Infectious Diseases (all articles)
RCT | Lower rates of treatment failure with standard-course vs. short-course therapy in pediatric UTIs
5 Jul, 2023 | 01:09h | UTCShort-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial – JAMA Pediatrics (link to abstract – $ for full-text)
See also: Visual Abstract
Commentary: Treatment Failure Down With Standard-Course Therapy in Pediatric UTI – HealthDay
SR | Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis
5 Jul, 2023 | 01:04h | UTC
Consensus Statement 2023 Update | Timing of elective surgery and risk assessment after SARS-CoV-2 infection
30 Jun, 2023 | 15:00h | UTCTiming of elective surgery and risk assessment after SARS-CoV-2 infection: 2023 update – Anaesthesia
Commentary on Twitter
?"In most circumstances, surgery should proceed unless risk assessment indicates that the risk of proceeding exceeds the risk of delay."@Assoc_Anaes @RCoANews @UkFssa @RCSnews @elboghdadly @doctimcook @justin_kua @NigelMercer @rmoonesinghe
?https://t.co/gfjymze0oi pic.twitter.com/D8bEfAHBD7
— ??????????? (@Anaes_Journal) June 20, 2023
Global incidence in hospital-associated infections resistant to antibiotics: an analysis of point prevalence surveys from 99 countries
30 Jun, 2023 | 14:33h | UTC
Review | Breathing difficulties after covid-19: a guide for primary care
29 Jun, 2023 | 14:04h | UTCBreathing difficulties after covid-19: a guide for primary care – The BMJ
RCT | Bulevirtide reduces HDV RNA and ALT levels in chronic hepatitis D patients
28 Jun, 2023 | 13:20h | UTCSummary: This randomized phase 3 trial evaluated the efficacy of bulevirtide, an inhibitor of HDV entry into hepatocytes, in patients with chronic hepatitis D. Patients were randomized to receive either 2 mg or 10 mg of bulevirtide daily for 144 weeks, or no treatment for 48 weeks followed by 10 mg bulevirtide daily for 96 weeks. The study involved 150 patients, 49 in the 2-mg group, 50 in the 10-mg group, and 51 in the control group.
After 48 weeks of treatment, 45% and 48% of patients in the 2-mg and 10-mg groups respectively achieved the primary end point of undetectable HDV RNA level or a decrease of at least 2 log10 IU per milliliter from baseline, and normalization of ALT level. Only 2% in the control group reached the primary endpoint. ALT levels normalized in 51% and 56% of patients in the 2-mg and 10-mg groups respectively, a significant difference from the 12% normalization in the control group. Notably, loss of HBsAg did not occur by week 48 in the bulevirtide groups. No serious adverse events related to the treatment were reported, though side effects including headache, pruritus, and fatigue were more common in the bulevirtide groups.
These results demonstrate the effectiveness of bulevirtide in reducing HDV RNA and ALT levels in patients with chronic hepatitis D. However, the absence of HBsAg loss in bulevirtide groups raises questions about its long-term implications.
Article: A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Presented today at #EASLCongress: In a randomized trial, 48 weeks of treatment with bulevirtide, which inhibits hepatitis D virus entry into hepatocytes, reduced HDV RNA and alanine aminotransferase levels in patients with chronic hepatitis D. https://t.co/Q8RNZFbQlQ
— NEJM (@NEJM) June 22, 2023
RCT | Dolutegravir is noninferior as a replacement for ritonavir-boosted protease inhibitor in HIV therapy
27 Jun, 2023 | 13:52h | UTCSummary: This randomized clinical trial (RCT) assessed the switch from ritonavir-boosted protease inhibitor (PI) to dolutegravir in HIV patients without genotype information but with viral suppression. The multicenter, open-label trial, involving 795 participants across four sites in Kenya, compared those who switched to dolutegravir (398) with those continuing with their current ritonavir-boosted PI regimen (397). The primary end point was an HIV type 1 RNA level of at least 50 copies per milliliter at week 48.
At the end of the trial period, the number of patients in both groups who met the primary end point was nearly the same (5.0% in the dolutegravir group and 5.1% in the ritonavir-boosted PI group). This indicates the noninferiority of dolutegravir, within a 4% margin. Additionally, no mutations conferring resistance to either drug were detected. The incidence of treatment-related adverse events of grade 3 or 4 was similar in both groups (5.7% for dolutegravir and 6.9% for ritonavir-boosted PI).
The study concludes that dolutegravir is a noninferior alternative to ritonavir-boosted PI for previously treated, virally suppressed HIV patients lacking drug-resistance mutation data. The similar safety profiles also support the switch. However, further research may provide valuable insights on the long-term implications of the switch.
Article: Second-Line Switch to Dolutegravir for Treatment of HIV Infection – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Second-Line Switch to Dolutegravir Noninferior in HIV – HealthDay
Commentary on Twitter
In an open-label, multicenter trial in Kenya, HIV-infected patients following a ritonavir-boosted protease inhibitor regimen were assigned to switch to dolutegravir or continue the regimen. The dolutegravir-based regimen was noninferior. https://t.co/jL70h5ejnV
— NEJM (@NEJM) June 21, 2023
RCT | Evaluating the viability of dolutegravir monotherapy in primary HIV infection
27 Jun, 2023 | 13:50h | UTCSummary: The study in focus is a randomized, controlled, non-inferiority trial spanning over 192 weeks, titled “EARLY-SIMPLIFIED”. It evaluated the effect of simplifying combination antiretroviral therapy (cART) to dolutegravir (DTG) monotherapy in patients with early-stage HIV-1 infection. The trial recruited 101 people who had begun cART within 180 days of a documented primary HIV-1 infection with suppressed viral load.
The patients were randomly divided into two groups: DTG monotherapy (n=68) and continued cART (n=33). The primary endpoints were viral failure rates at 48, 96, 144, and 192 weeks. Results revealed no difference in viral response between the two groups at 96 weeks, suggesting non-inferiority of DTG monotherapy. At the end of the trial (192 weeks), no virological failures were recorded in either group.
The study indicates that early initiation of cART during primary HIV infection might permit sustained virological suppression after switching to DTG monotherapy. However, the study was limited by its highly selected patient population and the transition to an observational design after 96 weeks. It provides insight into the potential for minimizing ART toxicity by stratifying patients according to the latent reservoir size or duration of active infection before starting therapy.
M-A | Risk factors for non-tuberculous mycobacterial pulmonary disease
27 Jun, 2023 | 13:27h | UTCCommentary: Comorbid respiratory disease key predictor of NTM-PD – MDedge
WHO outlines 40 research priorities on antimicrobial resistance
26 Jun, 2023 | 00:50h | UTCNews release: WHO outlines 40 research priorities on antimicrobial resistance – World Health Organization
Report: Global research agenda for antimicrobial resistance in human health – World Health Organization
Commentary on Twitter
?WHO published its 1st global research agenda for the world’s scientists to address the most urgent human health priorities to combat antimicrobial resistance
It outlines 40 research topics on drug-resistant bacteria,fungi& Mycobacterium TB
H/t @paimadhuhttps://t.co/AOVObnJK5Q pic.twitter.com/owZJwMIDXK— Antibiotic Steward Bassam Ghanem?? (@ABsteward) June 22, 2023
RCT | High-dose dual-antibiotic cement doesn’t lower infection rates in hip hemiarthroplasty
26 Jun, 2023 | 00:47h | UTCSummary: This randomized superiority trial studied the effect of high-dose dual-antibiotic loaded cement versus standard care single-antibiotic loaded cement on deep surgical site infection (SSI) rates in hip hemiarthroplasty patients. This large-scale study, conducted in 26 UK hospitals, included people aged 60 and older with a hip fracture.
The trial randomly allocated 4936 participants to either treatment group. The primary outcome was deep SSI at 90 days post-randomisation. Notably, no significant difference was found between the groups. About 1.7% of participants in the single-antibiotic group and 1.2% in the dual-antibiotic group experienced a deep SSI (adjusted odds ratio 1.43; 95% CI 0.87–2.35; p=0.16). This result contradicts previous findings suggesting that high-dose dual-antibiotic cement could reduce infection rates.
News release: Antibiotic bone cement found not to reduce infection after hip replacement – University of Oxford
Review | Differentiating infection, colonization, and sterile inflammation in critical illness
26 Jun, 2023 | 00:41h | UTCDifferentiating infection, colonisation, and sterile inflammation in critical illness: the emerging role of host-response profiling – Intensive Care Medicine (free for a limited period)
Commentary on Twitter
Infection, colonisation, sterile inflammation in critical illness?
? current approaches to distinguishing
? host–pathogen interactions
? techniques to characterise host response
? challenges/limitations of host‑response diagnostics
#FOAMcc @yourICM
?️https://t.co/d3vhgrt3ZE pic.twitter.com/eDFiinMvSp— Intensive Care Medicine (@yourICM) June 22, 2023
Review | Update on the management of patients with HIV infection in anesthesia and critical care
26 Jun, 2023 | 00:36h | UTC
Review | The antibiotic bead pouch – A useful technique for infection prevention and therapy in trauma surgery
26 Jun, 2023 | 00:35h | UTC
Review | Therapeutic drug monitoring of antimicrobials in critically ill obese patients
26 Jun, 2023 | 00:29h | UTCTherapeutic Drug Monitoring of Antimicrobials in Critically Ill Obese Patients – Antibiotics
Commentary on Twitter
?️⚡️Narrative Review @antibioticsmdpi
with @fabio_taccone
Therapeutic Drug Monitoring of Antimicrobials in Critically Ill Obese Patients #IDTwitter #CCTwitter https://t.co/s8dvWjtIwt pic.twitter.com/WWyflkblVY— Antibiotic Steward Bassam Ghanem?? (@ABsteward) June 24, 2023
RCT | Single-Dose VLA1553 Chikungunya vaccine shows high immunogenicity and seems safe
23 Jun, 2023 | 13:38h | UTCNews Release: First phase 3 trial of a chikungunya vaccine candidate finds it is generally safe and provokes an immune response – The Lancet
Commentary on Twitter
New: First phase 3 trial of a chikungunya vaccine candidate finds it is generally safe and provokes an immune response. https://t.co/YSzV5oxXRc pic.twitter.com/rGL7A5eLAr
— The Lancet (@TheLancet) June 13, 2023
Retrospective study | Increasing prevalence and severity of carbapenem-resistant Klebsiella Pneumoniae in ICUs
23 Jun, 2023 | 13:25h | UTC
Consensus Paper | Primary prophylaxis of invasive fungal diseases in patients with hematological malignancies
23 Jun, 2023 | 13:23h | UTC
Cohort Study | Risk and outcome of infective endocarditis in streptococcal bloodstream infections according to streptococcal species
22 Jun, 2023 | 15:09h | UTC
Review | Early lead extraction for infected implanted cardiac electronic devices
22 Jun, 2023 | 15:03h | UTC
Cohort Study | Dengue patients at high risk of cholecystitis and pancreatitis within 30 days
21 Jun, 2023 | 13:34h | UTC
Review | Antifungal dosing in critically ill patients on extracorporeal membrane oxygenation
21 Jun, 2023 | 13:31h | UTC
M-A | CRP at 5 mg/L cut-off efficient for tuberculosis screening in HIV outpatients
21 Jun, 2023 | 13:30h | UTC
Commentary on Twitter
ERR: C-reactive protein at a 5 mg cut-off and two newly developed clinical prediction models from this study show clinical utility for TB screening among outpatient PLHIV, while the WHO-recommended four-symptom screen showed suboptimal clinical utility https://t.co/msm13KXR0Y pic.twitter.com/O0wS1Xv4da
— ERS publications (@ERSpublications) June 11, 2023
The foot in diabetes – a reminder of an ever-present risk
21 Jun, 2023 | 13:10h | UTCThe foot in diabetes – a reminder of an ever-present risk – Clinical Medicine Journal
Related: Guideline Series | Prevention and management of diabetes-related foot disease
Opinion | Strategic masking to protect patients from all respiratory viral infections
20 Jun, 2023 | 12:50h | UTCStrategic Masking to Protect Patients from All Respiratory Viral Infections – New England Journal of Medicine (link to abstract – $ for full-text)