Infectious Disease & Sepsis

Lower vs Higher Fluid Volumes in Adult Patients With Sepsis

In a systematic review updating the optimal IV fluid volume strategy for adult sepsis patients, the study compared lower vs. higher fluid volumes. The results, based on trials with low risk of bias, indicated that lower IV fluid volumes have minimal to no impact on all-cause mortality (Relative Risk: 0.99, 97% CI, 0.89-1.10) or serious adverse events (Relative Risk: 0.95, 97% CI, 0.83-1.07) compared to higher volumes. However, these conclusions come with some imprecision, not ruling out potential benefits or risks. Notably, the trials did not report on health-related quality of life.

Lower vs Higher Fluid Volumes in Adult Patients With Sepsis - CHEST (chestnet.org)

Activities of the newer antibiotics against gram-negative resistant organisms.

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.