Infectious disease physician characteristics and prescription of meropenem in the hospital

Abstract Objective: Physician characteristics may be correlated with medical treatment decisions and patient outcomes. This study examined the correlations between characteristics of infectious disease (ID) physicians and the use of the restricted antimicrobial meropenem. Design: This was a retrospective cohort study following 27 attending ID physicians for 5 years at a large academic medical center. Methods: All inpatient ID clinical encounters between 2013 and 2018 were assessed for physician and patient characteristics, including patient Charlson Comorbidity Index, patient sex, ID service seeing the patient, physician career stage, physician training location, and physician sex. Adjusted and unadjusted odds ratios were calculated for the receipt of meropenem on the same day as an ID clinical note. Results: Between 2013 and 2018, meropenem was administered on the same day as 9046 (11.1%) of 81,787 inpatient ID encounters. After adjustment for patient and practice-specific factors, physician career stage was associated with administration of meropenem. Patients seen by mid-career and late-career ID physicians were more likely to receive meropenem than those seen by early-career physicians (aOR 1.22 95% confidence interval [CI 1.13–1.31 and aOR 1.17 95% CI 1.10–1.25, respectively). Conclusions: ID provider characteristics may help target future antimicrobial stewardship program interventions

Imported Haycocknema perplexum Infection, United States

We report an imported case of myositis caused by a rare parasite, Haycocknema perplexum, in Australia in a 37-year-old man who had progressive facial, axial, and limb weakness, dysphagia, dysphonia, increased levels of creatine kinase and hepatic aminotransferases, and peripheral eosinophilia for 8 years. He was given extended, high-dose albendazole. © 2022 Centers for Disease Control and Prevention (CDC). All rights reserved

Personalised dosing: Printing a dose of one's own medicine

© 2015 Elsevier B.V. All rights reserved. Ink-jet printing is a versatile, precise and relatively inexpensive method of depositing small volumes of solutions with remarkable accuracy and repeatability. Although developed primarily as a technology for image reproduction, its areas of application have expanded significantly in recent years. It is particularly suited to the manufacture of low dose medicines or to short production runs and so offers a potential manufacturing solution for the paradigm of personalised medicines. This review discusses the technical and clinical aspects of ink-jet printing that must be considered in order for the technology to become widely adopted in the pharmaceutical arena and considers applications in the literature

Toxin-Specific Antibodies for the Treatment of Clostridium difficile: Current Status and Future Perspectives †

Therapeutic agents targeting bacterial virulence factors are gaining interest as non-antibiotic alternatives for the treatment of infectious diseases. Clostridium difficile is a Gram-positive pathogen that produces two primary virulence factors, enterotoxins A and B (TcdA and TcdB), which are responsible for Clostridium difficile-associated disease (CDAD) and are targets for CDAD therapy. Antibodies specific for TcdA and TcdB have been shown to effectively treat CDAD and prevent disease relapse in animal models and in humans. This review summarizes the various toxin-specific antibody formats and strategies under development, and discusses future directions for CDAD immunotherapy, including the use of engineered antibody fragments with robust biophysical properties for systemic and oral delivery

Adverse events in faecal microbiota transplant: a review of the literature.

Faecal microbiota transplant (FMT) is the infusion of donor faeces into the gut with the aim of improving microbial diversity. The procedure has gained significant interest recently in the treatment of recurrent Clostridium difficile infection (CDI). The literature is currently dominated by small case series and isolated case reports. There is no standardization of methods and recording of outcomes.Submitted (immediately with CC-BY-NC-ND), or accepted after 12 month embargo (CC-BY-NC-ND

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.Peer reviewe