Infectious Disease General
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Comparing the Safety of Cefepime and Piperacillin-Tazobactam: The ACORN Trial
Qian and colleagues conducted a pragmatic, open-label, randomized clinical trial to determine whether the empiric use of piperacillin-tazobactam or cefepime affects the risk of acute kidney injury (AKI) or neurological dysfunction in patients hospitalized for sepsis. The study showed no significant difference in the incidence of AKI between groups, but rates of neurological dysfunction were slightly higher in patients treated with cefepime.
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Malaria in Pregnancy — Simplified Treatment Decisions
History, data, and international consensus lead to the same conclusion: Artemether-lumefantrine is the first choice for treatment of uncomplicated falciparum malaria in everyone, even pregnant women.
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Antibiotic Stewardship vs. Diagnostic Stewardship for Reducing Unnecessary Antibiotics in Asymptomatic Bacteriuria
A statewide quality study compared antibiotic stewardship to diagnostic stewardship for hospitalized patients with asymptomatic bacteriuria. It found that reducing urine cultures decreased unnecessary antibiotic prescribing better than antibiotic stewardship.
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First-Choice Antibiotic for Acute Bacterial Sinusitis in Children
Review of a large database reveals that, for children treated for acute sinusitis, amoxicillin and amoxicillin-clavulanate yield similar rates of treatment failure. However, medication side effects are more common when amoxicillin-clavulanate is used.
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New International Guidelines on Prolonged Infusion Beta-Lactams
The largest randomized clinical trial of prolonged vs. intermittent beta-lactam antibiotic (meropenem) infusion in septic intensive care unit patients found no benefit in mortality or emergence of antibiotic resistance. Unfortunately, this trial has numerous flaws that ultimately limit its generalizability.
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Use of Ceftobiprole for Complicated Staphylococcus aureus Bacteremia
In a randomized, controlled trial conducted by Holland and colleagues, no significant difference in overall treatment success of complicated Staphylococcus aureus bacteremia was observed in patients who received ceftobiprole as compared with patients who received daptomycin.
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Infectious Disease Alert Updates
Infectious Disease Approval to Reduce Hospital Clostridioides difficile Cases; Oral Amoxicillin for Syphilis
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Proton Pump Inhibitors: Too Much of a Good Thing?
Proton pump inhibitor use in infants is associated with a 34% increase in the risk of subsequent infection-related hospitalization. These medications should be used only when the benefits clearly outweigh the risks.
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Duration of Antibiotic Therapy for Carbapenem-Resistant Enterobacterales Bacteremia
This multicenter, observational study provides the first focused comparison of short vs. prolonged antibiotic courses for carbapenem-resistant Enterobacterales bloodstream infections, suggesting that short courses (eight to 10 days) have similar outcomes to prolonged courses.
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Differential Time to Positivity Is a Useful Measure in Diagnosing Central Line-Associated Bloodstream Infections
A systematic review and meta-analysis found differential time to positivity (DTP) was a useful measurement in confirming or excluding central line-associated bloodstream infections (CLABSIs). However, DTP was not as accurate for CLABSIs resulting from Staphylococcus aureus (lower sensitivity) or Candida spp. (lower specificity) compared to other organisms.