Urgent Updates:  December 2022

Extended Follow-up of Microbiome Therapeutic SER-109 Through 24 Weeks for Recurrent Clostridioides Difficile Infection (RCDI) In a Randomized Clinical Trial

In a phase 3 trial (ECOSPOR III), SER-109, an investigational microbiome therapeutic composed of purified Firmicutes spores, was superior to placebo in reducing the rate of rCDI by week 8 (12% vs 40%; relative risk [RR], 0.32 [95% CI, 0.18-0.58]) SER-109 durably reduced rCDI rates and was well-tolerated through 24 weeks in patients with prevalent comorbidities. The benefit of SER-109 was evident as early as week 2, highlighting the need for rapid microbiome repair after completing standard-of-care antibiotics. 

Full Access: JAMA

 

Most Global Bacterial Deaths in 2019 Linked to Five Pathogens

Overall, lower respiratory infections were responsible for 4 million deaths, bloodstream infections accounted for 2.91 million deaths, and peritoneal and intra-abdominal infections for 1.28 million deaths. The findings, published in The Lancet, point to Staphylococcus aureus as the leading cause of bacterial death in 135 countries and Streptococcus pneumoniae associated with the most deaths in children younger than 5 years. The three other most clinically significant pathogens were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Full Access: Lancet

 

Paxlovid for Treatment of Long Covid (STOP-PASC)

The purpose of this study is to compare whether being treated with Paxlovid (nirmatrelvir plus ritonavir) for 15 days works better than being treated with placebo (plus ritonavir) to reduce severe symptoms of Long Covid. Participants will have 5 planned visits to the study clinic over 18 weeks and will take the drug (or placebo) for the first 15 days. An exploratory sub-study will investigate the correlation of physical activity and biometric parameters from digital wearable devices with the subjective symptom severity and other patient-reported outcomes in the main study. Full Access: Clinical Trials

 

FDA: Amoxicillin Shortage Hits U.S., How This Antibiotic Is Misused for Respiratory Illnesses

Since October 28, amoxicillin oral powder for suspension has been on the U.S. Food and Drug Administration’s (FDA’s) list of drug shortages. But a shortage of a commonly prescribed antibiotic like amoxicillin can be much more serious, it means that there may be one less option should you develop a bacterial infection in your ears, nose, throat, respiratory tract, urinary tract, or skin. Full Access: Forbes

 

WEEK 2 (12/08)

 

Endemic Mycoses: Underdiagnosed and Underreported

Blastomycosis, coccidioidomycosis, and histoplasmosis are the endemic mycoses that are most prevalent in North America. Exposure within the focal endemic regions is often unavoidable, and patients are frequently unaware of activities that increase individual risk. After the infectious “spores” are inhaled, these fungal pathogens often survive macrophage ingestion and escape, thereafter replicating and producing clinical illness. Full Access: Annals of Internal Medicine

 

Shorter Duration of Antibiotics Noninferior for Lyme Disease

A shorter course of oral doxycycline is effective in treating erythema migrans, the most frequent manifestation of early Lyme borreliosis, and can reduce harmful antibiotic use. The trial, conducted in Slovenia, randomly assigned 300 adults with solitary erythema to receive oral doxycycline, 100mg twice a day for 7 or 14 days. Although 7 days of oral doxycycline is effective for treating Lyme disease in adult European patients, the authors called for a similar study to be conducted in the US. Full Access: JAMA

 

Analysis of Antibiotic Exposure and Early-Onset Neonatal Sepsis (EOS) in Europe, North America, and Australia

In this cross-sectional study of 757,979 neonates born in 13 networks from 11 countries, 2.86% received antibiotics during the first postnatal week (range across networks, 1.18%-12.45%). The incidence of EOS was 0.49 cases per 1000 live births, and the EOS-associated mortality rate was 3.20%. Early postnatal antibiotic use was high compared with the rate of sepsis and varied across networks, suggesting it could be lowered safely. Full Access: JAMA

 

Could NSAIDs Like Ibuprofen, Aleve Make Arthritic Knees Worse?

Over-the-counter pain relievers like aspirin, Aleve or ibuprofen don’t do a thing to slow the progression of knee arthritis, and might even make things worse, a new study suggests.

Knee arthritis patients who regularly took nonsteroidal anti-inflammatory drugs (NSAIDs) wound up with worse knee inflammation and weakened cartilage, compared to a “control” group not taking the medications. Full Access: Healthday

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