9723 ; 0722-2211
ISSN (online)	1435-4373
ISSN	0934-9723 ; 0722-2211
DOI	10.1007/s10096-017-3010-z
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Zs.A 1732: Show issues

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Article ; Online: Dose finding in aspergillosis.

Viscoli, Claudio / Bassetti, Matteo

Medical mycology

2018 Volume 44, Issue Supplement_1, Page(s) S299–S303

Abstract: Invasive aspergillosis (IA) continues to represent a significant challenge for physicians in charge of immunocompromised patients. Voriconazole, caspofungin, itraconazole, and the different formulations of amphotericin B (AmB) are all approved for ... ...

Abstract	Invasive aspergillosis (IA) continues to represent a significant challenge for physicians in charge of immunocompromised patients. Voriconazole, caspofungin, itraconazole, and the different formulations of amphotericin B (AmB) are all approved for therapy of IA. To collect information on the effect of high dose of antifungals in the treatment of IA, data from the available medical literature were reviewed. For AmB there are no data demonstrating any better clinical activity of doses higher than standard. For liposomal-AmB preliminary data seem to show that high doses are not more efficacious than the standard dose, and it is probably more toxic. Anecdotal data of itraconazole suggest that high dosages might be feasible and it has been associated with good clinical results. Unpublished data about voriconazole suggest the absence of any better activity of high plasma concentrations. For caspofungin the efficacy of higher dosage did not seem to be better than that obtained with the traditional dosage. Prospective studies are required, because many confounding factors may obscure the effects of the higher dosages when data are retrieved retrospectively.
Language	English
Publishing date	2018-07-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1421796-x
ISSN	1460-2709 ; 1369-3786
ISSN (online)	1460-2709
ISSN	1369-3786
DOI	10.1080/13693780600838264
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Zs.A 520: Show issues

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Article ; Online: Rapid microbiological tests for bloodstream infections due to multidrug resistant Gram-negative bacteria: therapeutic implications.

Giacobbe, D R / Giani, T / Bassetti, M / Marchese, A / Viscoli, C / Rossolini, G M

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2019 Volume 26, Issue 6, Page(s) 713–722

Abstract: Background: Treating severe infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) is one of the most important challenges for clinicians worldwide, partly because resistance may remain unrecognized until identification of the causative ... ...

Abstract	Background: Treating severe infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) is one of the most important challenges for clinicians worldwide, partly because resistance may remain unrecognized until identification of the causative agent and/or antimicrobial susceptibility testing (AST). Recently, some novel rapid test for identification and/or AST of MDR-GNB from positive blood cultures or the blood of patients with bloodstream infections (BSIs) have become available. Objectives: The objective of this narrative review is to discuss the advantages and limitations of different rapid tests for identification and/or AST of MDR-GNB from positive blood cultures or the blood of patients with BSI, as well as the available evidence on their possible role to improve therapeutic decisions and antimicrobial stewardship. Sources: Inductive PubMed search for publications relevant to the topic. Content: The present review is structured in the following way: (a) rapid tests on positive blood cultures; (b) rapid tests directly on whole blood; (c) therapeutic implications. Implications: Novel molecular and phenotypic rapid tests for identification and AST show the potential for favourably influencing patients' outcomes and results of antimicrobial stewardship interventions by reducing both the time to effective treatment and the misuse of antibiotics, although the interpretation about their impact on actual therapeutic decisions and patients' outcomes is still complex. Factors such as feasibility and personnel availability, as well as the detailed knowledge of the local microbiological epidemiology, need to be considered very carefully when implementing novel rapid tests in laboratory workflows and algorithms. Providing high-level, comparable evidence on the clinical impact of rapid identification and AST is becoming of paramount importance for MDR-GNB infections, since in the near future rapid identification of specific resistance mechanisms could be crucial for guiding rapid, effective, and targeted therapy against specific resistance mechanisms.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship ; Bacteremia/diagnosis ; Bacteremia/drug therapy ; Blood Culture/methods ; Drug Resistance, Multiple, Bacterial ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacterial Infections/diagnosis ; Gram-Negative Bacterial Infections/drug therapy ; Humans ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2019-10-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2019.09.023
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Zs.A 4541: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 284: Show issues

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Article: Management of infection in cancer patients. studies of the EORTC International Antimicrobial Therapy Group (IATG).

Viscoli, C

European journal of cancer (Oxford, England : 1990)

2002 Volume 38 Suppl 4, Page(s) S82–7

Abstract: Infection remains an important cause of morbidity and mortality in cancer patients, especially those undergoing chemotherapy for haematological malignancies. The practice of instituting an empirical broad-spectrum antibiotic therapy as soon as possible ... ...

Abstract	Infection remains an important cause of morbidity and mortality in cancer patients, especially those undergoing chemotherapy for haematological malignancies. The practice of instituting an empirical broad-spectrum antibiotic therapy as soon as possible after the onset of fever has substantially reduced the clinical impact of this complication. In the last 25 years, the International Antimicrobial Therapy Group of the European Organisation for Research and Treatment of Cancer (EORTC-IATG) have published nearly 30 articles and a number of abstracts on several facets of the epidemiology and management of infection in cancer patients. With a progressive methodological refinement, the EORTC-IATG trials have established the standard for the management of febrile neutropenia, both by setting methodologies and definitions and by testing several antibiotic regimens that are active and effective for this indication. With the aim of supporting a more rational use of antibiotics in cancer patients, the most recent trials have dealt with the management of low risk patients, showing the safety and feasibility of oral therapy.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Clinical Trials as Topic/methods ; Europe ; Humans ; International Agencies ; Medical Oncology ; Neoplasms/complications ; Neutropenia/complications ; Opportunistic Infections/complications ; Opportunistic Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2002-03
Publishing country	England
Document type	Journal Article
ZDB-ID	82061-1
ISSN	1879-0852 ; 0959-8049 ; 0277-5379 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0959-8049 ; 0277-5379 ; 0964-1947
DOI	10.1016/s0959-8049(01)00461-0
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Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 583: Show issues

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Article ; Online: Partial Meal Replacement for Weight Loss after Stroke: Results of a Pilot Clinical Trial.

Dearborn Tomazos, Jennifer / Viscoli, Catherine / Amin, Hardik / Lovelett, Laurel Jean / Rivera, Jessica / Gull, Anum / Kernan, Walter N

Cerebrovascular diseases (Basel, Switzerland)

2023 Volume 53, Issue 1, Page(s) 54–61

Abstract: Introduction: Over half of patients with acute ischemic stroke are overweight or obese as defined by a body mass index (BMI) ≥25 kg/m2. Professional and government agencies recommend weight management for these persons to improve risk factors for ... ...

Abstract	Introduction: Over half of patients with acute ischemic stroke are overweight or obese as defined by a body mass index (BMI) ≥25 kg/m2. Professional and government agencies recommend weight management for these persons to improve risk factors for cardiovascular disease, including hypertension, dyslipidemia, vascular inflammation, and diabetes. However, approaches to weight loss have not been adequately tested specifically in patients with stroke. In anticipation of a larger trial with vascular or functional outcomes, we tested the feasibility and safety of a 12-week partial meal replacement (PMR) intervention for weight loss in overweight or obese patients with a recent ischemic stroke. Methods: This randomized open-label trial enrolled participants from December 2019 to February 2021 (with hiatus from March to August 2020 due to COVID-19 pandemic restrictions on research). Eligible patients had a recent ischemic stroke and BMI 27-49.9 kg/m2. Patients were randomized to a PMR diet (OPTAVIA® Optimal Weight 4 & 2 & 1 Plan®) plus standard care (SC) or SC alone. The PMR diet consisted of four meal replacements supplied to participants, two meals with lean protein and vegetables (self-prepared or supplied), and a healthy snack (also self-prepared or supplied). The PMR diet provided 1,100-1,300 calories per day. SC consisted of one instructional session on a healthy diet. Co-primary outcomes were ≥5% weight loss at 12 weeks and to identify barriers to successful weight loss among participants assigned to PMR. Safety outcomes included hospitalization, falls, pneumonia, or hypoglycemia requiring treatment by self or others. Due to the COVID-19 pandemic, study visits after August 2020 were by remote communication. Results: We enrolled 38 patients from two institutions. Two patients in each arm were lost and could not be included in outcome analyses. At 12 weeks, 9/17 patients in the PMR group and 2/17 patients in the SC group achieved ≥5% weight loss (52.9% vs. 11.9%; Fisher's exact p = 0.03). Mean percent weight change in the PMR group was -3.0% (SD 13.7) and -2.6% (SD 3.4) in the SC group (Wilcoxon rank-sum p = 0.17). No adverse events were attributed to study participation. Some participants had difficulty completing home monitoring of weight. In the PMR group, participants reported that food cravings and dislike for some food products were barriers to weight loss. Conclusion: A PMR diet after ischemic stroke is feasible, safe, and effective for weight loss. In future trials, in-person or improved remote outcome monitoring may reduce anthropometric data variation.
MeSH term(s)	Humans ; Overweight ; Diet, Reducing/adverse effects ; Diet, Reducing/methods ; Ischemic Stroke ; Pandemics ; Obesity/complications ; Obesity/diagnosis ; Obesity/therapy ; Weight Loss ; Meals ; COVID-19
Language	English
Publishing date	2023-05-15
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1069462-6
ISSN	1421-9786 ; 1015-9770
ISSN (online)	1421-9786
ISSN	1015-9770
DOI	10.1159/000530996
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Zs.A 3181: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 226: Show issues

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Article ; Online: Recent advances in the management of invasive candidiasis: role of anidulafungin.

Viscoli, Claudio

Drugs

2009 Volume 69 Suppl 1, Page(s) 1–3

MeSH term(s)	Antifungal Agents/therapeutic use ; Candida/drug effects ; Candida/pathogenicity ; Candidiasis/drug therapy ; Candidiasis/microbiology ; Candidiasis/pathology ; Echinocandins/therapeutic use ; Humans
Chemical Substances	Antifungal Agents ; Echinocandins ; anidulafungin (9HLM53094I)
Language	English
Publishing date	2009
Publishing country	New Zealand
Document type	Introductory Journal Article
ZDB-ID	120316-2
ISSN	1179-1950 ; 0012-6667
ISSN (online)	1179-1950
ISSN	0012-6667
DOI	10.2165/11315490-000000000-00000
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Zs.A 762: Show issues

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Article ; Online: Antifungal prophylaxis and pre-emptive therapy.

Viscoli, Claudio

Drugs

2009 Volume 69 Suppl 1, Page(s) 75–78

Abstract: In recent years, several reports have underlined the increasing role of fungal infections as a cause of morbidity and mortality in hospitalized non-haematological patients. For this reason, and also in light of the high mortality rate associated with ... ...

Abstract	In recent years, several reports have underlined the increasing role of fungal infections as a cause of morbidity and mortality in hospitalized non-haematological patients. For this reason, and also in light of the high mortality rate associated with these infections, chemoprophylaxis has been advocated for surgical patients hospitalized in intensive care units (ICUs). The available evidence suggests that the triazoles fluconazole and itraconazole are able to decrease Candida colonization and possibly infection compared with placebo, but this result has only been obtained in high-risk patients undergoing repeated surgical procedures for tertiary peritonitis. Consequently, triazole antifungal prophylaxis should be used with caution, and only in patients at high risk of invasive candidiasis, including high-risk surgical and ICU patients. A pre-emptive approach, defined as initiating antifungal treatment without confirmation of fungal infection, seems to be effective and safe.
MeSH term(s)	Antifungal Agents/adverse effects ; Antifungal Agents/therapeutic use ; Candidiasis/prevention & control ; Critical Care ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Humans ; Mycoses/microbiology ; Mycoses/prevention & control ; Risk
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2009-11-02
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	120316-2
ISSN	1179-1950 ; 0012-6667
ISSN (online)	1179-1950
ISSN	0012-6667
DOI	10.2165/11315540-000000000-00000
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Article: The evolution of the empirical management of fever and neutropenia in cancer patients.

Viscoli, C

The Journal of antimicrobial chemotherapy

1998 Volume 41 Suppl D, Page(s) 65–80

Abstract: Infectious complications are an important cause of morbidity and mortality in cancer patients, especially those receiving chemotherapy. Furthermore, neutropenia, fever and infection limit the dose-intensity of antineoplastic chemotherapy in cancer ... ...

Abstract	Infectious complications are an important cause of morbidity and mortality in cancer patients, especially those receiving chemotherapy. Furthermore, neutropenia, fever and infection limit the dose-intensity of antineoplastic chemotherapy in cancer patients. Fever without clinical signs of a localized infection is the commonest clinical presentation in neutropenic patients. Early empirical administration of broad-spectrum antibiotics at the onset of fever has become common practice, but the specific empirical regimen remains controversial. Guidance from therapeutic clinical trials is not straightforward, since it is difficult to compare trials, due to major differences and deficiencies in their design and analysis. Clinical trials fall into two categories: (i) explanatory trials which assess the hypothesis under ideal conditions, and (ii) pragmatic trials, which assess the regimen under the conditions of clinical practice. Methodological issues that are of crucial importance in the recognition of limits and value of the results of clinical trials in this field are discussed. The EORTC-IATCG has performed nine large therapeutic trials of empirical antibacterial and antifungal therapy in febrile, neutropenic patients with cancer. The results of trials, V, VIII, IX and XI are reviewed, and issues to be resolved in future trials are also considered.
MeSH term(s)	Antibiotic Prophylaxis ; Clinical Trials as Topic ; Fever/complications ; Fever/immunology ; Humans ; Neoplasms/immunology ; Neoplasms/therapy ; Neutropenia/complications ; Neutropenia/immunology ; Opportunistic Infections/prevention & control
Language	English
Publishing date	1998-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/41.suppl_4.65
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Zs.A 1197: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 124: Show issues

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