Infectious Disease
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2024 Resolution: Not to Be Replaced by a Machine
Chatbots, such as ChatGPT, are thought to have potential to eventually replace some straightforward infectious disease consultations. However, current technology does not yet instill confidence that the use of chatbots will be adequately accurate or safe for complex patient care. In addition, philosophical and ethical constraints raise doubt about the value of replacing specialist physician consultations.
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Infectious Disease Alert Updates
Peak SARS-CoV-2 Viral Loads Delayed; Should MRSA Require Isolation and Contact Precautions?
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Sulbactam-Durlobactam for Treatment of Bacterial Pneumonia
Sulbactam-durlobactam is non-inferior to colistin in the treatment of serious bacterial infections caused by Acinetobacter baumannii-calcoaceticus complex organisms.
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Bartonella quintana in New York City
Six cases of Bartonella quintana infection were detected in New York City in individuals experiencing homelessness; four required cardiac valve replacement for endocarditis.
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Prevention of Ventilator-Associated Pneumonia
Administration of amikacin for three days beginning early in mechanically ventilated patients significantly reduces ventilator-associated pneumonia.
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Adjunctive Dexamethasone Is Not Beneficial for HIV Patients with Tuberculous Meningitis
A randomized, placebo-controlled clinical trial in human immunodeficiency virus-positive adults with tuberculous meningitis found no benefit for adjunctive dexamethasone in survival or risk of neurologic immune reconstitution inflammatory syndrome (IRIS). Side effects were similar to placebo.
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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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Major Cardiovascular Event Risk Reduction with Pitavastatin in Patients Living with HIV
Among participants living with HIV who are at low-to-moderate risk for cardiovascular disease, those who received pitavastatin were 35% less likely to experience a major adverse cardiovascular event over a follow-up of approximately five years vs. those who received placebo.
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Infectious Disease Alert Updates
Infectious Disease Approval to Reduce Hospital Clostridioides difficile Cases; Oral Amoxicillin for Syphilis