Infectious Disease Topics
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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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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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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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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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Infectious Disease Alert Updates
Cardiac Effects of Bedaquiline and Delamanid in Combination; Is Leprosy ‘Endemic’ in Florida?; Linezolid Dosing in Cardiac Surgery
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Novel Oral Amphotericin B Formulation Shows Promise for Cryptococcal Meningitis
A randomized, controlled trial by Boulware and colleagues demonstrated that a new oral lipid nanocrystal formulation of amphotericin had similar antifungal activity and survival rates but significantly less toxicity compared to intravenous amphotericin when used as induction therapy for human immunodeficiency virus-associated cryptococcal meningitis.
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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.
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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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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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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.