Infectious Disease
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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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CDC Recommends RSV Vaccine for Patients in Third Trimester
The agency says this solution should be administered to patients during weeks 32 through 36 of pregnancy to protect babies against the dangerous virus, both before and shortly after birth.
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More Reports of Severe Group A Streptococcal Infection
Around the world, rates of severe illness caused by group A Streptococcus are rising. Possible explanations for the increase include immunity-altering, post-pandemic changes in exposure to respiratory pathogens and the emergence of new pathogenic M strains of Streptococcus.
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Using Doxycycline as Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections
In an open-label, randomized study involving men who have sex with men and transgender women, using doxycycline within 72 hours of condomless sex was associated with a two-thirds reduction in the incidence of bacterial sexually transmitted infections vs. those who received standard care.
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COVID-19 Vaccine, 2023-2024 Formula (Comirnaty, Spikevax)
The newest vaccines target XBB.1.5, which is no longer the dominant circulating variant, but they offer protection against XBB.1.16 and more distant variants (e.g., EG.5.1, FL.1.1.1, and BA.2.86).
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Oral Penicillin Challenge vs. Skin Testing: Diagnosing Low-Risk Patients with Reported Penicillin Allergy
In a comparison of direct oral penicillin challenge in low-risk patients to skin testing followed by oral challenge, researchers reported no significant differences. Direct oral penicillin challenge appears to be a safe and effective way to delabel a penicillin allergy.
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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.