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In the omicron era, nirmatrelvir/ritonavir (Paxlovid) is highly effective in reducing the risk of severe COVID-19 and mortality.
Source
Effectiveness of Paxlovid in Reducing Severe COVID-19 and Mortality in High Risk Patients. Clin Infect Dis. 2022 Jun 2;ciac443. doi: 10.1093/cid/ciac443. Online ahead of print.
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Paxlovid offers an oral option for treating COVID-19 infection. Here is what you need to know before prescribing.
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Using the CASH-75 score can help predict the absence of atypical pathogens (L. pneumophila or M. pneumoniae) as the causative agents of community acquired pneumonia (CAP) in hospitalized patients.
Source
Accuracy of a score predicting the presence of an atypical pathogen in hospitalized patients with moderately severe community-acquired pneumonia. BMC Infect Dis. 2022 May 3;22(1):424. doi: 10.1186/s12879-022-07423-1.
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Among adults with culture-confirmed bacteremic pneumococcal pneumonia, empiric macrolide therapy was associated with 45% reduction in the odds for mortality, regardless of macrolide treatment duration, an effect was not seen with quinolones.
Source
The Effect of Macrolides on Mortality In Bacteremic Pneumococcal Pneumonia: A Retrospective Nationwide Cohort Study, Israel, 2009-2017. Clin Infect Dis. 2022 Apr20;ciac317. Doi: 10.1093/cid/ciac317.
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We are writing too many prescriptions for antibiotics for acute otitis media. Here is how we can improve.
Source
Rethinking Our Approach to Management of Acute Otitis Media. JAMA Pediatr. 2022 May 1;176(5):439-440. doi: 10.1001/jamapediatrics.2021.6575.
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Antibiotics have a good and bad side for women with uncomplicated cystitis. Use of trimethoprim-sulfamethoxazole (TMP-SMX) and other antibiotics, when compared to nitrofurantoin, had higher risk of adverse events.
Source
Association of Adverse Events With Antibiotic Treatment for Urinary Tract Infection. Clin Infect Dis. 2022 Apr 28;74(8):1408-1418. doi: 10.1093/cid/ciab637.
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Race was strongly associated with UTI risk, with non-Black children having 2-4 times greater odds of infection. However, replacement of race with 2 other variable resulted in similar diagnostic accuracy for the UTICalc tool.
Source
Reassessment of the Role of Race in Calculating the Risk for Urinary Tract Infection: A Systematic Review and Meta-analysis. JAMA Pediatr. 2022 Apr 18. doi: 10.1001/jamapediatrics.2022.0700. Online ahead of print.
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Serious bacterial infection was rare in well appearing, afebrile infants with omphalitis, suggesting that routinely obtaining cultures may not be needed.
Source
Omphalitis and Concurrent Serious Bacterial Infection. Pediatrics. 2022 Apr 20;e2021054189. doi: 10.1542/peds.2021-054189. Online ahead of print.
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This brief report found that certain monoclonal antibodies: imdevimab-casirivimab (also known as REGEN-COV), tixagevimab-cilgavimab (also known as EVUSHELD), and sotrovimab precursor had lower neutralizing ability against the omicron BA.2 variant of COVID-19 than against earlier variants.
Source
Efficacy of Antiviral Agents against the SARS-CoV-2 Omicron Subvariant BA.2. N Engl J Med. 2022 Apr 14;386(15):1475-1477. doi: 10.1056/NEJMc2201933. Epub 2022 Mar 9.
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A new, rare form of acute hepatitis has been seen in children, mostly under age 5 years, that presents with vomiting, diarrhea, and abdominal pain, followed by acute hepatitis with jaundice. If you see a child with a “stomach virus” who has jaundice – check labs!
Source
Acute hepatitis is identified in more children, but cause remains elusive. BMJ. 2022 May 6;377:o1156. doi: 10.1136/bmj.o1156.
