Infectious Disease Alert – March 1, 2019
March 1, 2019
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Pediatric Pneumonia — Evolving Diagnosis and Management
Tachypnea has long been considered to identify which children with acute fever and cough might benefit from antibiotic treatment, especially in resource-limited parts of the world. Now, with declining rates of vaccine-preventable infections with Haemophilus influenzae and pneumococcus, new data suggest that approximately 90% of febrile, tachypneic, coughing (but still well enough for outpatient treatment) preschoolers do fine without antibiotics.
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The Downsides of High Vancomycin Troughs: No Longer ‘Mississippi Mud,’ but Still Hazardous
A retrospective cohort study from a large healthcare system found that elevated vancomycin troughs were common and associated with a higher body mass index and reduced baseline renal function, and led to more acute kidney injury and a longer hospital length of stay.
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Infection After Placement of Antibiotic Spacers in Prosthetic Joints
Researchers reviewed a case series of 51 patients who received retained “destination spacers” after resection of infected joint prostheses. The researchers noted a significant association between the presence of preoperative sinus drainage and re-infection. Longterm antimicrobial suppression after retention of a destination spacer did not result in significant prevention of re-infections.
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Eravacycline (Xerava)
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IV to Oral Conversion of Antibiotic Therapy for Bacteremia Due to Enterobacteriaceae
Oral step-down antibiotic therapy (IV to oral conversion) is safe and effective in patients with bloodstream infection due to Enterobacteriaceae.
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Infectious Disease Alert Updates
Jump in Cocci Cases, Winter 2017; Who Knew the Ink Was Not Sterile? Homeless Population Requires Hepatitis A Vaccination