Infectious Disease

Not Just for Kids – RSV vs Flu Impact on Adults

Infectious Disease, Pulmonary/Allergy

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Respiratory syncytial virus (RSV) is prevalent in hospitalized adults and is associated with higher odds of prolonged hospitalization and mechanical ventilation, particularly in patients with CHF and COPD.

Source
Prevalence and Clinical Outcomes of Respiratory Syncytial Virus versus Influenza in Adults Hospitalized with Acute Respiratory Illness from a Prospective Multicenter Study. Clin Infect Dis. 2023 Jan 24;ciad031. doi: 10.1093/cid/ciad031. Online ahead of print.

Can D-dimer Still Rule Out PE in COVID-19 Patients?

Infectious Disease, Venous Thromboembolism

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A negative D-dimer performed similarly in predicting a 30-day risk of pulmonary embolism (PE) regardless of a patient’s COVID-19 status.

Source
Prognostic association between d-dimer thresholds and 30-day pulmonary embolism diagnosis among emergency department patients with suspected SARS-CoV-2 infection: a Canadian COVID-19 Emergency Department Rapid Response Network study. CJEM. 2023 Feb;25(2):134-142. doi: 10.1007/s43678-022-00440-8. Epub 2023 Jan 10.

Watch Out for Candida auris – Traveling Incognito in Healthcare Settings

Infectious Disease

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Candida auris is an emerging, serious, multi-drug resistant fungal pathogen that can quickly spread in hospitals and long-term care facilities. Consider this in recently hospitalized patients or nursing home residents with a history of C. auris infection or colonization, as they may require appropriate infection control measures, testing, and treatment.

Source
On the Rise, Candida auris Outwits Treatments and Travels Incognito in Health Care Settings. JAMA. 2023 Jan 17;329(3):197-199. doi: 10.1001/jama.2022.17760.

VIZIR RCT – Zinc for COVID-19?

Infectious Disease, Pharmacy/Pharmacology

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Zinc supplementation for patients with COVID-19 decreased 30-day ICU admission rate and led to shorter symptom duration. Subgroup analysis showed these effects were especially pronounced for elderly patients and those with comorbid conditions.

Source
Twice-Daily Oral Zinc in the Treatment of Patients With Coronavirus Disease 2019: A Randomized Double-Blind Controlled Trial. Clin Infect Dis. 2023;76(2):185-191. doi:10.1093/cid/ciac807

New RCT – High-Dose or Standard-Dose Cephalexin for Cellulitis?

Infectious Disease, Pharmacy/Pharmacology

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In this trial, investigators compared high-dose cephalexin (1000 mg QID) to standard dose (500 mg QID) for the treatment of non-purulent cellulitis. They found that high-dose cephalexin was associated with fewer instances of treatment failure but a higher proportion of adverse events.

Source
High-dose cephalexin for cellulitis: a pilot randomized controlled trial. CJEM. 2023 Jan;25(1):22-30. doi: 10.1007/s43678-022-00433-7. Epub 2023 Jan 2.

Clindamycin or Linezolid for Toxic Shock?

Infectious Disease, Pharmacy/Pharmacology

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Current guidelines dictate that treatment of Group A Streptococcus pyogenes (GAS) necrotizing soft tissue infections (NSTI) and toxic shock syndrome (TSS) include clindamycin in conjunction to a beta lactam in order to inhibit exotoxin production; but might we consider co-treatment with linezolid instead?

Source
Should Linezolid Replace Clindamycin as the Adjunctive Antimicrobial of Choice in Group A Streptococcal Necrotizing Soft Tissue Infection and Toxic Shock Syndrome? A Focused Debate. Clin Infect Dis. 2023 Jan 13;76(2):346-350. doi: 10.1093/cid/ciac720.

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