Infectious Disease
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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
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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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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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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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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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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.