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Antibiotic Stewardship

Brief review | What’s new in therapeutic drug monitoring of antimicrobials?

8 May, 2023 | 13:08h | UTC

What’s new in therapeutic drug monitoring of antimicrobials? – Intensive Care Medicine

 

Commentary on Twitter

 

Diagnostic Stewardship | A continuum of antibiotic stewardship in combating antimicrobial resistance

4 May, 2023 | 13:58h | UTC

Diagnostic stewardship in infectious diseases: a continuum of antimicrobial stewardship in the fight against antimicrobial resistance – International Journal of Antimicrobial Agents

 

SR | Fecal microbiota transplantation effective in recurrent C. difficile treatment

3 May, 2023 | 15:29h | UTC

Fecal microbiota transplantation for the treatment of recurrent Clostridioides difficile (Clostridium difficile) – Cochrane Library

Summary: Stool transplantation for treatment of repeated Clostridioides difficile infection – Cochrane Library

Commentaries:

Cochrane study finds stool transplants more effective than antibiotics for treating recurring, life-threatening gut infections – Cochrane Library

Expert reaction to two Cochrane reviews looking at stool transplants for recurrent Clostridium difficile infection, and for inflammatory bowel disease – Science Media Centre

Fecal microbiota transplant: Effective solution for recurrent C. difficile infections – News Medical

Related:

RCT | Fecal microbiota transplantation better than standard of care for first or second Clostridioides difficile infection.

Long-term safety of fecal microbiota transplantation for recurrent Clostridioides difficile infection

 

Commentary on Twitter

 

Review | Helicobacter pylori infection

2 May, 2023 | 13:37h | UTC

Helicobacter pylori infection – Nature Reviews Disease Primers (if the link is paywalled, try this one)

 

Commentary on Twitter

 

RCT | Molecular point-of-care testing for gastroenteritis reduced isolation time but increased antibiotic use

28 Apr, 2023 | 13:15h | UTC

Clinical impact of syndromic molecular point-of-care testing for gastrointestinal pathogens in adults hospitalised with suspected gastroenteritis (GastroPOC): a pragmatic, open-label, randomised controlled trial – The Lancet Infectious Diseases

Commentary: Molecular testing in suspected infectious diarrhoea—the value of negative results – The Lancet Infectious Diseases

 

M-A | Utility of differential time to positivity in diagnosing central line associated bloodstream infections

26 Apr, 2023 | 14:24h | UTC

Utility of Differential Time to Positivity in Diagnosing Central Line Associated Bloodstream Infections: A Systematic Review and Meta-Analysis – Clinical Infectious Diseases

 

Commentary on Twitter

 

M-A | Prevalence of atypical pathogens in patients with severe pneumonia

26 Apr, 2023 | 14:02h | UTC

Prevalence of atypical pathogens in patients with severe pneumonia: a systematic review and meta-analysis – BMJ Open

 

RCT | Piperacillin-tazobactam better than cefoxitin in antimicrobial prophylaxis for open pancreatoduodenectomy

21 Apr, 2023 | 13:08h | UTC

Piperacillin-Tazobactam Compared With Cefoxitin as Antimicrobial Prophylaxis for Pancreatoduodenectomy: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Informing a Rational Approach to Antimicrobial Prophylaxis in Open Pancreatoduodenectomy – JAMA (free for a limited period)

 

Commentary on Twitter

 

Review | New antibiotics for Staphylococcus aureus infection

18 Apr, 2023 | 13:02h | UTC

New Antibiotics for Staphylococcus aureus Infection: An Update from the World Association of Infectious Diseases and Immunological Disorders (WAidid) and the Italian Society of Anti-Infective Therapy (SITA) – Antibiotics

 

Consensus Paper | Strategies to prevent Clostridioides difficile infections in acute-care hospitals

17 Apr, 2023 | 13:17h | UTC

Strategies to prevent Clostridioides difficile infections in acute-care hospitals: 2022 Update – Infection Control & Hospital Epidemiology

News Release: Updated guidance: Antimicrobial stewardship programs essential for preventing C. difficile in hospitals – Society for Healthcare Epidemiology of America

Commentary: New guidance deems antibiotic stewardship essential for preventing C diff infections – CIDRAP

 

Phase 2 RCT | High-dose VE303 reduces recurrent Clostridioides difficile infection rates

17 Apr, 2023 | 13:12h | UTC

VE303, a Defined Bacterial Consortium, for Prevention of Recurrent Clostridioides difficile Infection: A Randomized Clinical Trial – JAMA (free for a limited period)

See also: Visual Abstract

 

RCT | Doxycycline postexposure prophylaxis effective in preventing gonorrhea, chlamydia, and syphilis in MSM

12 Apr, 2023 | 13:30h | UTC

Summary: In this open-label, randomized study involving 501 men who have sex with men (MSM) and transgender women, researchers investigated the effectiveness of postexposure doxycycline in preventing bacterial sexually transmitted infections (STIs), specifically gonorrhea, chlamydia, and syphilis. Participants with a previous STI in the past year, either taking preexposure prophylaxis (PrEP) against HIV or living with HIV, were randomly assigned to receive 200 mg of doxycycline within 72 hours after condomless sex or standard care without doxycycline. STI testing was performed quarterly, with the primary end point being the incidence of at least one STI per follow-up quarter.

Results demonstrated a significant reduction in STI incidence in both the PrEP and persons living with HIV cohorts who received doxycycline.  Overall, the combined incidence of these three STIs was lower by two thirds with doxycycline postexposure prophylaxis compared to standard care. The study also reported five grade 3 adverse events but no serious adverse events attributed to doxycycline. This finding supports the use of doxycycline postexposure prophylaxis among MSM with recent bacterial STIs.

Article: Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Doxycycline after sex found to reduce STI incidence in gay men, transgender women – CIDRAP

 

Commentary on Twitter

 

Perspective | Proposal of a model of care for outpatient antimicrobial therapy for infective endocarditis

12 Apr, 2023 | 13:08h | UTC

Outpatient Parenteral Antimicrobial Therapy for Infective Endocarditis—Model of Care – Antibiotics

 

Commentary on Twitter

 

Brief Review | Ten tips on fever in the ICU

10 Apr, 2023 | 14:02h | UTC

Ten tips on fever – Intensive Care Medicine

 

Consensus Paper | Best management of patients with an acute sore throat

6 Apr, 2023 | 13:32h | UTC

Best management of patients with an acute sore throat – a critical analysis of current evidence and a consensus of experts from different countries and traditions – Infectious Diseases

 

M-A | Comparison of the diagnostic accuracies of monocyte distribution width, procalcitonin, and C-reactive protein for sepsis

6 Apr, 2023 | 13:00h | UTC

Comparison of the Diagnostic Accuracies of Monocyte Distribution Width, Procalcitonin, and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis – Critical Care Medicine

 

ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia

5 Apr, 2023 | 13:45h | UTC

ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia – Intensive Care Medicine

 

Commentary on Twitter

 

RCT | Comparable efficacy of cefotaxime, ceftriaxone, and ciprofloxacin in treating spontaneous bacterial peritonitis

3 Apr, 2023 | 14:01h | UTC

Summary: This multicenter, prospective, open-label, randomized controlled trial compared the efficacy of cefotaxime, ceftriaxone, and ciprofloxacin as initial treatments for spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. The study included 261 patients aged 16 to 75, with liver cirrhosis, ascites, and a polymorphonuclear cell count of >250/mm3. Researchers performed follow-up paracentesis at 48 hours to evaluate the assigned antibiotics, and assessed resolution rates at 120 and 168 hours of treatment.

The primary endpoint, resolution rates at 120 hours, showed no statistically significant difference between the groups: 67.8% for cefotaxime, 77.0% for ceftriaxone, and 73.6% for ciprofloxacin. One-month mortality rates were also similar. The study concluded that these antibiotics are equally effective as initial treatments for SBP, particularly for community-acquired infections, when administered based on response-guided therapy.

Article: Response-Guided Therapy With Cefotaxime, Ceftriaxone, or Ciprofloxacin for Spontaneous Bacterial Peritonitis: A Randomized Trial: A Validation Study of 2021 AASLD Practice Guidance for SBP – American Journal of Gastroenterology (free for a limited period)

 

A syndrome-specific antibiotic stewardship intervention reduced antipseudomonal antibiotic use in diabetic foot infections

29 Mar, 2023 | 13:10h | UTC

Impact of a syndrome-specific antibiotic stewardship intervention on antipseudomonal antibiotic use in inpatient diabetic foot infection management – Antimicrobial Stewardship & Healthcare Epidemiology

 

Plasma D-Dimer may be useful in the diagnosis of periprosthetic joint infection

29 Mar, 2023 | 12:33h | UTC

Plasma D-Dimer Is Noninferior to Serum C-Reactive Protein in the Diagnosis of Periprosthetic Joint Infection – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)

News Release: D-dimer blood test shows value in detecting prosthetic joint infections – Wolters Kluwer

 

CDC report reveals escalating Candida auris transmission and resistance in the US

28 Mar, 2023 | 15:10h | UTC

Worsening Spread of Candida auris in the United States, 2019 to 2021 – Annals of Internal Medicine

News Release: Increasing Threat of Spread of Antimicrobial-resistant Fungus in Healthcare Facilities – Centers for Disease Control and Prevention

Commentaries:

CDC reports dramatic increase in US Candida auris cases – CIDRAP

Cases and transmission of highly contagious fungal infections see dramatic increase between 2019 and 2021 – American College of Physicians

An emerging fungal threat spread at an alarming rate in US health care facilities, study says – CNN

Related:

CDC Report: Transmission of pan-resistant Candida auris in health care facilities.

Case reports: Multidrug-resistant Candida auris infections in critically ill Covid-19 patients

Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings

Global Epidemiology of Emerging Candida Auris (reviews and commentaries on the subject)

The superbug Candida auris is giving rise to warnings — and big questions – STAT

Candida Auris – “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” (reviews and commentaries on the subject)

 

Commentary on Twitter

 

Brief Review | Antifungal stewardship in critically ill patients

28 Mar, 2023 | 14:57h | UTC

Antifungal stewardship in critically ill patients – Intensive Care Medicine (if the link is paywalled, try this one)

 

Commentary on Twitter

 

M-A | Examining shorter antibiotic treatment durations for community acquired pneumonia in adults

27 Mar, 2023 | 13:29h | UTC

Summary: The systematic review and duration-effect meta-analysis included nine randomized trials with a total of 2,399 patients, analyzing antibiotic treatment durations for community-acquired pneumonia (CAP) in adults. The primary outcome was clinical improvement on day 15, with secondary outcomes including all-cause mortality, serious adverse events, and clinical improvement on day 30.

The study found that shorter treatment durations (3–9 days) were likely to be non-inferior to the standard 10-day treatment, and no significant difference in all-cause mortality or serious adverse events was observed. The study suggests that a 3–5 day treatment duration likely offers the optimal balance between efficacy and treatment burden if patients are clinically stable. However, the results are limited by the small number of included studies, the overall moderate-to-high risk of bias, and the varying severity of CAP among patients in the studies. Therefore, further research focusing on the shorter duration range is required.

Article: Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: a systematic review and duration-effect meta-analysis – BMJ Open

Related:

Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians – Annals of Internal Medicine

Efficacy of short-course antibiotic treatments for community-acquired pneumonia in adults: A systematic review and meta-analysis – Antimicrobial Agents and Chemotherapy

Short-Course vs Long-Course Antibiotic Therapy for Children With Nonsevere Community-Acquired Pneumonia: A Systematic Review and Meta-analysis – JAMA Pediatrics

Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children: The SCOUT-CAP Randomized Clinical Trial – JAMA Pediatrics

Short-Course Antimicrobial Therapy for Pediatric Community-Acquired Pneumonia: The SAFER Randomized Clinical Trial – JAMA Pediatrics

Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial – JAMA

 

Phase 2b RCT | Efficacy and safety of PL-5 (Peceleganan) spray for wound infections

27 Mar, 2023 | 13:08h | UTC

Efficacy and Safety of PL-5 (Peceleganan) Spray for Wound Infections: A Phase IIb Randomized Clinical Trial – Annals of Surgery

 

Study reveals high rates of nonadherence to antimicrobial prophylaxis guidelines, often due to unnecessary vancomycin use

23 Mar, 2023 | 13:13h | UTC

Summary: The study evaluated adherence to surgical antimicrobial prophylaxis guidelines in 825 US hospitals for elective surgeries from 2019-2020. The study found that 41% of surgical prophylaxis regimens were nonadherent to the American Society of Health-System Pharmacists guidelines.

Unnecessary vancomycin use was the most common reason for nonadherence to surgical antimicrobial prophylaxis guidelines, accounting for 77% of nonadherent regimens and occurring in 31% of all surgeries. It’s noteworthy that when vancomycin was used, it was often unnecessarily combined with cefazolin, and patients who received this combination had a 19% higher risk of acute kidney injury compared to those who received cefazolin alone.

The authors suggest that quality-improvement efforts aimed at reducing unnecessary vancomycin use and potential guideline revisions may offer impactful strategies for improving the risk-benefit profile of antimicrobial prophylaxis.

Article: Adherence to Antimicrobial Prophylaxis Guidelines for Elective Surgeries Across 825 US Hospitals, 2019–2020 – Clinical Infectious Diseases

 

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