Neurosyphilis – What You Need to Know
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Neurosyphilis is on the rise – brush up on the facts now before you miss it.
Source
State-of-the-Art Review: Neurosyphilis. Clin Infect Dis. 2023 Aug 18;ciad437. doi: 10.1093/cid/ciad437. Online ahead of print.
Syphilis – What You Need to Know
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Syphilis is on the rise in certain subgroups. This article provides a well-organized infographic that can be used to summarize treatment and management of patients in all stages of infection.
What Children, If Any, Benefit from Antibiotics for Sinusitis?
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Children with persistent or worsening rhinosinusitis experienced a modest improvement in symptoms when given amoxicillin-clavulanate vs. placebo.
Source
Identifying Children Likely to Benefit From Antibiotics for Acute Sinusitis: A Randomized Clinical Trial. JAMA. 2023;330(4):349-358. doi:10.1001/jama.2023.10854
Myth Bust – Does Croup Really Get Better in Cold Air?
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Is taking a croupy child outdoors in the cold air an old wive's tale or evidence-based practice? Turns out, it actually works!
SCOUT RCT | 5 or 10-day Treatment for Pediatric UTI?
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This multi-center, double-blinded, non-inferiority trial found that short-course antimicrobial therapy had relatively low treatment failure rates compared to standard-course in children diagnosed with UTI who showed clinical improvement after 5 days of antibiotics.
Source
Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. JAMA Pediatr. 2023 Jun 26:e231979. doi: 10.1001/jamapediatrics.2023.1979. Epub ahead of print.
Can We Draw Blood Cultures from an Arterial Line?
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In this multicenter prospective diagnostic study, the proportion of contaminated blood cultures obtained from arterial catheters was noninferior to blood cultures obtained via venipuncture.
Source
Contamination of Blood Cultures From Arterial Catheters and Peripheral Venipuncture in Critically Ill Patients: A Prospective Multicenter Diagnostic Study. Chest. 2023 Jul;164(1):90-100. doi: 10.1016/j.chest.2023.01.030. Epub 2023 Jan 30.
PEN-FAST 2.0 – Directly Testing for PCN Allergy – The PALACE RCT
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Starting with the PEN-FAST Decision Tool, direct oral challenges to low-risk individuals with reported penicillin allergies is safe, effective, and can remove a majority of mislabeled instances.
Source
Efficacy of a Clinical Decision Rule to Enable Direct Oral Challenge in Patients With Low-Risk Penicillin Allergy: The PALACE Randomized Clinical Trial. JAMA Intern Med. Published online July 17, 2023. doi:10.1001/jamainternmed.2023.2986
Macrolides and Long-Term Survival in ICU Patients with Community-Acquired Pneumonia
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Empiric macrolide therapy was associated with improved six and twelve-month survival among ICU patients with community-acquired pneumonia (CAP).
Source
Impact of macrolide treatment on long-term mortality in patients admitted to the ICU due to CAP: a targeted maximum likelihood estimation and survival analysis. Crit Care. 2023 May 31;27(1):212. doi: 10.1186/s13054-023-04466-x.
How Much Do You Know About Orbital Cellulitis?
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Orbital cellulitis is a high-risk and low-prevalence disease characterized by a painful, red eye, usually with eyelid erythema. Red flags include pain with eye movements, photophobia, diplopia, decreased visual acuity, decreased color vision, and proptosis.
Source
High risk and low prevalence diseases: Orbital cellulitis. Am J Emerg Med. 2023 Jun;68:1-9. doi: 10.1016/j.ajem.2023.02.024. Epub 2023 Feb 26.
RECOVERY RCT – High or Low Dose Dexamethasone for COVID-19?
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In this large, randomized controlled trial, hypoxic patients requiring simple or no oxygen who received higher dose dexamethasone (20mg for 5 days, then 10mg for 5 days) had a higher mortality compared to patients who received usual care, most of whom were treated with 6mg per day of dexamethasone for 10 days.
Source
Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2023 May 6;401(10387):1499-1507. doi: 10.1016/S0140-6736(23)00510-X. Epub 2023 Apr 13.