Internal Medicine Alert – December 30, 2024

Outpatient CAP Treatment in Adults: Narrower Spectrum Therapy Is Better Tolerated

Examination of a large database led to the conclusion that treatment of community-acquired pneumonia in outpatients with narrower-spectrum agents (macrolides or doxycycline) was associated with similar clinical outcomes but with a lower incidence of adverse effects when compared to broader-spectrum therapy.

Pink Eye: Do Antibiotics Matter?

Acute infectious conjunctivitis, commonly referred to as pink eye, is common in children and is caused by bacteria more often than by viruses. Nonetheless, neither the clinical course of uncomplicated cases nor the spread of infection to peers is significantly altered by treatment with topical antibiotics or by exclusion of infected children from daycare and school settings.

Post-Traumatic Epilepsy and the Risk of Dementia

A subset of people with head injury will develop post-traumatic epilepsy (PTE). This prospective cohort study demonstrated a 4.5-fold increased risk of dementia in those with PTE compared to people without head trauma or epilepsy, and that this risk exceeds that observed in people with head trauma or epilepsy alone.

Withholding Intubation in Some Acutely Poisoned Coma Patients May Help

In this unblinded, randomized trial of adults presenting with acute poisoning and a Glasgow Coma Scale score less than 9, those for whom intubation was withheld unless emergently indicated had decreased intensive care unit and hospital lengths of stay and a lower rate of pneumonia.

Parasites and Poverty in the South

Parasite contamination of soil remains prevalent in some areas of the southern United States.

Intravenous Tenecteplase for Stroke After 4.5 Hours Does Not Improve Outcome

Standard therapy for acute ischemic stroke is intravenous thrombolysis within 4.5 hours from onset of symptoms. Alteplase has been the standard medication, but in recent years, tenecteplase has supplanted alteplase because of its ease of administration as a single intravenous bolus and lower cost.

Acoramidis Tablets (Attruby)

The U.S. Food and Drug Administration has approved acoramidis, an oral drug for the treatment of transthyretin-related amyloid cardiomyopathy.