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Therapeutic Advances in Infectious Disease

Ashley N Fox, Winter J Smith, Katherine E Kupiec, Stephanie J Harding, Beth H Resman-Targoff, Stephen B Neely, Bryan P White, Ryan E Owens
Background: Food and Drug Administration-approved daptomycin dosing uses actual body weight, despite limited dosing information for obese patients. Studies report alterations in daptomycin pharmacokinetics and creatine phosphokinase elevations associated with higher weight-based doses required for obese patients. Limited information regarding clinical outcomes with alternative daptomycin dosing strategies in obesity exists. Objective: This study evaluates equivalency of clinical and safety outcomes in obese patients with daptomycin dosed on adjusted body weight versus a historical cohort using actual body weight...
January 2019: Therapeutic Advances in Infectious Disease
Iliyan Todorov, Margarita Gospodinova, Yana Bocheva, Gergana Popcheva
Background: Serum amyloid A (SAA) protein is a major acute phase protein. Increased concentrations have been reported in many inflammatory diseases. In bacterial infections, high levels correlate with those of C-reactive protein (CRP). In viral infections, where CRP changes are weaker, SAA is of value for establishing early diagnosis, monitoring the severity, and the evolution of the disease. Objective: Evaluation of SAA as a marker for diagnosis of infectious mononucleosis, including severe forms...
January 2019: Therapeutic Advances in Infectious Disease
Madison M Murphy, Edna Patatanian, Mark A Gales
Clostridium difficile infections have a high recurrence rate following acute treatment. Extended duration vancomycin (EDV) is a mainstay for the treatment of recurrent Clostridium difficile infections (rCDI). Clinical disease guidelines recommend a variety of different vancomycin treatment regimens though based on weak, low-quality evidence. Patients typically receive an initial vancomycin treatment course of 7-14 days for the acute infection, followed by an extended duration vancomycin course. Multiple publications on the utility of EDV regimens have been published but few include reported effectiveness outcomes associated with a prescribed treatment regimen...
November 2018: Therapeutic Advances in Infectious Disease
Danya Roshdy, Rupal Jaffa, Kelly E Pillinger, Josh Guffey, Nigel Rozario, Lisa Davidson, Lewis McCurdy
Background: Acute bacterial skin and skin structure infections (ABSSSI) are a leading cause of hospitalization, but are often treated inappropriately in the inpatient setting. A multifaceted stewardship intervention was implemented to encourage prescribing of guideline-concordant therapy (GCT). Objective: To examine the impact of this initiative on antimicrobial prescribing practices and patient outcomes. Methods: This was a single-center, retrospective study of adult inpatients admitted with a primary or secondary diagnosis of ABSSSI, classified by type and severity based on signs of systemic infection...
November 2018: Therapeutic Advances in Infectious Disease
Gautham Krishnamurthy, Jayapal Rajendran, Vishal Sharma, Hemanth Kumar, Harjeet Singh
Background: Peritoneal tuberculosis has varying clinical manifestations. The study was conducted to highlight the entity of incidental peritoneal tuberculosis. Diagnostic and therapeutic dilemma is likely to occur on detection of unexpected peritoneal nodules. Materials and methodology: Incidental peritoneal tuberculosis was defined as peritoneal tuberculosis (peritoneal tubercles or ascites) detected intraoperatively in patients undergoing surgical exploration for other indications with no preoperative suspicion of abdominal tuberculosis or active tubercular lesions anywhere in the body...
September 2018: Therapeutic Advances in Infectious Disease
Nomvuyo Z Mothobi, Jeffrey Masters, Deborah J Marriott
A case of tenofovir-induced Fanconi syndrome in a patient receiving antiretroviral therapy for HIV infection, with resolution of the related electrolyte abnormalities upon switch from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate, is reported. Tenofovir alafenamide fumarate, a novel prodrug of tenofovir containing significantly lower doses of tenofovir than tenofovir disoproxil fumarate, has been associated with a favourable renal profile compared to tenofovir disoproxil fumarate. Generally, the rare complication of tenofovir disoproxil fumarate-induced Fanconi syndrome is managed by cessation of tenofovir...
September 2018: Therapeutic Advances in Infectious Disease
Ajinkya M Pawar, Kerry L LaPlante, Tristan T Timbrook, Aisling R Caffrey
Background: Evidence suggests statins may improve survival in patients with bloodstream infections. However, there is no consensus on optimal timing and duration of exposure. Objectives: To quantify statin therapy duration associated with decreased mortality in bacteremic statin users. Methods: We conducted a case-control study using OptumClinformatics™ with matched Premier hospital data (1 October 2009-31 March 2013). Cases who died during the hospitalization were matched 1:1 to survivors on disease risk scores (DRSs)...
September 2018: Therapeutic Advances in Infectious Disease
Gerardo Alvarez-Uria, Manoranjan Midde, Jayaram Battula, Himachandra N B Pujari
Background: While mortality of HIV-related cryptococcal meningitis (CM) in developed countries is relatively low, in developing countries over half of patients die within 10 weeks. Current recommended therapies are often not suitable for resource-poor settings, and new shorter regimens are urgently needed. Intrathecal administration of liposomal amphotericin B (lAmB) has shown promising results in animal models. However, the safety and tolerability of intrathecal lAmB in humans are not well known...
September 2018: Therapeutic Advances in Infectious Disease
Bipadabhanjan Mallick, Harshal S Mandavdhare, Sourabh Aggarwal, Harjeet Singh, Usha Dutta, Vishal Sharma
Background: Chylous ascites is an uncommon presentation of mycobacterial infection. Methods: We report three cases of tubercular chylous ascites, and in addition, we performed a systematic review of the published literature for the clinical presentation, treatment, and outcomes of mycobacterial chylous ascites. We followed the PRISMA guidelines for the systematic review. Results: A total of 33 cases (including three of ours) were included...
July 2018: Therapeutic Advances in Infectious Disease
Amritpal Kaur, Rajan Bhagat, Navjot Kaur, Nusrat Shafiq, Vikas Gautam, Samir Malhotra, Vikas Suri, Ashish Bhalla
Background: Tremendous infectious disease burden and rapid emergence of multidrug resistant pathogens continues to burden our healthcare system. Antibiotic stewardship program often implements antibiotic policies that help in preventing unnecessary use of antibiotics and in optimizing management. To develop such a policy for management of infections in the emergency unit, it is important to analyze the information regarding antibiotic prescription patterns in patients presenting to the emergency room referred from various healthcare settings...
July 2018: Therapeutic Advances in Infectious Disease
Ashley F Soule, Sarah B Green, Lisa M Blanchette
Traditional metronidazole dosing regimens utilize an every 8 h dosing strategy to treat anaerobic and mixed anaerobic infections. However, pharmacokinetic data demonstrate that the half-life of metronidazole is 8-12 h and blood levels at 12 h exceed the in vitro minimum inhibitory concentration (MIC) for most anaerobic infections. The primary objective of this study was to evaluate the frequency of clinical cure among patients who received metronidazole every 12 h compared with those who received an every 8 h frequency...
May 2018: Therapeutic Advances in Infectious Disease
Stacia Crochet, Chun-Chih Huang, Melissa Fries, Rachel K Scott
Background: A case of mother to child transmission (MTCT) of HIV at a medical center in Washington, DC, resulted in the implementation of universal opt-out rapid testing of patients admitted for delivery. This article evaluates the policy's efficacy and implementation. Methods: We evaluated the implementation using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results: We could not evaluate decrease in MTCT rate secondary to low sample size ( n  = 3324) and no true-positive results...
March 2018: Therapeutic Advances in Infectious Disease
Margaret Mokomane, Ishmael Kasvosve, Emilia de Melo, Jeffrey M Pernica, David M Goldfarb
Acute diarrhoeal diseases remain a leading cause of global morbidity and mortality particularly among young children in resource-limited countries. Recent large studies utilizing case-control design, prospective sampling and more sensitive and broad diagnostic techniques have shed light on particular pathogens of importance and highlighted the previously under recognized impact of these infections on post-acute illness mortality and growth. Vaccination, particularly against rotavirus, has emerged as a key effective means of preventing significant morbidity and mortality from childhood diarrhoeal disease...
January 2018: Therapeutic Advances in Infectious Disease
Judy A Frain, Ling Chen
Objective: The purpose of this randomized-controlled pilot study was to explore the effectiveness of a home-based computerized cognitive training intervention in improving cognitive function in a population of older adults with mild cognitive impairment who are living with HIV. Methods: In all, 24 participants were enrolled in this study. All study participants were impaired [defined as Montreal Cognitive Assessment (MoCA) score < 26]; 12 were randomly assigned to a computer-training intervention group and 12 to a control group...
January 2018: Therapeutic Advances in Infectious Disease
Swati Patolia, Getahun Abate, Nirav Patel, Setu Patolia, Sharon Frey
Background: The incidence of multidrug-resistant (MDR) organisms is increasing along with mortality. Identifying risk factors for the development of MDR Gram-negative bacilli (GNB) bacteremia could greatly impact patient care and management. Methods: Data from the electronic health record of patients with GNB over 13-month period were collected at a single university medical center. Baseline demographic data, risk factor, microbiological data, recurrence of bacteremia, and mortality were recorded...
January 2018: Therapeutic Advances in Infectious Disease
Hana Rac, Jamie L Wagner, S Travis King, Katie E Barber, Kayla R Stover
Background: Candidemia represents a leading cause of healthcare-associated bloodstream infections with significant morbidity and mortality. Previous studies have demonstrated that comprehensive care bundles improve candidemia management but are time-consuming. Objective: To determine the impact of a one-time targeted candidemia intervention on time to initiation of adequate therapy compared to standard of care. Methods: This Institutional Review Board (IRB)-approved, quasi-experiment evaluated a targeted candidemia intervention involving a single phone call to the primary team providing recommendations for care...
January 2018: Therapeutic Advances in Infectious Disease
(no author information available yet)
[This corrects the article DOI: 10.1177/2049936117690501.].
November 2017: Therapeutic Advances in Infectious Disease
Nursel Calik Basaran, Sibel Ascioglu
Advancements in medicine have led to a considerable increase in the proportion of patients living with severe chronic diseases, malignancies, and HIV infections. Most of these conditions are associated with acquired immune-deficient states and treatment-related immunosuppression. Although infections as a result of neutropenia have long been recognized and strategies for management were developed, non-neutropenic immunosuppression has been overlooked. Recently, community-acquired infections in patients with frequent, significant exposure to healthcare settings and procedures have been classified as 'healthcare-associated infections' since they are more similar to hospital-acquired infections...
November 2017: Therapeutic Advances in Infectious Disease
Matthew Song, Thomas J Dilworth, Erik Munson, Jim Davis, Ramy H Elshaboury
Purpose: To determine the frequency at which fluoroquinolones and aminoglycosides demonstrate in vitro activity against non-urinary, non-skin/skin structure Pseudomonas aeruginosa isolates exhibiting decreased susceptibilities to one or more β-lactam agents. Methods: β-lactam-non-susceptible P. aeruginosa isolates recovered from blood, bone, lower respiratory tract, pleural fluid, cerebrospinal fluid, or peritoneal fluid cultures between October 2010 and October 2014 were reviewed from four community hospitals within a single health-system...
November 2017: Therapeutic Advances in Infectious Disease
Abraham Pulido-Cejudo, Mario Guzmán-Gutierrez, Abel Jalife-Montaño, Alejandro Ortiz-Covarrubias, Jose Luis Martínez-Ordaz, Héctor Faustino Noyola-Villalobos, Luis Mauricio Hurtado-López
Over the last 25 years, the terminology of skin and soft tissue infections, as well as their classification for optimal management of patients, has changed. The so-called and recently introduced term 'acute bacterial skin and skin structure infections' (ABSSSIs), a cluster of fairly common types of infection, including abscesses, cellulitis, and wound infections, require an immediate effective antibacterial treatment as part of a timely and cautious management. The extreme level of resistance globally to many antibiotic drugs in the prevalent causative pathogens, the presence of risk factors of treatment failure, and the high epidemic of comorbidities (e...
September 2017: Therapeutic Advances in Infectious Disease
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