Correction to: Influence of Single-Dose Antibiotic Prophylaxis for Early-Onset Pneumonia in High-Risk Intubated Patients.

Due to an error introduced during the production process, J. Dedrick Jordan's name was improperly tagged in the original publication of this article. It is tagged correctly here.

Influence of Single-Dose Antibiotic Prophylaxis for Early-Onset Pneumonia in High-Risk Intubated Patients.

BACKGROUND: Early-onset pneumonia (EOP) after endotracheal intubation is common among critically ill patients with a neurologic injury and is associated with worse clinical outcomes. METHODS: This retrospective cohort study observed outcomes pre- and post-implementation of an EOP prophylaxis protocol which involved the administration of a single dose of ceftriaxone 2 g around the time of intubation. The study included patients ≥ 18 years who were admitted to the University of North Carolina Medical Center (UNCMC) neuroscience intensive care unit (NSICU) between April 1, 2014, and October 26, 2016, and intubated for ≥ 72 h. RESULTS: Among the 172 patients included, use of an EOP prophylaxis protocol resulted in a significant reduction in the rate of microbiologically confirmed EOP compared to those without prophylaxis (7.4 vs 19.8%, p = 0.026). However, EOP prophylaxis did not decrease the combined incidence of microbiologically confirmed or clinically suspected EOP (32.2 vs 37.4%, p = 0.523). No difference in the rate of late-onset pneumonia (34.6 vs 26.4%, p = 0.25) or virulent organism growth (19.8 vs 14.3%, p = 0.416) was observed. No difference was observed in the duration of intubation, duration of intensive care unit (ICU) stay, duration of hospitalization, or ICU antibiotic days within 30 days of intubation. In hospital mortality was found to be higher in those who received EOP prophylaxis compared to those who did not receive prophylaxis (45.7 vs 29.7%, p = 0.04). CONCLUSIONS: The administration of a single antibiotic dose following intubation may reduce the incidence of microbiologically confirmed EOP in patients with neurologic injury who are intubated ≥ 72 h. A prophylaxis strategy does not appear to increase the rate of virulent organism growth or the rate of late-onset pneumonia. However, this practice is not associated with a decrease in days of antibiotic use in the ICU or any clinical outcomes benefit.

Development of fertilizers for enhanced nitrogen use efficiency - Trends and perspectives.

Despite nitrogen (N) being the most important crop nutrient, its use as fertilizer is associated with high losses. Such losses pollute the environment and increase greenhouse gas production and other environmental events associated with high ammonia volatilization and nitrous oxide emission. They also cause soil nitrate leaching and run-off that pollute surface and underground waters, with human health implications. The net outcomes for the plant are reduced N uptake and crop productivity that, together, increase the costs associated with fertilization of agricultural lands and dampen farmers' confidence in the efficacy and profitability of fertilizers. To address these problems, enhanced efficiency fertilizers (EEFs) are continuously being developed to regulate the release of N from fertilizers, allowing for improved uptake and utilization by plants, thereby lowering losses and increasing crop productivity per unit of fertilizer. The EEFs are classified based on whether they are inorganic- bio- or organic-coated; their mode of action on different N forms, including urease activity and nitrification inhibition; and the technologies involved in their development, such as targeted compositing of multiple nutrients and nanotechnology. This review is a critical revisit of the materials and processes utilized to coat or formulate enhanced efficiency N-fertilizers for reducing N losses, including their shortcomings, advances made to address such shortcomings, and effects on mitigating N losses and/or enhancing plant uptake. We provide perspectives that could assist in further improving promising and potentially effective and affordable coating or formulation systems for scalable improvements that allow for reducing the rate of N-fertilizer input in crop production. It is especially critical to develop multi-nutrient fertilizers that provide balanced nutrition to plants and humans, while improving N use efficiency and mitigating N-fertilizer effects on human and environmental health.