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Infectious Disease General

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  • Restricting Remdesivir in an Immune Era: No Harm, Big Savings

    A quasi-experimental, eight-hospital, pre-post restriction of remdesivir to only symptomatic, oxygen-requiring, immunocompromised adults during July 2023 to June 2024 led to a 90% reduction in remdesivir use (37.7% to 4.1%) without any increase in 14- or 28-day all-cause mortality, 30-day readmission, or hospital length of stay. Medium- and high-risk covariate models confirmed no mortality signal, while an intriguing rise in intensive care unit admission and mechanical ventilation use among the few post-intervention recipients was most consistent with residual confounding and confounding by indication (i.e., the sickest patients being channeled to receive therapy). In an era of widespread hybrid immunity from Omicron-descended variants, broad remdesivir formulary restriction can be implemented safely and can yield substantial cost savings without compromising outcomes.

  • Updated Recommendations for Drug-Susceptible and Drug-Resistant Tuberculosis

    The authors provide an update of recommendations for the treatment of tuberculosis, including cases with drug resistance. The recommendations include the use of newer drugs that have undergone clinical trials and shorter durations of therapy.

  • Baloxavir Prevents Household Transmission of Influenza

    Treatment with a single dose of baloxavir led to an adjusted relative risk reduction of 29% in household transmission of influenza compared to placebo. There was no significant difference in safety signals between baloxavir and placebo.

  • Staphylococcus aureus Endocarditis: A Selection of Just-Published Studies

    A selection of reports published in the last two months cover microbiologic diagnosis and management issues.

  • Measles Outbreaks in the United States

    Several measles outbreaks have been active in the United States, with more than 1,000 cases reported already in 2025. Most outbreaks begin as unvaccinated individuals in the United States come into contact with an infected individual who has recently arrived after international travel. Vaccination is effective, but current U.S. vaccine coverage rates are below the 95% rate considered necessary to provide herd immunity.

  • Infectious Disease Updates

    Old Habits Die Hard, Especially with TB; Paxlovid: Is It Still Worth the Cost?

  • Career Satisfaction and the Unmet Need for Infectious Disease Clinicians

    There is a shortage of physicians in the United States, and many current physicians are considering reducing or ending their current clinical practices. Leading risk factors for discontinuing clinical work are taking fewer than 15 days of vacation each year, continuing to respond to electronic medical record inbox messages during vacation, and working more than 30 minutes per day during vacation.

  • Moldy Bloodstream Infections

    Bloodstream infections due to molds are uncommon, occurring predominantly in association with severe immunocompromise, even in the presence of anti-mold prophylaxis.

  • Preventing Respiratory Syncytial Virus Illness in Infants

    Prevention of respiratory syncytial virus (RSV) illness by using a monoclonal antibody, nirsevimab, in young infants entering the winter RSV season was recommended in 2023. Subsequently, effectiveness was evaluated in children in the northeastern United States. Nirsevimab was 68% effective in preventing RSV-associated need for medical care and 81% effective in preventing hospitalization for RSV-related illness.

  • Antibiotics for Asymptomatic Bacteriuria: Using Urinalysis to Improve Stewardship

    A cohort study found that in patients receiving antibiotics for a urinary tract infection, a urinalysis with pyuria and/or nitrituria identified 40% more cases of unnecessary antibiotic use compared to asymptomatic bacteriuria.