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Infectious Disease Alert Updates

Cardiac Effects of Bedaquiline and Delamanid in Combination; Is Leprosy ‘Endemic’ in Florida?; Linezolid Dosing in Cardiac Surgery

Novel Oral Amphotericin B Formulation Shows Promise for Cryptococcal Meningitis

A randomized, controlled trial by Boulware and colleagues demonstrated that a new oral lipid nanocrystal formulation of amphotericin had similar antifungal activity and survival rates but significantly less toxicity compared to intravenous amphotericin when used as induction therapy for human immunodeficiency virus-associated cryptococcal meningitis.

Differential Time to Positivity Is a Useful Measure in Diagnosing Central Line-Associated Bloodstream Infections

A systematic review and meta-analysis found differential time to positivity (DTP) was a useful measurement in confirming or excluding central line-associated bloodstream infections (CLABSIs). However, DTP was not as accurate for CLABSIs resulting from Staphylococcus aureus (lower sensitivity) or Candida spp. (lower specificity) compared to other organisms.

Duration of Antibiotic Therapy for Carbapenem-Resistant Enterobacterales Bacteremia

This multicenter, observational study provides the first focused comparison of short vs. prolonged antibiotic courses for carbapenem-resistant Enterobacterales bloodstream infections, suggesting that short courses (eight to 10 days) have similar outcomes to prolonged courses.

Proton Pump Inhibitors: Too Much of a Good Thing?

Proton pump inhibitor use in infants is associated with a 34% increase in the risk of subsequent infection-related hospitalization. These medications should be used only when the benefits clearly outweigh the risks.

Fatal Flea-Borne Typhus in California

Three fatal cases of flea-borne typhus, which is endemic in Southern California as well as in Texas and Hawaii, occurred in Los Angeles County in 2022 — the first such fatalities in two decades.

Increasing Reports of Severe Group A Streptococcal Infection

Around the world, rates of severe illness due to group A Streptococcus are increasing. Possible explanations for the increase include immunity-altering, post-pandemic changes in exposure to respiratory pathogens, as well as the emergence of new pathogenic M strains of Streptococcus.

Oral Antibiotics in Endocarditis: Hitting the Target

Pharmacodynamic/pharmacokinetic analysis of patients in the POET study provides understanding of the efficacy of intravenous-to-oral stepdown antibiotic therapy in patients with endocarditis.

Oral Penicillin Challenge Found to Be Noninferior to Skin Testing Followed by Oral Challenge in Low-Risk Patients with Reported Penicillin Allergy

A multicenter, randomized clinical trial that compared direct oral penicillin challenge in low-risk patients to skin testing followed by oral challenge found no significant differences. Direct oral penicillin challenge appears to be a safe and effective way to delabel a penicillin allergy.

Malaria Vaccination: Dangerous, Dubious, or Ready for Prime Time?

Malaria vaccination with the RTS,S/AS01 vaccine is safe and effective. Implementation of the four-dose vaccination regimen for young children in areas of moderate- and high-intensity malaria transmission is in progress — with the expectation that hundreds of thousands of lives could be saved each year.