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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.

Infectious Disease Updates

Post-COVID Cryptococcosis — Even in Those Without Immunosuppression; Think Tularemia

RSV Vaccination in Severely Immunocompromised Individuals

The antibody response to respiratory syncytial virus vaccination is significantly impaired in many severely immunocompromised individuals.

Agreeing to Care for Unvaccinated Children

Many primary care clinicians choose not to enroll pediatric patients in their practices when the parents disagree with standard childhood immunization. However, such refusal to provide primary care raises significant controversy and ethical concerns.

A Plasma Cell-Free DNA PCR Panel Test for Invasive Mold Disease

Lieu and colleagues performed a retrospective study of patients with suspected invasive mold disease that showed a high degree of concordance between noninvasive plasma cell-free deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) testing and invasive specimen fungal test results.

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.