Urgent Updates | July 7, 2022 

A MULTISITE COLLABORATIVE TO DECREASE INAPPROPRIATE ANTIBIOTICS IN URGENT CARE CENTERS
The Society of Pediatric Urgent Care invited pediatric UC clinicians to participate in a multisite quality improvement study from June 2019 to December 2019. The diagnoses included acute otitis media (AOM), otitis media with effusion, and pharyngitis. Algorithms based on published guidelines were used to identify inappropriate antibiotic prescriptions according to indication, agent, and duration.  Participating pediatric UC providers decreased inappropriate antibiotic prescriptions from 60.3% to 27.8% using publicly available interventions.
Full Access: AAP

PERIL IN PARADISE: RAT LUNGWORM’S THREAT IN TROPICAL GETAWAYS
ANGIOSTRONGYLUS CANTONENSIS: AGENT OF A SOMETIMES FATAL GLOBALLY EMERGING INFECTIOUS DISEASE (RAT LUNGWORM DISEASE)
Ever since A. cantonensis, also called “rat lungworm,” was first discovered in southern China in the mid-1930s, the neurotropic nematode has slowly but inexorably spread. Today it inhabits tropical islands and warm, humid areas of five continents.  Rat lungworm is a dangerous invasive species that is the agent of a potentially fatal globally emerging infectious disease. Humans are infected most commonly by ingestion, deliberately or inadvertently, of the parasite larvae in their intermediate snail hosts. The larvae make their way to the brain where they can cause severe neurological damage before eventually dying.
Full Access: Pubmed

IMPACT OF FLUOROQUINOLONE CASCADE REPORTING OF URINE SAMPLES ON ANTIBIOTIC PRESCRIBING RATES IN A NETWORK OF URGENT CARE CLINICS
Cascade reporting is an antimicrobial stewardship strategy that has been successfully implemented in inpatient settings, but evidence of its impact on outpatient settings is scarce. 

Cascade reporting of antimicrobial susceptibility of Enterobacterales in urine cultures is a feasible and sustainable antimicrobial stewardship that can be applied in urgent care and express care clinics in an integrated health system.
Full Access: ASHE

HOSPITALIZATION AND EMERGENCY DEPARTMENT ENCOUNTERS FOR COVID-19 AFTER PAXLOVID TREATMENT — CALIFORNIA, DECEMBER 2021–MAY 2022
In this analysis of data from patients aged ≥12 years in a large integrated health care system who received Paxlovid treatment during December 2021–May 2022, hospitalizations or ED encounters for COVID-19–related illness during the 5–15 days after Paxlovid dispensation occurred among <1% of all patients. The rarity of these outcomes is consistent with evidence from recent case reports and large observational studies, which found that symptoms experienced by patients with COVID-19 rebound after treatment with Paxlovid are milder than those experienced during the primary infection (35) and are unlikely to lead to hospitalization.
Full Access: CDC