The emergency medicine physician serves a critical role for trauma and surgical patients. Early recognition of infections and understanding the indications for prophylaxis are critical for management of pediatric trauma patients. The authors explore the most common etiologic agents by body system and prophylactic and therapeutic strategies.
A Virginia resident who had not received pre- or post-exposure prophylaxis died of rabies resulting from a dog bite during a prolonged trip to India. Many exposed healthcare workers subsequently received post-exposure prophylaxis.
A randomized, open-label, superiority trial found that daily antibiotic prophylaxis for patients who use clean, intermittent self-catheterization reduced symptomatic urinary tract infections by 48% over a 12-month period. Antibiotic resistance became prevalent in urinary isolates from the group receiving prophylaxis compared to controls.
Even in the era of newborn screening, pneumococcal vaccination, and penicillin prophylaxis, children with sickle cell disease continue to be at risk of morbidity and mortality from invasive pneumococcal disease, mostly from non-vaccine serotypes.
A Phase III, randomized, double-blind, placebo-controlled superiority trial that included patients 18 years of age or older undergoing allogeneic hematopoietic stem cell transplantation found that prophylaxis with letermovir resulted in significantly lower risk for cytomegalovirus infection in the first 24 weeks than placebo. Safety and adverse events were similar between letermovir and placebo.