Infectious Disease & Sepsis

Ceftobiprole for Treatment of Complicated Staphylococcus aureus Bacteremia

In a phase 3, double-blind, noninferiority trial, ceftobiprole's effectiveness was compared with daptomycin for treating complicated Staphylococcus aureus bacteremia, including the methicillin-resistant strains. The study population comprised 390 patients, 387 of whom had confirmed S. aureus bacteremia. The primary outcome was to determine overall treatment success 70 days post-randomization. Both drugs demonstrated comparable effectiveness, with ceftobiprole proving to be noninferior to daptomycin. Notably, the occurrence of adverse events was similar between the two treatment groups, although gastrointestinal issues, primarily mild nausea, appeared more frequent in the ceftobiprole group.

Conclusions:

Ceftobiprole demonstrates noninferiority when compared to daptomycin in the treatment of patients with complicated S. aureus bacteremia. The overall safety profiles of both drugs were comparable, though a higher incidence of gastrointestinal issues, especially mild nausea, was noted with ceftobiprole.

Probiotics in AKI and Sepsis: A Clinical Insight

During acute kidney injury (AKI) stemming from sepsis, a dysbiotic change in the intestinal microbiota is observed, impacting kidney function recovery. To evaluate the therapeutic potential of probiotics in alleviating this dysbiosis and potentially enhancing kidney function recovery, a double-blind clinical trial was conducted. 92 patients with sepsis-associated AKI were treated with either probiotics or a placebo for one week. The primary outcomes investigated were kidney function recovery and mortality at 6 months, while secondary outcomes included markers like urea, urine volume, need for kidney replacement therapy, and any adverse events. The study found no significant benefits of probiotics in improving KFR or reducing 6-month mortality. However, a notable reduction in urea levels was observed in the probiotics group.

Full article: Probiotics in septic acute kidney injury, a double blind, randomized control trial (tandfonline.com)

For those who did not witness the start of the HIV pandemic, this was the first report!

And here is the progress made in relation to antiretroviral medications (ART) over the past 40 years or so!

This shows the life cycle of HIV and the different mechanisms of ART medications.

A Large-Scale Multicenter Retrospective Study on Nephrotoxicity Associated With Empiric Broad-Spectrum Antibiotics in Critically Ill Patients

In this retrospective cohort study, researchers investigated the association between commonly prescribed empiric antibiotics on ICU admission and the risk of acute kidney injury (AKI). The study included 35,654 patients who received either vancomycin and piperacillin-tazobactam, vancomycin and cefepime, or vancomycin and meropenem exclusively. AKI was defined based on the Kidney Disease: Improving Global Outcomes stage 2 or 3 criteria using serum creatinine levels.

The results indicated that vancomycin and piperacillin-tazobactam were associated with a higher risk of AKI and initiation of dialysis compared to both vancomycin and cefepime and vancomycin and meropenem. The odds of AKI were particularly significant in patients without renal insufficiency who received a longer duration of vancomycin and piperacillin-tazobactam therapy compared to vancomycin and meropenem therapy.