Infectious Disease & Sepsis

Combination therapy with colistin and meropenem was not superior to colistin monotherapy for the treatment of pneumonia or BSI caused by XDR A. baumannii, P. aeruginosa, or CRE in 464 patients who were enrolled in a randomized study published in NEJM evidence.

There was no difference in mortality (43% vs 37%), clinical failure (65% vs 58%), or microbiologic cure rates (65% vs 60%) between monotherapy and combination therapy groups respectively.

https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200131

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

• 677 patients were included in the study and randomly assigned to either methylprednisolone 80 mg as a continuous daily infusion for 8 days followed by slow tapering or dexamethasone 6 mg daily for up to 10 days in adult patients with COVID-19 pneumonia requiring oxygen or noninvasive respiratory support

• There was no significant difference in mortality between the two groups by day 28

• Methylprednisolone did not reduce mortality at 28 days compared to conventional dexamethasone in COVID-19 pneumonia

In a study among 14-hospital integrated system in Pittsburgh that was published in JAMA, source control intervention within 6 hours of presentation in 4962 patients with community-acquired sepsis, was associated with 29% risk-adjusted 90-day mortality compared with delayed source control.

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