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Clostridioides difficile Toxin Vaccine Failed to Prevent Primary Infection in Trial

A Phase III randomized clinical trial on adults 50 years of age and older found that a detoxified toxin A/B vaccine failed to reach its primary endpoint of preventing Clostridioides difficile infection. The vaccine was safe and well tolerated.

Uncomplicated Pediatric Appendicitis: Antibiotics or Appendectomy?

Some patients with acute uncomplicated appendicitis do well with initial antibiotic treatment and do not require surgical appendectomy. However, as with adults, approximately one-third of antibiotic-treated children eventually will require surgical removal of the appendix despite the initial short-term success of medical management.

Infectious Disease Updates

Clostridioides difficile: Reduced Susceptibility to Vancomycin? Antibiotics Reduce Culture Yield in Joint Infection

Unhurried Patient Care

Unhurried conversations during patient encounters can improve outcomes for patients and enhance career satisfaction of physicians. Specific communication strategies can foster unhurried conversations without adding undue time to clinical care.

Procalcitonin-Guided Care Leads to Shorter Duration of Antibiotics in Sepsis Patients

In this multicenter, intervention-concealed, randomized clinical trial of 2,760 critically ill patients hospitalized with sepsis, the use of a daily procalcitonin-guided protocol resulted in shorter antibiotic duration as compared with standard care, without a significant difference in 28-day all-cause mortality. There was no significant difference in antibiotic duration between patients managed with a daily C-reactive protein-guided protocol and standard care, and the difference in all-cause mortality between these two groups was inconclusive.

Aeromonas Infections — Do Not Go Near the Water

Infection with Aeromonas mostly involves skin and soft tissue and traumatic wounds occurring with exposure to water contaminated by the organism. The organism often is resistant to carbapenems because of the presence of a chromosomal carbapenemase, while often remaining susceptible to third-generation cephalosporins.

Fidaxomicin Is More Clinically Effective than Vancomycin for C. difficile Infection

There is a lack of real-world data on using fidaxomicin for Clostridioides difficile infection (CDI). A retrospective, single-center study found that treatment of CDI with fidaxomicin leads to reduced clinical failure compared to oral vancomycin.

Infectious Disease Updates

MDRO Colonization Increases Risk of Infection; Peri-Operative Ertapenem; Whole-Genome Sequencing Shows Negligible Transmission of Clostridioides difficile in the ICU

Noninferiority of Seven vs. 14 Days of Antibiotic Therapy for Bloodstream Infections

In this multinational, noninferiority trial that included more than 3,600 hospitalized patients with bloodstream infections from various pathogens and infectious syndromes, seven days of antibiotic therapy was noninferior to 14 days with respect to death from any cause by 90 days. Patients were excluded if they had severe immunosuppression or foci requiring prolonged treatment, or if their blood cultures yielded Staphylococcus aureus or possible contaminants. Various secondary outcomes were similar between the two groups.

Parvovirus and Increasing Danger in Pregnancy and Sickle Cell Disease

The incidence of human parvovirus B19 infection is increasing in the United States, putting vulnerable groups at risk of serious complications.