Infectious Disease

Is Nirmaltrevir-Ritonavir (Paxlovid) Safe for CKD or Dialysis Patients?


We’re trying something new! Watch quick videos, with my personal take on the articles we cover each week and more! Here’s the JournalFeed YouTube channel link. ~Clay


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Modified dose nirmaltrevir-ritonavir is well-tolerated in patients with CKD as therapy for mild COVID-19 and effectively suppresses viral load.

Source
Safety Profile and Clinical and Virological Outcomes of Nirmatrelvir-Ritonavir Treatment in Patients With Advanced Chronic Kidney Disease and Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2023 Aug 2:ciad371. doi: 10.1093/cid/ciad371. Epub ahead of print.

Should We Do Brain Imaging on Suspected Infective Endocarditis Patients?

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Among patients with infective endocarditis (IE), 39% of neurologically “asymptomatic” patients had a cerebral embolic event (CEE) on neuroimaging, and a new surgical indication was established in 19% of these cases. CEEs were seen in 73% of neurologically symptomatic patients. But there were some issues with this study…

Source
Role of Cerebral Imaging on Diagnosis and Management in Patients With Suspected Infective Endocarditis. Clin Infect Dis. 2023 Aug 14;77(3):371-379. doi: 10.1093/cid/ciad192.

SCOUT RCT | 5 or 10-day Treatment for Pediatric UTI?

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This multi-center, double-blinded, non-inferiority trial found that short-course antimicrobial therapy had relatively low treatment failure rates compared to standard-course in children diagnosed with UTI who showed clinical improvement after 5 days of antibiotics.

Source
Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26:e231979. doi: 10.1001/jamapediatrics.2023.1979. Epub ahead of print.

Can We Draw Blood Cultures from an Arterial Line?

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In this multicenter prospective diagnostic study, the proportion of contaminated blood cultures obtained from arterial catheters was noninferior to blood cultures obtained via venipuncture.

Source
Contamination of Blood Cultures From Arterial Catheters and Peripheral Venipuncture in Critically Ill Patients: A Prospective Multicenter Diagnostic Study. Chest. 2023 Jul;164(1):90-100. doi: 10.1016/j.chest.2023.01.030. Epub 2023 Jan 30.

PEN-FAST 2.0 – Directly Testing for PCN Allergy – The PALACE RCT

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Starting with the PEN-FAST Decision Tool, direct oral challenges to low-risk individuals with reported penicillin allergies is safe, effective, and can remove a majority of mislabeled instances.

Source
Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA Intern Med. Published online July 17, 2023. doi:10.1001/jamainternmed.2023.2986

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