Urgent Updates:  March 2023

Study Estimates Global Prevalence of SJS/TEN Linked to Antibiotics

According to the first meta-analysis to examine the worldwide prevalence of Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) in connection with antibiotics, researchers found that antibiotics were associated with 28% of all cases of SJS and TEN. The metanalysis involved 38 studies with 2,917 patients from more than 20 countries. 86% of all SJS/TEN cases were associated with a single drug, with the rest involving multiple drug triggers, infections, or other causes. More than a quarter (28%) of those patients had used an antibiotic, and the sulfonamides were the class most often triggering SJS/TEN. Full Access: Medscape

FDA Authorizes First Over-the-Counter At-Home Test to Detect Both Influenza and COVID-19 Viruses

The U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the first over-the-counter (OTC) at-home diagnostic test that can differentiate and detect influenza A and B, commonly known as the flu, and SARS-CoV-2, the virus that causes COVID-19. The Lucira COVID-19 & Flu Home Test is a single-use at-home test kit that provides results from self-collected nasal swab samples in roughly 30 minutes.  Full Access: FDA

Paxlovid Doesn’t Increase Risk for Rebound COVID Infection: Study

Researchers found that patients who received Paxlovid, Lagevrio, or no antiviral medication had rebounds at similar rates, ranging from 4.5% to 6.6%. The study included 4,592 people in Hong Kong who were hospitalized within 3 days of a COVID diagnosis. The study period during the time that the Omicron subvariant BA.2.2 was predominant. Full Access: The Lancet

Increase in Extensively Drug-Resistant Shigellosis in the United States

The Centers for Disease Control and Prevention (CDC) has been monitoring an increase in extensively drug-resistant (XDR) Shigella infections (shigellosis) reported through national surveillance systems. Clinicians treating patients infected with XDR strains have limited antimicrobial treatment options. XDR Shigella strains can spread antimicrobial resistance genes to other enteric bacteria. Given these potentially serious public health concerns, CDC asks healthcare professionals to be vigilant about suspecting and reporting cases of XDR Shigella infection to their local or state health department and educating patients and communities at increased risk about prevention and transmission. Full Access: CDC

 A Woman Dies Every Two Minutes Due to Pregnancy or Childbirth: UN Agencies

New Data Show Major Setbacks for Maternal Health in Many Parts of the World, Highlighting Stark Disparities in Healthcare Access

Every two minutes, a woman dies during pregnancy or childbirth, according to the latest estimates released in a report by United Nations agencies. The report, which tracks maternal deaths nationally, regionally and globally from 2000 to 2020, shows there were an estimated 287 000 maternal deaths worldwide in 2020. In two of the eight UN regions – Europe and Northern America, and Latin America and the Caribbean – the maternal mortality rate increased from 2016 to 2020, by 17% and 15% respectively. Full Access: WHO

Doxy PEP Does Not Lower Risk of STIs in Cisgender Women

The benefits of doxycycline postexposure prophylaxis (Doxy PEP) in preventing the transmission of sexually transmitted infections (STIs) in men and transgender women do not appear to extend to cisgender women, who have disproportionately high rates of infection in many regions. Full Access: Medscape

 Effect of an Intranasal Corticosteroid on Quality of Life and Local Microbiome in Young Children with Chronic Rhinosinusitis – A Randomized Clinical Trial

In this open label randomized clinical trial including 63 children, the group treated with intranasal mometasone presented better clinical improvement, a greater increase in nasopharyngeal microbiome richness, and a greater decrease in nasal ILC3 abundance compared with the control group. Intranasal corticosteroids may be clinically effective in the treatment of pediatric chronic rhinosinusitis and may help correct sinonasal dysbiosis. This randomized clinical trial demonstrated that treatment with an INC improved the quality of life of children with CRS and had a significant effect on increasing sinonasal biodiversity. Full Access: JAMA

Physicians Are More Burned Out Than Ever—Here’s What Can Be Done About It

Despite a growing body of evidence supporting a systemic approach to health care worker well-being, we’ve seen some alarming trends in burnout and turnover in health care. Suggestions to address burnout includes creating a “culture of well-being.” It lays out 7 priority areas for action: creating positive work and learning environments, investing in assessment and research, supporting mental health, addressing regulatory and policy barriers, using effective technology, adopting well-being as an institutional value, maintaining a diverse, inclusive health care workforce. Full Access: JAMA