Purpose: Shortening the duration of antibiotic therapy (ABT) is a key measure in antimicrobial stewardship. The optimal duration of ABT for treatment of postoperative intra-abdominal infections (PIAI) in critically ill patients is unknown.
Methods: A multicentre prospective randomised trial conducted in 21 French intensive care units (ICU) between May 2011 and February 2015 compared the efficacy and safety of 8-day versus 15-day antibiotic therapy in critically ill patients with PIAI. Among 410 eligible patients (adequate source control and ABT on day 0), 249 patients were randomly assigned on day 8 to either stop ABT immediately (n = 126) or to continue ABT until day 15 (n = 123). The primary endpoint was the number of antibiotic-free days between randomization (day 8) and day 28. Secondary outcomes were death, ICU and hospital length of stay, emergence of multi drug-resistant (MDR) bacteria and re operation rate, with 45-day follow-up.
Results: Patients treated for 8 days had a higher median number of antibiotic-free days than those treated for 15 days (15 [6–20] vs 12 [6–13] days, respectively; P < 0.0001) (Wilcoxon rank difference 4.99 days [95% CI 2.99–6.00; P < 0.0001). Equivalence was established in terms of 45-day mortality (rate difference 0.038, 95% CI − 0.013 to 0.061). Treatments did not differ in terms of ICU and hospital length of stay, emergence of MDR bacteria or re-operation rate, while subsequent drainage between day 8 and day 45 were observed following short-course ABT (P= 0.041).
Conclusion: Short-course antibiotic therapy in critically ill ICU patients with PIAI reduces antibiotic exposure. Continuation of treatment until day 15 is not associated with any clinical benefit.

The case for adopting the E-vita open plus for treating complex aneurysms and dissections of the thoracic aorta, in a carefully selected group of people, is supported by the evidence.
Using the E-vita open plus could remove the need for a second procedure and the associated risk of serious complications, and it should therefore be considered for people:who would otherwise need a 2-stage repair procedure because their aortic disease extends into or beyond the distal part of their aortic arch (into the proximal descending aorta),but who would not need additional intervention (such as stent grafting) in the descending aorta.
The E-vita open plus is estimated to generate cost savings compared with current 2-stage repair from about 2years after the procedure. The estimated cost saving per patient at 5years after the procedure is around £13,334 when compared with 2-stage repair involving open insertion of a vascular graft,£10,225 when compared with 2-stage repair involving endovascular stent grafting and £12,536 when compared with open surgical debranching followed by endoluminal stent grafting. At 10years after the procedure, the estimated cost savings range from around £22,704 to £29,210 across the 3 comparators.

The service deals with the management of children with serious tracheal disease in childhood. It is primarily concerned with the treatment of long segment congenital tracheal stenosis (and its associated [60%] lesions), severe tracheo bronchomalacia and a variety of other, rarer pathologies. Management involves assessment of airway disease by bronchoscopy, bronchography, optical coherence tomography, echocardiography, 3-D imaging by computed tomography (CT) and magnetic resonance imaging (MRI). Treatment may involve surgery, for example slide tracheoplasty for tracheal stenosis, or stenting for malacia. Follow up is both by shared care with referring institutions but by annual review at Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) with anatomic, physiologic and quality of life assessment