ANTIBIOTICS FOR LOWER RESPIRATORY TRACT INFECTION IN CHILDREN PRESENTING IN PRIMARY CARE IN ENGLAND (ARTIC PC): A DOUBLE-BLIND, RANDOMISED, PLACEBO-CONTROLLED TRIAL
Antibiotics are very commonly prescribed for children presenting with uncomplicated lower respiratory tract infections (LRTIs), but there is little evidence from randomized controlled trials of the effectiveness of antibiotics. No differences were seen for the primary outcome between the treatment groups in the five prespecified clinical subgroups (patients with chest signs, fever, physician rating of unwell, sputum or chest rattle, and short of breath). Unless pneumonia is suspected, clinicians should provide safety-netting advice but not prescribe antibiotics for most children presenting with chest infections.
Full Access: The Lancet

DRUG COCKTAIL SIGNIFICANTLY REDUCED SEVERE COVID, DEATH IN OUTPATIENTS
A monoclonal antibody combination of casirivimab and imdevimab (REGEN-COV) significantly reduced the risk of COVID-19–related hospitalizations and death from any cause in the phase 3 portion of an adaptive trial of outpatients. Additionally, the randomized trial showed that the combination resolved symptoms and reduced the SARS-CoV-2 viral load more quickly compared with placebo.
Full Access: Medscape

FDA OKAYS NEW ORAL CGRP ANTAGONIST FOR MIGRAINE PREVENTION
The US Food and Drug Administration has approved atogepant (Qulipta), a novel calcitonin gene-related peptide (CGRP) receptor antagonist, for the prevention of episodic migraines. In the ADVANCE trial, there was a reduction of 3.69 migraine days with the 10-mg dose, 3.86 days with the 30-mg dose, and 4.2 days with the 60-mg dose. The data indicated that atogepant has a favorable safety profile, with the most common adverse events associated with treatment were constipation, nausea, and upper respiratory tract infection.
Full Access: Medscape

FDA APPROVES INTRANASAL DHE (TRUDHESA) FOR ACUTE MIGRAINE
The US Food and Drug Administration (FDA) has approved an intranasal dihydroergotamine mesylate 0.725 mg per spray (DHE) for the acute treatment of migraine with or without aura in adults. Some of the most frequently reported adverse events during the study were nasal congestion, nausea, nasal discomfort, abnormal olfactory test results, and vomiting. The outcomes related to efficacy showed that 2 hours after a single dose, 38% of patients reported freedom from pain.
Full Access: Medscape

TWO MORE REPORTS OF FUNCTIONAL NEUROLOGICAL DISORDER AFTER COVID-19 VACCINE
Researchers in the United Kingdom report two cases of functional neurological disorder (FND) that occurred in women in their 30s after they received a COVID-19 vaccine. Symptoms of FND include muscle weakness, fatigue, cognitive impairment, dizziness, and impaired gait. They suggest that clinicians consider FND in the differential diagnosis when assessing post-vaccine neurologic symptoms. The researchers stress that FND is treatable, that no brain damage is involved, and that it is not caused by some toxin in the vaccine.
Full Access: Medscape