Infectious Disease Topics
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Pemivibart for COVID-19 Prophylaxis: Clinical Trial Confirms its Efficacy
Confirming the results of the immunobridging analysis that led to its initial authorization for emergency use, this study demonstrates that pemivibart is effective as prophylaxis against COVID-19, including in immunocompromised patients.
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What Is New with Leptospirosis?
Leptospirosis continues to cause seasonal problems in some urban areas, especially those with large populations of rats and imperfect garbage handling. New diagnostic tests are being developed, and plasma exchange offers the potential of improved outcomes for patients with leptospirosis accompanied by severe pulmonary hemorrhage.
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Patients Hospitalized for Nonsevere COVID-19: No Benefit of CAP Antibiotics
A large population-based, retrospective, cohort study found there was no benefit for antibiotics targeting community-acquired pneumonia in patients hospitalized with nonsevere COVID-19. These results provide evidence against antibiotic use in this population.
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Early Preoperative Antibiotics Before Appendectomy
Pre-incision treatment did not reduce intra-operative perforation, and likewise did not change purulent contamination, peri-appendicular abscess, or histologic gangrene. It did lower 30-day surgical-site infection (SSI) (1.6% vs. 3.2%; P = 0.03) and re-intervention for SSI (0.3% vs. 1.1%), but the effect was marginally significant, giving a number-needed-to-treat of 63 for any SSI and 125 for a re-intervention.
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Infectious Disease Updates
Mpox Accelerates in Africa; Why Does Colonization Become Active C. difficile? Avian Influenza in Felines Exposed to Dairy Workers
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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.
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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.
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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.
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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.
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Infectious Disease Updates
Old Habits Die Hard, Especially with TB; Paxlovid: Is It Still Worth the Cost?