Want help keeping up with ID/stewardship publications? We have got your back! Here are our picks for the top new ID/stewardship journal articles trending on Twitter from August 2018.
Authored By: Bassam Ghanem, Pharm.D., MS, BCPS & Timothy P. Gauthier, Pharm.D., BCPS-AQ ID
[Last updated: 14 September 2018]
Keeping up with literature within a niche area of a given field can be challenging. Staying current with literature in an entire specialty is arguably impossible. This is one of the big reasons some professionals are drawn to Twitter and other social media networks: to stay in the loop!
Both of the accounts @ABsteward (B.G.) & @IDstewardship (T.P.G.) are here to help and in this new monthly publication series we will be providing summaries to help you keep an eye on the leading edge of science in the fields of antimicrobial stewardship & infectious diseases.
The following are new publications we found most interesting or noteworthy in August of 2018. We do not have strict criteria on article selection.
ARTICLE #1
POET: Partial oral versus intravenous antibiotic treatment of endocarditis | NEJM.
Link: https://www.nejm.org/doi/full/10.1056/NEJMoa1808312
Patients with left-sided endocarditis are typically treated with intravenous antibiotics for 6 weeks. POET was a randomized, non-inferiority, multicenter trial which found that in patients who had left sided endocarditis caused by streptococcus, E. faecalis, S. aureus, or coagulase-negative staphylococci, who were in clinically stable condition, a shift from initial intravenous to oral antibiotic treatment on about day 17 was non-inferior to continued intravenous antibiotic treatment.
ARTICLE #2
Four months of rifampin or nine months of isoniazid for latent tuberculosis in adults | NEJM
Link: https://www.nejm.org/doi/full/10.1056/NEJMoa1714283
Patients with latent tuberculosis are typically treated with a 9-month regimen of isoniazid. However, this regimen has been associated with poor adherence and toxic effects. This randomized controlled trial involving more than 6,800 adults in nine countries found that the 4 months regimen of rifampin was non-inferior to the 9 month regimen of isoniazid for the prevention of active tuberculosis and was associated with a higher rate of treatment completion and better safety.
ARTICLE #3
Emergency department visits for adverse drug events from antibiotics in children, 2011-2015 | JPIDS
Link: https://academic.oup.com/jpids/advance-article/doi/10.1093/jpids/piy066/5063274
Antibiotics are among the most commonly prescribed medications for children. Researchers from CDC estimated the frequencies and rates of emergency department (ED) visits for antibiotic adverse drug events (ADE) in children using nationally representative public health surveillance data from 2011-2015. ADEs to antibiotics in children led to an estimated 69,464 ED visits in US each year. Two-fifths (40.7%) of ED visits for antibiotic ADEs involved a child aged ≤2 years, and 86.1% involved an allergic reaction. Amoxicillin was the most commonly implicated antibiotic among children aged ≤9 years.
ARTICLE #4
Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in intensive care unit patients with infection and sepsis patients: a patient-level meta-analysis of randomized trials | Critical Care
Link: https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2125-7
The clinical utility of serum procalcitonin (PCT) levels in guiding antibiotic treatment decisions in patients with sepsis remains unclear and widely debated. This meta-analysis of individual patient data from 11 randomized trials included 4,482 patients revealed that PCT-guided antibiotic treatment in ICU patients with sepsis resulted in lower mortality (NNT = 38.5) and shorter antibiotic treatment duration (-1.1 days).
ARTICLE #5
Incidence of acute kidney injury among critically ill patients with brief empiric use of anti-pseudomonal beta-lactams with vancomycin | CID
Link: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy724/5079140
The combination of piperacillin/tazobactam and vancomycin (PTZ/VAN) has been identified as likely nephrotoxic, but existing studies focus on extended durations. This retrospective cohort study of 3,299 ICU patients compared the risk of acute kidney injury with a short course of PTZ/VAN up to 72 hours to other anti-pseudomonal beta-lactam/vancomycin combinations. They found that brief exposure to PTZ/VAN was not associated with a greater risk of short- or 60-day adverse renal outcomes compared to other empiric broad-spectrum combinations.
ARTICLE #6
Does shared decision-making reduce antibiotic prescribing in primary care? | JAC
Outpatient antibiotic use is a new frontier in antimicrobial stewardship, but how can physicians get their patients on board with their treatment plans? There is a lot of interest in shared decision-making (SDM) to help address this question. In this study a questionnaire answered by ~1,200 members of the Dutch Health Care Consumer Panel found that in practices employing SDM, general practitioners prescribed fewer antibiotics to adult patients under the age of 40, in preference-sensitive situations.
ARTICLE #7
Optimal treatment of MSSA bacteraemias: a meta-analysis of cefazolin versus antistaphylococcal penicillins |JAC
Link: https://academic.oup.com/jac/advance-article-abstract/doi/10.1093/jac/dky259/5066380?redirectedFrom=fulltext
Controversy exists over the optimal treatment of MSSA bacteraemia. This meta-analysis compared the clinical outcomes between cefazolin and antistaphylococcal penicillins (ASPs). The meta analysis concluded that cefazolin appeared to be better tolerated and was associated with a significant decrease in 90-day mortality compared to ASPs. No differences in clinical failure were observed.
Additional notable articles not included above…
- Significant Publications on Infectious Diseases Pharmacotherapy in 2017 | JPP
- The essential role of pharmacists in antibiotic stewardship in outpatient care: An official position statement of the Society of Infectious Diseases Pharmacists | JAPhA
- Doxycycline in UK guidelines for hospital-acquired pneumonia: where is the evidence base? | JAC
- Contraindicated drug–drug interactions associated with oral antimicrobial agents prescribed in the ambulatory care setting in the United States | CMI
- A PrEP model incorporating clinical pharmacist encounters and antimicrobial stewardship program oversight may improve retention in care | CID
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