Infectious Disease
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Empiric Anti-MRSA Therapy in Pneumonia May Not Always Be a Good Idea
In a retrospective cohort study, 88,605 patients in the Veterans Administration system who were hospitalized with pneumonia were examined. Thirty-eight percent received empiric anti-methicillin-resistant Staphylococcus aureus (MRSA) treatment. Empiric anti-MRSA treatment was not associated with a reduction in mortality in any subgroup of patients studied and appeared to cause harm in many patients.
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Combination Therapy of MRSA Bacteremia Was Not Beneficial in a Randomized Clinical Trial
In a randomized clinical trial conducted at 27 hospitals in four countries, researchers found that the addition of an antistaphylococcal beta-lactam to vancomycin or daptomycin (99% received vancomycin) did not lead to improved outcomes in MRSA bacteremia. The trial was stopped early because of safety concerns, including a higher risk of acute kidney injury in the combination group.
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Quantifying the Risk of SARS-CoV-2 Transmission in the United States
In the United States, the rate of symptomatic transmission of SARS-CoV-2 to contacts was only 0.45%, but was 10.5% in household contacts; there were tertiary symptomatic transmissions. However, since only symptomatic individuals underwent testing, the actual overall rate of transmission with or without resultant symptomatic illness is likely to be higher.
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Pharmacotherapy Considerations for COVID-19
This article provides a brief summary of selected pharmacotherapy options proposed for COVID-19.
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A ‘Normal’ Initial ECG?
The ECG in the figure was obtained from a 30-year-old man who was admitted to the hospital to “rule out myocardial infarction.” His symptoms of chest discomfort were thought to be atypical and unlikely to be due to a cardiac etiology. His initial ECG (not shown) was interpreted as normal. Evaluation, including serial troponins and stress testing, were deemed normal. Before sending the patient home, the ECG in the figure was obtained.
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Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia)
This is the first FDA-approved oral immunotherapy for desensitizing peanut allergy in children to help reduce the risk of allergic reactions.
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The Safety and Effectiveness of Pyrethroid Insecticides as the Battle Against Mosquitoes Continues
There is a statistical association between a urine test suggestive of exposure to pyrethroid insecticides and increased mortality over the subsequent 14 years.
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Optimal Antithrombic Therapy After PCI for Atrial Fibrillation Patients
In three subgroups of coronary artery disease patients with atrial fibrillation, apixaban plus a P2Y12 inhibitor provided superior safety and similar efficacy outcomes as treatment with warfarin, aspirin, or both for six months.
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Heart Failure-Exacerbating Medications
In a large, diverse cohort of Medicare patients hospitalized for heart failure exacerbations, almost half were on medications known to exacerbate heart failure; more than one-third were on these agents at discharge.
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Infectious Disease Alert Updates
Step-Wise Interventions for Hospital-Onset Clostridioides difficile