Urgent Updates | February 29, 2024

Paxlovid is Effective but Underused—Here’s What the Latest Research Says About Rebound and More

Approximately 33 000 patients were hospitalized for COVID-19 in the US during the week ending January 13, a period in which 1 in 25 US deaths were due to the disease. One likely reason: relatively few eligible patients are getting nirmatrelvir-ritonavir, the preferred treatment for keeping mild to moderate COVID-19 from progressing to severe disease. Under the US government’s Patient Assistance Program, the treatment will remain free through the end of this year for Medicare or Medicaid beneficiaries and for those who are uninsured. Insured individuals can enroll in the PAxcess program, which can cover their out-of-pocket costs. Full Access: JAMA

Real-World Users of Triple Therapy for Asthma in the US

This retrospective cohort study used medical and pharmacy claims data of adults with asthma with or without chronic obstructive pulmonary disease (COPD) initiated on triple therapy with single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) or multiple-inhaler triple therapy (MITT). A total of 12,395 patients were included. In real-world practice, triple therapy is often utilized following other asthma controller medication use. High disease burden, as evidenced by substantial use of rescue medications and continued asthma-related exacerbations, suggests that patients may not have achieved adequate asthma control prior to triple-therapy initiation. Full Access: AJCM

Characteristics of Sudden Unexpected Infant Deaths on Shared and Nonshared Sleep Surfaces

Among Sudden unexpected infant deaths (SUID), surface sharing and nonsharing infants varied by age at death, race and ethnicity, insurance type, presence of unsafe sleep factors, prenatal smoke exposure, and supervisor impairment. Most SUID, regardless of sleep location, had multiple unsafe sleep factors present, demonstrating the need for comprehensive safe sleep counseling for every family at every encounter. Full Access: AAP

Oral Gepotidacin versus Nitrofurantoin in Patients with Uncomplicated Urinary Tract Infection (EAGLE-2 And EAGLE-3): Two Randomized, Controlled, Double-Blind, Double-Dummy, Phase 3, Non-Inferiority Trials

Gepotidacin was non-inferior to nitrofurantoin in both studies and superior to nitrofurantoin in EAGLE-3. The most common adverse event with gepotidacin was diarrhea, whereas the most common adverse event with nitrofurantoin was nausea. Cases were mostly mild or moderate. No life-threatening or fatal events occurred.

Gepotidacin is an efficacious oral antibiotic with acceptable safety and tolerability profiles. As a first-in-class investigational oral antibiotic with activity against common uropathogens, including clinically important drug-resistant phenotypes, gepotidacin has the potential to offer substantial benefit to patients. Full Access: The Lancet

Identifying the Best Initial Oral Antibiotics for Adults with Community-Acquired Pneumonia: A Network Meta-Analysis

In this meta-analysis researchers compared the rates of clinical response and mortality for empiric oral antibiotic regimens in adults with mild-moderate community-acquired pneumonia (CAP). Researchers included randomized trials of adults with radiologically confirmed mild to moderate CAP initially treated orally and reporting clinical cure or mortality. They found trends toward a better clinical response and lower mortality for quinolones as empiric antibiotics for CAP, but found no conclusive evidence of any antibiotic being clearly more effective than another. More trials are needed to inform guideline recommendations on the most effective antibiotic regimens for outpatients with mild to moderate CAP. Full Access: Journal of General Internal Medicine