Two More Cases of Oseltamivir-Resistant Avian Influenza
In some patients, incomplete viral suppression by standard-dose oseltamivir might lead to drug-resistant strains.
By Allan S. Brett, MD
February 24, 2006
Covering:
de Jong MD et al., N Engl J Med 2005 Dec 22; 353:2667-72
Moscona A., N Engl J Med 2005 Dec 22; 353:2633-6
Preventing TB Transmission in Healthcare Settings
Infectious Diseases Clinical Practice Guideline Watch
Updated CDC guidelines are aimed at avoiding another TB resurgence and eliminating infection of healthcare workers by individuals with unsuspected or undiagnosed TB.
By Richard T. Ellison III, MD
February 24, 2006
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Recomm Rep 2005 Dec 30; 54:1-141
No Benefit of Clarithromycin in Stable Heart Disease
Cardiology Summary and Comment
A randomized trial even detected potential harm from this macrolide antibiotic.
By Beat J. Meyer, MD
February 23, 2006
Covering:
Jespersen CM et al. for the CLARICOR Trial Group., BMJ 2006 Jan 7; 332:22-4
Guideline Implementation: Getting What You Pay For
Emergency Medicine Summary and Comment
A high-intensity strategy for implementing pneumonia guidelines in the ED increased compliance.
By J. Stephen Bohan, MD, MS, FACP, FACEP
February 14, 2006
Covering:
Yealy DM et al., Ann Intern Med 2005 Dec 20; 143:881-94
Influenza A Treatment: Our Shrinking Armamentarium
The CDC recommends against the use of adamantanes for treating influenza A for the remainder of the 2005–2006 flu season.
By Peggy Sue Weintrub, MD
February 10, 2006
Covering:
Bright RA et al., JAMA 2006 Feb 2; 295:e1-4
Don’t Rely on Amantadine and Rimantadine This Flu Season
Infectious Diseases Summary and Comment
Free
High rates of drug resistance among influenza A viruses render the adamantanes useless this year in the U.S.
By Stephen G. Baum, MD
January 27, 2006
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2006 Jan 20; 55:44-6
Healthcare-Associated Pneumonia — An Important New Entity
Infectious Diseases Summary and Comment
Pneumonia developing in nonhospital medical facilities, sometimes termed "healthcare-associated," shares many features with hospital-acquired pneumonia.
By Thomas Glück, MD
January 27, 2006
Covering:
Kollef MH et al., Chest 2005 Dec; 128:3854-62
Hiramatsu K and Niederman MS., Chest 2005 Dec; 128:3784-7
Live Intranasal Influenza Vaccine: Adverse Events Are Minimal
During the first 2 years after licensure, no unexpected serious risks were identified with use according to approved indications.
By Richard T. Ellison III, MD
January 27, 2006
Covering:
Izurieta HS et al., JAMA 2005 Dec 7; 294:2720-5
New Data on Treating Bronchiolitis
In the absence of any medication that consistently and effectively treats bronchiolitis in young children, therapeutic efficacy should be assessed case by case.
By Robert A. Dershewitz, MD, MSc
January 27, 2006
Covering:
Modl M et al., J Pediatr 2005 Nov; 147:617-21
Amirav I et al., J Pediatr 2005 Nov; 147:627-31
Nontuberculous Mycobacterial Immune Reconstitution Inflammatory Syndrome
Antimycobacterial therapy does not appear to improve symptoms associated with this syndrome, but most patients still have favorable outcomes.
By Carlos del Rio, MD
January 18, 2006
Covering:
Phillips P et al., Clin Infect Dis 2005 Nov 15; 41:1483-97
TB Incidence Among HIV-Infected Patients Receiving Antiretrovirals in Developed Countries
TB risk is elevated among patients with a low CD4-cell count at the initiation of potent combination antiretroviral therapy and among those with a poor immunologic response to such therapy.
By Carlos del Rio, MD
January 18, 2006
Covering:
The Antiretroviral Therapy Cohort Collaboration., Clin Infect Dis 2005 Dec 15; 41:1772-82
Lawn SD and Wood R., Clin Infect Dis 2005 Dec 15; 41:1783-6
TB Meningitis: Higher Mortality in HIV-Positive Patients
In a cohort of Vietnamese patients with TB meningitis, HIV-positive patients had higher 9-month mortality rates than HIV-negative patients.
By G. Sonia Nagy, MD
January 18, 2006
Covering:
Thwaites GE et al., J Infect Dis 2005 Dec 15; 192:2134-41
Surveillance for Influenza-Related Deaths of Children
Infectious Diseases Summary and Comment
Free
CDC surveillance shows 153 influenza-associated deaths in U.S. children during the 2003–2004 flu season.
By Robert S. Baltimore, MD
January 13, 2006
Covering:
Bhat N et al., N Engl J Med 2005 Dec 15; 353:2559-67
Two More Cases of Oseltamivir-Resistant Avian Influenza
General Medicine Summary and Comment
In some patients, incomplete viral suppression by standard-dose oseltamivir might lead to drug-resistant strains.
By Allan S. Brett, MD
January 13, 2006
Covering:
de Jong MD et al., N Engl J Med 2005 Dec 22; 353:2667-72
Moscona A., N Engl J Med 2005 Dec 22; 353:2633-6
Live Intranasal Influenza Vaccine: Adverse Events Are Minimal
Infectious Diseases Summary and Comment
During the first 2 years after licensure, no unexpected serious risks were identified with use according to approved indications.
By Richard T. Ellison III, MD
January 13, 2006
Covering:
Izurieta HS et al., JAMA 2005 Dec 7; 294:2720-5
Oseltamivir-Resistant Influenza A (H5N1) Infections in Humans
Infectious Diseases Summary and Comment
Drug-resistant strains were isolated from two patients who died despite oseltamivir treatment.
By Neil R. Blacklow, MD
January 13, 2006
Covering:
De Jong MD et al., N Engl J Med 2005 Dec 22; 353:2667-72
Hospital Admission for CAP: Still a Judgment Call
Infectious Diseases Summary and Comment
Low risk for death on the PSI doesn’t necessarily equal low risk for complications.
By Neil M. Ampel, MD
January 13, 2006
Covering:
Marrie TJ and Huang JQ., Am J Med 2005 Dec; 118:1357-63
Siegel RE., Am J Med 2005 Dec; 118:1312-3
Patient Transport Increases VAP Risk
Infectious Diseases Summary and Comment
Intrahospital transport triples the risk for ventilator-associated pneumonia in critically ill, mechanically ventilated patients.
By Richard T. Ellison III, MD
January 13, 2006
Covering:
Bercault N et al., Crit Care Med 2005 Nov; 33:2471-8
Might Iseganan Prevent VAP?
Infectious Diseases Summary and Comment
Coating the oropharynx with a synthetic antimicrobial peptide did not prevent ventilator-associated pneumonia.
By Neil M. Ampel, MD
January 13, 2006
Covering:
Kollef M et al., Am J Respir Crit Care Med 2006 Jan 1; 173:91-7
Influenza Vaccine: Expanding Indications for Children with Neuromuscular Disease
The CDC Advisory Committee on Immunization Practices (ACIP) has recently recommended influenza vaccination for many high-risk groups, including patients with hemoglobinopathies; patients receiving long-term salicylate . . .
By Peggy Sue Weintrub, MD
January 12, 2006
Covering:
Keren R et al., JAMA 2005 Nov 2; 294:2188-94
Nasal Steroids for Acute Rhinosinusitis
General Medicine Summary and Comment
A randomized trial suggests that inhaled steroids are superior to antibiotics after a week or two of nasal and sinus symptoms.
By Allan S. Brett, MD
January 10, 2006
Covering:
Meltzer EO et al., J Allergy Clin Immunol 2005 Dec; 116:1289-95
Blood Cultures for Pneumonia: Please Make It Stop!
Emergency Medicine Summary and Comment
By Richard D. Zane, MD, FAAEM
January 4, 2006
Covering:
Kennedy M et al., Ann Emerg Med 2005 Nov; 46:393-400
Moran GJ and Abrahamian FM., Ann Emerg Med 2005 Nov; 46:407-8
Walls RM and Resnick J., Ann Emerg Med 2005 Nov; 46:409-11
New Data on Treating Bronchiolitis
General Medicine Summary and Comment
In the absence of any medication that consistently and effectively treats bronchiolitis in young children, therapeutic efficacy should be assessed case by case.
By Robert A. Dershewitz, MD, MSc
January 3, 2006
Covering:
Modl M et al., J Pediatr 2005 Nov; 147:617-21
Amirav I et al., J Pediatr 2005 Nov; 147:627-31
