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There was a strong association with lower mortality and hospitalization in high-risk patients with COVID-19 who were treated with either nirmatrelvir/ritonavir or molnupiravir.

Source
Nirmatrelvir or Molnupiravir Use and Severe Outcomes From Omicron Infections. JAMA Netw Open. 2023 Sep 5;6(9):e2335077. doi: 10.1001/jamanetworkopen.2023.35077.

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.

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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.

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Neurosyphilis is on the rise – brush up on the facts now before you miss it.

Source
State-of-the-Art Review: Neurosyphilis. Clin Infect Dis. 2023 Aug 18;ciad437. doi: 10.1093/cid/ciad437. Online ahead of print.

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Syphilis is on the rise in certain subgroups. This article provides a well-organized infographic that can be used to summarize treatment and management of patients in all stages of infection.

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Children with persistent or worsening rhinosinusitis experienced a modest improvement in symptoms when given amoxicillin-clavulanate vs. placebo.

Source
Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial. JAMA. 2023;330(4):349-358. doi:10.1001/jama.2023.10854

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Is taking a croupy child outdoors in the cold air an old wive's tale or evidence-based practice? Turns out, it actually works!

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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.

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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.

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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