Research Roundup: Antibiotics; Myocarditis; Convalescent Plasma; Seasonal Viruses; Staph Infections

CIDRAP:
UK Study Supports Oral Antibiotics For Patients With Bone, Joint Infections

A study by UK researchers published today in Clinical Infectious Diseases indicates that findings of the Oral Versus Intravenous Antibiotics (OVIVA) trial can be implemented into clinical practice. The OVIVA trial, conducted in the United Kingdom, found that oral antibiotic therapy was non-inferior to intravenous therapy when used during the first 6 weeks in patients with bone and joint infections (BJIs). The results of the trial were initially presented in 2017 and published in 2019, but to date there have been no reports describing their reproducibility in real-world settings. (9/14)

American Academy Of Pediatrics:
Reducing Antibiotic Prescribing In Primary Care For Respiratory Illness

One-third of outpatient antibiotic prescriptions for pediatric acute respiratory tract infections (ARTIs) are inappropriate. We evaluated a distance learning program’s effectiveness for reducing outpatient antibiotic prescribing for ARTI visits. (Kronman et al, 9/1)

CIDRAP:
Rapid Diagnostics, Stewardship Linked To Quicker Time To Optimal Antibiotics

The introduction of a rapid diagnostic test (RDT) in conjunction with antimicrobial stewardship (AMS) activities and infectious disease (ID) consultation at an academic tertiary medical center was associated with shortened time to optimal antibiotic therapy in patients with bloodstream infections, University of Maryland researchers reported in Open Forum Infectious Diseases. In the retrospective quasi-experimental study, researchers with the University of Maryland’s School of Medicine and School of Pharmacy compared time to optimal antibiotic therapy and clinical outcomes in patients with gram-negative bloodstream infection (GN BSI) during three different periods: pre-RDT/AMS, post-RDT/pre-AMS, and post-RDT/AMS. Rapid diagnostics, stewardship linked to quicker time to optimal antibiotics. (9/14)

CIDRAP:
Antibiotic Overuse Noted After Discharge In Pneumonia, UTI Patients

A study of patients diagnosed as having pneumonia and urinary tract infections (UTIs) at 46 hospitals in Michigan found that about half had antibiotic overuse after discharge, researchers reported late last week in Clinical Infectious Diseases. The retrospective cohort study, led by researchers with Michigan Medicine, looked at patients treated for pneumonia or UTI at hospitals in the Michigan Hospital Medicine Safety Consortium from July 2017 through 2019 to quantify the proportion of patients discharged with antibiotic overuse, which was defined as unnecessary antibiotic use, excess antibiotic duration, or suboptimal fluoroquinolone use. The researchers used linear regression analysis to assess hospital-level association between antibiotic overuse after discharge in patients treated for pneumonia versus patients treated for UTI. (9/14 )

Also —

JAMA Network:
Cardiovascular Magnetic Resonance Findings In Competitive Athletes Recovering From COVID-19 Infection 

Myocarditis is a significant cause of sudden cardiac death in competitive athletes and can occur with normal ventricular function.1 Recent studies have raised concerns of myocardial inflammation after recovery from coronavirus disease 2019 (COVID-19), even in asymptomatic or mildly symptomatic patients.2 Our objective was to investigate the use of cardiac magnetic resonance (CMR) imaging in competitive athletes recovered from COVID-19 to detect myocardial inflammation that would identify high-risk athletes for return to competitive play. (Rajpal et al, 9/11)

CIDRAP:
Small Study Finds Benefit From Convalescent Plasma In Severe COVID-19

Preliminary data from a small study published today in Nature Medicine suggests convalescent plasma may have some efficacy in patients with severe COVID-19. The retrospective, propensity score-matched case-control study involved 39 patients who received convalescent plasma for severe or life-threatening COVID-19 at Mount Sinai Hospital in New York from Mar 20 to Apr 20. The patients, who were an average age of 55 and had few baseline comorbidities other than obesity (mean mass body index, 31.7), received convalescent plasma under compassionate use guidelines an average of 4 days after admission. For the analysis, they were matched 1:4 to 156 control patients admitted during the same period. (9/15)

Frontiers:
Seasonality Of Respiratory Viral Infections: Will COVID-19 Follow Suit? 

Respiratory viruses, including coronaviruses, are known to have a high incidence of infection during winter, especially in temperate regions. Dry and cold conditions during winter are the major drivers for increased respiratory tract infections as they increase virus stability and transmission and weaken the host immune system. The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged in China in December 2020 and swiftly spread across the globe causing substantial health and economic burdens. Several countries are battling with the second wave of the virus after a devastating first wave of spread, while some are still in the midst of their first wave. It remains unclear whether SARS-CoV-2 will eventually become seasonal or will continue to circulate year-round. In an attempt to address this question, we review the current knowledge regarding the seasonality of respiratory viruses including coronaviruses and the viral and host factors that govern their seasonal pattern. Moreover, we discuss the properties of SARS-CoV-2 and the potential impact of meteorological factors on its spread. (Audi et al, 9/15)

CIDRAP:
New Guidelines Issued For S Aureus Prevention, Control In NICUs

The Centers for Disease Control and Prevention (CDC) has issued new recommendations for the prevention and control of Staphylococcus aureus in neonatal intensive care unit (NICU) patients. The guidelines are based on current understanding of the transmission dynamics of S aureus in the NICU and were developed through a systematic review of the best available literature available through August 2019. The review was guided by questions about the most effective strategies for preventing S aureus transmission from colonized or infected NICU patients, which sampling sites and laboratory assays most effectively identify colonization in NICU patients, and what risk factors exist for S aureus infection in NICU patients. (9/15)