Urgent Updates | December 8, 2022

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, 100 mg 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