Other Ophthalmic Surgery Organ Transplantation Orthopaedics Other Osteoarthritis Osteoporosis Otitis Otorhino. Dr. Ron F. Grossman of the University of Toronto, outlined the new Canadian Guidelines which are similar to those about to be introduced by the American Thoracic Society in the United States. However, the vast majority of patients are seen as outpatients. Studies looking at outcome have traditionally used mortality and certainly for patients hospitalized this is appropriate. But for the large numbers treated outside of hospital, Dr. Grossman suggested that measures such as morbidity, time to return to work, and economics, are more appropriate measures to use.
Drug resistance is also an issue.
He cited data from a number of studies to show that length of stay is increased and mortality is altered when this is the case. This would have the clear advantage of limiting polypharmacy, lowering costs, and decreasing the likelihood of adverse drugs reactions. It would also decrease antibiotic selection pressure and reduce the emergence of resistance. However, the reality is that laboratory information arrives too late to initiate treatment based on findings, and rapid testing may not be accurate enough. For these reasons, guidelines have been developed.