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Infectious Diseases
Top Medical News
In critically ill patients who have been on invasive mechanical ventilation (IMV) for at least 3 days, a subsequent 3-day course of preventive inhaled amikacin reduced the burden of ventilator-associated pneumonia (VAP) during 28 days of follow-up, findings from the AMIKINHAL trial have shown.
A 5-day course of oral amoxicillin-clavulanate performs just as wells as a 10-day course in the treatment of febrile urinary tract infection (fUTI) in children, a study has shown.
Adding clarithromycin to standard of care appears to improve clinical response and reduce inflammation in patients with community-acquired pneumonia, as reported in the phase III ACCESS trial.
In the treatment of patients with early syphilis, a 5-day course of linezolid does not appear to perform as well as the standard of care benzathine penicillin G (BPG), as shown in a study.
At the 27th Congress of the Asian Pacific Society of Respirology (APSR) 2023, a Pfizer-sponsored symposium addressed the evolving challenges of COVID-19, particularly for patients with pre-existing respiratory conditions. Chaired by Dr Chan Kwok Wai Adrian, a renowned respiratory physician and intensivist from Mount Elizabeth Novena Hospital, Singapore, and featuring insights from Professor Yang Kuang-Yao of National Yang Ming Chiao Tung University, Taipei, Taiwan, the symposium focused on the disease’s impact, treatment guidelines, regional management strategies, and the role of nirmatrelvir/ritonavir, a new oral combination pill, in the treatment of COVID-19.
A prospective study from Singapore provides evidence of the clinical effectiveness of mRNA-based vaccines against COVID-19 in individuals with cancer.
New drug applications approved by US FDA as of 16-31 December 2023 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
Special Reports
At the 27th Congress of the Asian Pacific Society of Respirology (APSR) 2023, a Pfizer-sponsored symposium addressed the evolving challenges of COVID-19, particularly for patients with pre-existing respiratory conditions. Chaired by Dr Chan Kwok Wai Adrian, a renowned respiratory physician and intensivist from Mount Elizabeth Novena Hospital, Singapore, and featuring insights from Professor Yang Kuang-Yao of National Yang Ming Chiao Tung University, Taipei, Taiwan, the symposium focused on the disease’s impact, treatment guidelines, regional management strategies, and the role of nirmatrelvir/ritonavir, a new oral combination pill, in the treatment of COVID-19.
A 43-year-old male former intravenous drug user presented with incidental findings of elevated alanine transaminase (ALT) levels in December 2021. The patient had depression and drug-induced psychosis associated with previous heroin, ketamine and methamphetamine use. He was on quetiapine 300 mg daily for his psychotic symptoms, pantoprazole 40 mg daily as needed for occasional acid reflux, and simvastatin 10 mg daily for hyperlipidaemia. He did not have hepatitis B virus (HBV) or human immunodeficiency virus (HIV) coinfection.
Cabotegravir (CAB) plus rilpivirine (RPV) is a long-acting (LA) injectable antiretroviral therapy (ART) recommended for people living with HIV (PLHIV) who have achieved viral suppression with oral medications. The health-related quality of life (HRQoL) impact of injectable CAB + RPV (Vocabria®/ Rekambys®, GlaxoSmithKline) and safety considerations of ART were discussed by experts in public health and patient advocates in an industry-sponsored satellite symposium during the 12th International AIDS Society Conference on HIV Science (IAS 2023) held in Brisbane, Australia.
Remdesivir can be used in COVID-19 patients with severe renal impairment, including those on dialysis, according to recent US FDA approval of its expanded indication based on results of the REDPINE trial.
A 73-year-old male presented to the Accident & Emergency Department on 8 March 2022 (day 1) with fever (38°C), sore throat, cough, sputum and shortness of breath (SOB). Upon arrival, his blood pressure was 159/59 mm Hg, heart rate was 90 beats/minute, and oxygen saturation was 85 percent on room air, which improved to 96 percent with 3 L/min of supplemental oxygen. He was a hepatitis B virus carrier not receiving antivirals and had diabetes mellitus, which was well controlled with diet. He was not vaccinated against SARS-CoV-2 and had no prior exposure to COVID-19 oral antivirals.
Monoclonal antibodies (mAbs) have emerged as an attractive option for both COVID-19 immunoprophylaxis and treatment, especially since their efficacy vs SARS-CoV-2 is irrespective of patients’ immune system status. MIMS Doctor interviewed Dr Wilson Lam, Specialist in Infectious Disease in private practice in Hong Kong, who shared his experience with tixagevimab/cilgavimab, a combination of two long-acting mAbs, in providing protection against COVID-19 infection as well as evidence supporting its use as early treatment for adolescents and adults with COVID-19 who are at increased risk of progressing to severe disease.
Fully vaccinated immunocompromised individuals (ICIs) are at higher risk of breakthrough SARS-CoV-2 infection and severe COVID-19 than people with normally functioning immune systems. This article explores latest data supporting the role of tixagevimab/cilgavimab, a combination of two long-acting monoclonal antibodies (mAbs), in providing additional protection against SARS-CoV-2 infection and minimizing the risk of severe COVID-19 among ICIs.
Conference Reports
Four-day-a-week dosing of dual therapy for HIV performs similarly to daily doses in terms of sustaining viral suppression in the DUETTO trial. However, virological failure (VF) and drug resistance rates were higher with the 4-day/week dosing regimen.
People living with HIV (PLWH) who were diagnosed with COVID-19 had a 35-percent higher risk of a major cardiovascular (CV) event in the following year than PLWH without COVID in a Spanish study.
Viral suppression is maintained through 48 weeks in adults with HIV-1 harbouring drug resistance mutations, who switched to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) fixed-dose combination pill from a boosted protease inhibitor (bPI) therapy, according to recent data from the phase IV open-label PIBIK trial.
Remdesivir and favipiravir does not appear to be heart-friendly in patients with COVID-19, according to a study presented at APSR 2023.
SARS-CoV-2 continues to evolve into newer variants. Post-Delta, these variants are generally more highly transmissible and immune-evasive, although not more virulent, said Dr Gregory Poland, Mary Lowell Leary Emeritus Professor of Medicine and director of Mayo Vaccine Research Group, Mayo Clinic in Rochester, Minnesota, US, at IDWeek 2023.
Management of most adults with COVID-19, particularly those with mild-to-moderate disease, is increasingly occurring in the outpatient setting due to the availability of effective treatment options.
Podcast: Professor Flor Munoz discusses the importance of vaccination for pregnant women and children against COVID-19 at IDWeek 2023
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