Metabolic Syndrome in HIV/HCV Co-infected Patients
AbstractPurpose of reviewWe review the scope and burden of metabolic syndrome in HIV/HCV co-infected patients, risk factors, and potential mechanisms driving the increased cardio-metabolic risk in this population, and discuss relevant clinical considerations for management in the era of highly effective antiretroviral therapy (ART) and curative anti-HCV direct-acting antivirals.Recent findingsHIV/HCV co-infected patients are at elevated risk of metabolic syndrome, attributed to (1) patient-specific factors, (2) viral-mediated effects, and (3) ART exposure. Risk factors for cardio-metabolic disorders are common in this popu...
Source: Current Treatment Options in Infectious Diseases - December 2, 2019 Category: Infectious Diseases Source Type: research

New Options in Antifungal Therapy: New Drugs, Inhaled Antifungals, and Management of Resistant Pathogens
AbstractPurpose of reviewThis review aims to update the reader on recent information related to available antifungal pharmacotherapy and inform on agents that may be available for clinical use in the near future. Additionally, alternate drug delivery of existing agents, therapeutic drug monitoring, and management of resistant fungal pathogens will be discussed.Recent findingsRezafungin (a once-weekly echinocandin) and ibrexafungerp (an oral glucan synthase inhibitor) appear to be the investigational agents that are nearest to widespread use in clinical practice. Emerging information on isavuconazole (mean inhibitory concen...
Source: Current Treatment Options in Infectious Diseases - November 26, 2019 Category: Infectious Diseases Source Type: research

Update on Adverse Effects of HIV Integrase Inhibitors
AbstractPurpose of reviewThe goal of this paper is to provide an up-to-date review of adverse events related to the class of integrase strand transfer inhibitors (INSTIs), which became the class of choice in few years. We sought answers specifically to issues pertaining to neuropsychiatric adverse events, as well as weight gain, which were the two most important categories of adverse events raised in recent studies based on real-life experience. The primary focus of this paper is on adults with a brief summary on pregnant women and children/adolescents.Recent findingsDolutegravir (DTG) bears the heaviest burden of neuropsy...
Source: Current Treatment Options in Infectious Diseases - November 16, 2019 Category: Infectious Diseases Source Type: research

Evolution, Trends, and Potential Explanations of the Increase in the Incidence of Tuberculosis: the Case of Uruguay
AbstractPurpose of reviewA descriptive analysis of the trend of tuberculosis incidence in Uruguay between 1995 and 2018.Recent findingsIn 2015, World Health Organization (WHO) proposed The END TB Strategy; the Latin American countries that implemented these strategies at the first level of care have had successful outcomes in terms of the reduction in the incidence, morbidity, and mortality of the disease.SummaryUruguay is a striking case in the regional environment regarding tuberculosis epidemiology. The trend of tuberculosis had a turning point in 2006, which defines two clearly different periods. The first period cover...
Source: Current Treatment Options in Infectious Diseases - November 14, 2019 Category: Infectious Diseases Source Type: research

Treatment of Non- Aspergillus Mold Infections: a Focus on Mucormycosis and Fusariosis
AbstractPurpose of reviewMucormycosis and fusariosis are associated with severe morbidity and high fatality rate. This review will discuss the challenges associated with the treatment of mucormycosis and fusariosis with a focus on recent data on antifungal susceptibility, novel therapeutic modalities, and combination therapy. Overall, the review aims to provide guidance to optimize management of these difficult-to-treat infections.Recent findingsIsavuconazole has comparable efficacy with liposomal amphotericin B for the treatment of mucormycosis. Treatment of fusariosis remains challenging, but voriconazole has been associ...
Source: Current Treatment Options in Infectious Diseases - November 8, 2019 Category: Infectious Diseases Source Type: research

Special Topics in the Care of Older People with HIV
AbstractPurpose of reviewAntiretroviral therapy has enabled many people with HIV to live long lives with their infection, but the literature suggests that long-term survivors are developing comorbidities and aging-related syndromes at earlier ages than their non-infected counterparts. In addition, there is evidence of sex-based differences in comorbidity risk.Recent findingsHow to best care for people aging with HIV is not known, but the tools of comprehensive geriatric assessment can identify people at risk for decline. Newer antiretroviral therapies offer promise of fewer side effects and drug interactions. We will also ...
Source: Current Treatment Options in Infectious Diseases - November 8, 2019 Category: Infectious Diseases Source Type: research

Bacterial Pyomyositis Associated with Human Immunodeficiency Virus: Diagnosis, Management, and Review of the Recent Literature
We present a case and provide a review of all the confirmed cases of pyomyositis in human immunodeficiency virus (HIV)-positive patients in the literature after the last published case series, from September 16, 2004 to February 1, 2019. The goal of this review is to examine recent trends in causative organisms, diagnostic modalities, and duration of therapy for patients with HIV and pyomyositis in the antiretroviral therapy (ART) era.Recent findingsPyomyositis affects predominately the lower extremities and can have extra-muscular manifestations. Magnetic resonance imaging is the gold standard for diagnosis but computed t...
Source: Current Treatment Options in Infectious Diseases - July 29, 2019 Category: Infectious Diseases Source Type: research

Opportunities to Overcome Implementation Challenges of Infection Prevention and Control in Low-Middle Income Countries
AbstractPurpose of reviewHealthcare-associated infections (HAIs) and rising antimicrobial resistance (AMR) have posed a major challenge in patient care across the globe, more so in lower-middle-income countries (LMICs). Studies have shown that implementation of an effective infection prevention and control (IPC) program reduces incidence of HAI to a large extent. However, implementation of such a program in low-resource setting has many challenges. Research have shown that gaps exist due to absence of political will, trained manpower, and alternate healthcare priorities.Recent findingsWith progress in science of healthcare...
Source: Current Treatment Options in Infectious Diseases - July 27, 2019 Category: Infectious Diseases Source Type: research

Diagnosis and Treatment of Carbapenemase-Producing Organisms —an Update
AbstractPurpose of reviewCarbapenem-producing organisms (CPO) have become important clinical pathogens in nosocomial infections causing increases in hospital stay, mortality, and costs. We sought to summarize recent findings related to the commonly encountered types of carbapenemases and their detection and review recent findings related to therapeutic options.Recent findingsMany new rapid and reliable methods of identifying carbapenem resistance have become available, underscoring the necessity to have the laboratory capacity for phenotypic and/or genotypic detection of carbapenemases to facilitate optimal therapy accordi...
Source: Current Treatment Options in Infectious Diseases - July 23, 2019 Category: Infectious Diseases Source Type: research

HIV-2 Infection: Latest Advances
AbstractHIV-2, despite being less common than HIV-1, is an important cause of morbidity and mortality. As more data are published on HIV-2 infection, it is clear that despite lower viral loads and higher CD4 cell counts than those seen in HIV-1, it is important to treat these patients with antiretroviral therapy to prevent progression of disease and early mortality.Purpose of reviewTo summarize the background characteristics of HIV-2, diagnostic and treatment considerations, and recent updates in treatment of HIV-2.Recent findingsProspective cohort studies of people with HIV-2 infection have shown that they have a signific...
Source: Current Treatment Options in Infectious Diseases - July 19, 2019 Category: Infectious Diseases Source Type: research

An Overview of Surgical Site Infection in Low- and Middle-Income Countries: the Role of Recent Guidelines, Limitations, and Possible Solutions
AbstractPurpose of reviewThe purpose of this manuscript is to review preventive strategies for surgical site infection (SSI) in low- and middle-income countries (LMIC) and how the recent World Health Organization (WHO) guidelines, along with the Centers for Disease Control (CDC) recommendations on SSI prevention, may be implemented on these settings, considering frequent limitations and possible solutions.Recent findingsSurgical site infection (SSI) is the most common postoperative complication and in LMIC is the first cause among healthcare-associated infections (HAI). SSIs are largely preventable if there is a standardiz...
Source: Current Treatment Options in Infectious Diseases - July 13, 2019 Category: Infectious Diseases Source Type: research

The Real Scenario in Infection Prevention and Control in Low- and Middle-Income Countries: the Challenge of “Starting From Scratch”
AbstractPurpose of reviewInfection control and prevention (the routine use of infection prevention and control policies, procedures, and interventions in healthcare institutions) is fundamental to improving patient care outcome while ensuring the health and safety of healthcare workers, patients, and visitors.Healthcare facilities with an effective infection prevention and control (IPC) program have demonstrated a decrease in healthcare-associated infections, a common complication of interaction with healthcare, through adherence to IPC guidelines resulting in safer clinical care environments and impacting patient morbidit...
Source: Current Treatment Options in Infectious Diseases - July 5, 2019 Category: Infectious Diseases Source Type: research

Antifungal Stewardship in Low- and Middle-Income Countries
AbstractPurpose of reviewAntifungal stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antifungals by promoting the selection of the optimal antifungal drug regimen, dose, duration of therapy, and route of administration.Recent findingsThe high mortality associated with invasive fungal diseases (IFDs), combined with suboptimal diagnostic tools, has driven the overuse of antifungal drugs. High drug costs and the toxicities of antifungal agents are the principal rationale for antifungal stewardship, while antifungal resistance is an emerging but less prevalent issue.Summary...
Source: Current Treatment Options in Infectious Diseases - July 5, 2019 Category: Infectious Diseases Source Type: research

Ivermectin for the Treatment of Soil-Transmitted Helmithiases
AbstractPurpose of reviewTo present ivermectin as a transformational tool for the control of neglected tropical diseases (NTDs) such as onchocerciasis and the drug of choice for the treatment of strongyloidiasis. Ivermectin is being re-discovered as a candidate drug for a variety of new indications among NTDs. In this review, new data are analyzed and put in context of current research interest as well as of the un-addressed issues for the treatment of soil-transmitted helminths (STH) infections.Recent findingsThe addition of ivermectin to the benzimidazole drugs appears as the most promising solution for three key issues ...
Source: Current Treatment Options in Infectious Diseases - July 3, 2019 Category: Infectious Diseases Source Type: research

Tropical Diseases in HIV
This article reviews existing data on coinfections of the most common tropical diseases and HIV, as well as current strategies for their treatment and control. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - July 1, 2019 Category: Infectious Diseases Source Type: research

Therapeutics for Dengue
AbstractPurpose of reviewDengue virus (DENV) infections are a global health emergency. Humans can experience multiple DENV infections, owing to the presence of four antigenically distinct DENV serotypes, DENV1 –4. DENV infection results in a spectrum of disease, ranging from mild and self-limiting to severe and life-threatening illness. Currently, one dengue vaccine is approved, although with modest efficacy, so dengue-directed therapeutics are still needed to minimize the disease burden. The current st andard-of-care treatment for dengue is only supportive but there is a pipeline of therapeutic treatments that are i...
Source: Current Treatment Options in Infectious Diseases - June 27, 2019 Category: Infectious Diseases Source Type: research

A Review of Safety and Effectiveness of Intravenous and Intraventricular Tigecycline in Healthcare-Associated Acinetobacter baumannii Meningitis and Ventriculitis
ConclusionDespite the limited studies, IV and IVT tigecycline has been used successfully and safely for the treatment of healthcare-associatedA. baumannii meningitis and ventriculitis. However, large randomized controlled trials are necessary to clearly evaluate the safety and effectiveness of IV and IVT tigecycline in healthcare-associatedA. baumannii meningitis and ventriculitis. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - June 27, 2019 Category: Infectious Diseases Source Type: research

Basic, Advanced, and Novel Metrics to Guide Antibiotic Use Assessments
AbstractPurpose of reviewThis review illustrates relevant and current antibiotic use (AU) metrics and demonstrates their differences. The authors also highlight novel, increasingly complex AU metrics proposed for use in antibiotic stewardship research.Recent findingsMany common antibiotic use metrics (e.g., days of therapy, length of therapy) are well defined, widely generalizable, and commonly used by antimicrobial stewardship programs. Multiple measures are required to comprehensively capture real-world AU, though utilization metrics often lack important contextual information needed to inform antibiotic stewardship stra...
Source: Current Treatment Options in Infectious Diseases - May 28, 2019 Category: Infectious Diseases Source Type: research

Antibiotics in the Pipeline for Treatment of Infections due to Gram-Negative Organisms
AbstractPurpose of reviewWe systematically review the literature on antibiotics approved by the Food and Drug Administration since 2015 or that are in development through phase III trials for the treatment of infections due to gram-negative organisms.Recent findingsThe crisis of antimicrobial resistance creates a dire need for the development of novel antimicrobials with enhanced activity against resistant bacteria. Of the agents that are currently in the pipeline or recently approved, few are from new classes and most represent modifications of preexisting agents. There continues to be a lack of treatment options especial...
Source: Current Treatment Options in Infectious Diseases - May 8, 2019 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship in Patients with Hematological Malignancies: Key Considerations
AbstractPurpose of reviewThis review establishes current evidence supporting antimicrobial stewardship programs for malignant hematology and hematopoietic stem cell transplant patients. It describes best practices and identifies opportunities for research. It examines metrics relevant to the patient population, and new approaches to the management of high-risk febrile neutropenia.Recent findingsThere is an urgent need for antimicrobial stewardship programs to optimize antimicrobial use in malignant hematology and stem cell transplant patients. Audit and feedback is effective and safe. Febrile neutropenia is a key area to o...
Source: Current Treatment Options in Infectious Diseases - May 7, 2019 Category: Infectious Diseases Source Type: research

Are We Overlooking the Use of Oral Ribavirin for Respiratory Syncytial Virus Infection Following Hematopoietic Stem Cell Transplantation?
We describe our experience using oral ribavirin (RBV) for RSV infections in HSCT recipients.MethodsRetrospective cohort analysis of HSCT recipients diagnosed with RSV infection and treated with either oral RBV or supportive care between September 2014 and April 2015.ResultsTwenty-six HSCT recipients were identified as RSV-positive in this study. Oral RBV (mean daily dose 16.7  mg kg) was prescribed to 14 (54%) patients. A higher proportion of patients in the RBV group had lower respiratory tract infection (RTI) (p = 0.007) and were inpatient (p 
Source: Current Treatment Options in Infectious Diseases - May 2, 2019 Category: Infectious Diseases Source Type: research

Beta-lactam Allergy Review: Implications for Antimicrobial Stewardship Programs
AbstractPurpose of reviewBeta-lactam allergies, and specifically penicillin allergies, result in receipt of therapy that is not considered first line in many instances. Being labeled as allergic many times comes via subjective history from the patient. Carrying this label can cause a patient to receive broad-spectrum therapy with increased side effects and resistance. Antimicrobial stewardship programs can play a role in allergy evaluation and intervention based on resources. This review provides an update on beta-lactam allergies and emphasizes incorporation of evaluating these patients as a core tenant of antimicrobial s...
Source: Current Treatment Options in Infectious Diseases - May 1, 2019 Category: Infectious Diseases Source Type: research

The Present and Future State of Antimicrobial Stewardship and Rapid Diagnostic Testing: Can One Ideally Succeed Without the Other?
AbstractPurpose of reviewThe growth and development of rapid diagnostic technologies (RDTs) in infectious diseases (ID) have grown significantly over the past several years. The aim of these platforms is to identify causative pathogens more quickly and target antimicrobial therapy earlier, ultimately improving patient outcomes. Use of RDT specifically from blood specimens to optimize antimicrobial therapy and improve patient outcomes is a recommendation by the most recent antimicrobial stewardship (AMS) guidelines. In this review, we aim to highlight currently available FDA-approved RDTs for clinicians, data supporting the...
Source: Current Treatment Options in Infectious Diseases - May 1, 2019 Category: Infectious Diseases Source Type: research

Do We Need Antifungal Stewardship?
AbstractPurpose of reviewInvasive fungal infections (IFIs) are recognized as a significant health problem worldwide. Inappropriate use of antifungals contributes to antifungal resistance and emerging fungi. There is an urgent clinical need to limit inappropriate antifungal usage through judicious antifungal stewardship (AFS).Recent findingsThe main goals of AFS are optimized care, de-escalation or withdrawal of antifungal therapy when appropriate, reduced costs, and reduced fungal resistance, with no negative impact in terms of morbidity or mortality. AFS should be tailored for each institution and health-care system, and ...
Source: Current Treatment Options in Infectious Diseases - April 17, 2019 Category: Infectious Diseases Source Type: research

Barriers to Treatment of Hepatitis C Virus in the Direct-Acting Antiviral Era
AbstractPurpose of reviewHepatitis C Virus (HCV) is a major public health problem in the USA, accounting for more deaths than any other infectious disease. New infections have been on the rise in recent years because of increased parenteral transmission related to injection drug use and the opioid epidemic. Curative treatment for HCV is now available; however, many barriers to treatment still exist.Recent findingsDirect-acting antiviral (DAA) treatments have been available since 2011 in combination with interferon, and since 2014, as part of interferon-free regimens, and have greatly improved both safety and efficacy and m...
Source: Current Treatment Options in Infectious Diseases - April 13, 2019 Category: Infectious Diseases Source Type: research

Procalcitonin as a Diagnostic, Therapeutic, and Prognostic Tool: a Critical Review
AbstractPurpose of reviewThe target of this review is to highlight the current evidence about the utility of procalcitonin (PCT) in different clinical conditions, such as sepsis, respiratory tract infections, urinary tract infections, and bacteremias. The authors aim to discuss the potential benefits and limitations of this biomarker and propose how to safely individualize antibiotic treatment in clinical practice.Recent findingsMany studies have demonstrated that PCT measurements increase within 6 –12 h after bacterial invasion and correlate with disease severity and outcomes of patients with infection. Consequ...
Source: Current Treatment Options in Infectious Diseases - February 21, 2019 Category: Infectious Diseases Source Type: research

Advances in Infection Control for Clostridioides (Formerly Clostridium ) difficile Infection
AbstractPurpose of reviewWe reviewed seminal papers and recently published articles discussing multiple aspects of infection prevention applied toClostridioides (formerlyClostridium)difficile infection (CDI).Recent findingsWe identified hot topics including the importance of understanding the gut microbiome in CDI and its implications from an infection prevention perspective, the increasing role of antibiotic stewardship including testing stewardship in preventing and mitigating CDI, and the increasing role of clinical decision support systems to improve early diagnosis and decrease inappropriate testing.SummaryIn addition...
Source: Current Treatment Options in Infectious Diseases - February 18, 2019 Category: Infectious Diseases Source Type: research

Innovations in Quality Improvement of Intravascular Catheter-Related Bloodstream Infections
AbstractPurpose of reviewSignificant reductions in catheter-related bloodstream infections (CRBSI) have occurred in the United States. Reductions in CRBSIs are attributed to the widespread implementation of the practice-based measures and innovations in the diagnosis, treatment, and prevention of CRBSI.Recent findingsDiagnosis of CRBSI historically required removal of the central venous catheter (CVC) for catheter tip culture. Removing the CVC for CRBSI diagnosis predisposes many patients to potential life-threatening complications. Advances in diagnostic techniques such as culturing catheter hubs, catheter entry site cult...
Source: Current Treatment Options in Infectious Diseases - February 8, 2019 Category: Infectious Diseases Source Type: research

Bacterial Antibiotic Resistance: on the Cusp of a Post-antibiotic World
AbstractPurpose of reviewThe specific aim of this article is to provide evidence that antibiotic resistance (AR) has become a human disease unto itself and to describe the current means of preventing, treating, and reversing AR in individuals and in affected populations.Recent findingsAn ever-increasing number of infections are being classified as multidrug resistant (MDR). Low and middle-income countries are most likely to increase the spread of AR due to limited healthcare infrastructure coupled with policies that promote unregulated access to antibiotics. The genetic basis for AR has become more thoroughly understood as...
Source: Current Treatment Options in Infectious Diseases - January 26, 2019 Category: Infectious Diseases Source Type: research

Treatment of Tuberculosis in Brazil —Past, Present, and Future Challenges
AbstractPurpose of reviewAlmost 75  years since the introduction of chemotherapy for the treatment of tuberculosis (TB), it remains the single leading infectious cause of mortality and one of the top 10 causes of deaths in 2016 worldwide. Brazil is one of the countries with the highest burden of disease in the world, and despite the downward trend in disease incidence and mortality, TB is still the third leading cause of death among infectious diseases in the country. Although diagnosis and treatment are performed universally and free of charge, barriers in access result in 69,500 new cases and 4500 deaths each year. ...
Source: Current Treatment Options in Infectious Diseases - January 26, 2019 Category: Infectious Diseases Source Type: research

Physician barriers to implementation of hospital-based antimicrobial stewardship programs (ASPs): a global perspective
AbstractPurpose of reviewAntimicrobial resistance (AMR) is a significant global health issue. Hospital-based antimicrobial stewardship programs (ASPs) are an important component of a “One Health” approach for addressing AMR. However, the adaptation and implementation of ASPs in low-resource settings often faces multiple barriers, which need to be identified and addressed to ensure program effectiveness.Recent findingsBarriers to ASPs adoption have been identified at the health system and hospital levels, within the organization and interpersonal relationships in wards and departments, and at the individual leve...
Source: Current Treatment Options in Infectious Diseases - January 22, 2019 Category: Infectious Diseases Source Type: research

Building a Hepatitis C Clinical Program: Strategies to Optimize Outcomes
AbstractPurpose of reviewAn increasing number of specialists and non-specialists are developing clinical programs to treat and cure hepatitis C virus (HCV). The goal of this paper is to evaluate and describe optimal strategies to improve outcomes related to HCV care delivery.Recent findingsScreening and diagnosis of HCV should be guided by established recommendations. Given the recognized disparity in HCV diagnosis and linkage to care, a multi-modal approach involving care coordination and technology resources should be used to improve patient engagement. Access to HCV treatment may be optimized through systematic document...
Source: Current Treatment Options in Infectious Diseases - October 18, 2018 Category: Infectious Diseases Source Type: research

Treatment of Chagas Disease in the United States
AbstractPurpose of ReviewChagas disease (CD) is endemic to much of Latin America, but also present in the United States (U.S.). Following a lengthy asymptomatic period, CD produces serious cardiac or gastrointestinal complications in 30 –40% of people. Less than 1% of the estimated six million cases in the Americas, including 326,000–347,000 in the U.S., are diagnosed. Infected persons are typically unaware and the bulk of clinicians are unfamiliar with current treatment guidelines. This review provides U.S. and other clinician s with the latest knowledge of CD treatment.Recent FindingsChagas cardiomyopathy (CC...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

Cutaneous Botryomycosis and Staphylococcus aureus : Diagnosis, Management, and a Systemic Literature Review
We present a case and provide a review of the literature of all confirmed cases of cutaneous botryomycosis due toStaphylococcus aureus between January 1, 1990 and January 31, 2018.Recent findingsCutaneous botryomycosis occurs in diverse age groups and more frequently in men. Immunodeficiency increases risk for botryomycosis. Preceding trauma commonly occurs, and after bacterial inoculation, patients develop a variety of chronic skin lesions. Culture and biopsy of lesions aid in diagnosis. Pathology usually displays the Splendore-Hoeppli reaction. Culture confirms the identity of the bacterium and provides antimicrobial sen...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

Advances in Clinical Diagnosis and Management of Chikungunya Virus Infection
AbstractPurpose of reviewIn this review, we attempt to give the reader an update on clinical diagnosis, management, and treatment of Chikungunya virus (CHIKV) infection regarding the course of the disease and the role of clinical laboratory. CHIKV infection evolves through three phases: acute, sub-acute, and chronic. Protocol for patient assessment and management should be in agreement with each phase requirements.Recent findingsDespite its benignity, CHIKV infection has shown an increase in severe cases during recent outbreaks. Among the most affected group are neonates, elderly population, and patients with co-morbiditie...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

An Overview of the Treatment of Mycobacterium ulcerans Infection (Buruli Ulcer)
AbstractPurpose of reviewBuruli ulcer is a major cause of morbidity in the regions where it is endemic across 33 countries. The treatment of the disease has changed drastically over the last 15  years with a move away from reliance on wide surgical excision, increased confidence in the efficacy of antibiotics and a better understanding of the pathogenesis ofMycobacterium ulcerans infections.Recent findingsAntibiotic regimens based on rifampicin for 8  weeks combined with either streptomycin, clarithromycin or a quinolone companion drug are highly effective againstM. ulcerans. Excisional surgery and thermotherapy ...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

New Advances in the Treatment of Trichuriasis
AbstractPurpose of reviewInfection with the intestinal nematodeTrichuris trichiura is a common public health relevant human infection. Since the commonly used drugs show low efficacy against this infection, recent literature about the state-of-the-art treatment of trichuriasis is reviewed particularly with regard to current efforts to improve the situation.Recent findingsThe drugs albendazole and mebendazole are widely used in preventive chemotherapy in high-risk areas around the world, since they are easy to administer and also effective against other soil-transmitted helminth (STH) infections. Unfortunately, both drugs s...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

Recent Advances in the Diagnosis of Neurocysticercosis
AbstractPurpose of reviewNeurocysticercosis (NCC) results from the localization in the central nervous system (CNS) of larval stages of the cestode parasiteTaenia solium. NCC is the most common helminthic parasitic disease of the nervous system and the main cause of acquired epilepsy. This literature review presents an update in NCC diagnostic techniques, including neuroimaging, immunological assays, molecular assays, and clinical manifestations.Recent findingsNCC can cause a wide array of neurological manifestations, most of them being non-pathognomonic. Diagnosis of this infection represents a challenge due to its nonspe...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

Current Challenges in Antibiotic Stewardship in Low- and Middle-Income Countries
AbstractPurpose of reviewASPs are key tools in the time where an increase in the rates of bacterial resistance and cases ofClostridium difficile disease is observed worldwide, forcing a more efficient use of antibiotic therapy. We review some examples of the actual state of bacterial resistance in low- and middle-income countries (LMIC), as well as some of the proposed strategies for the establishment of ASPs in resource-constrained environments.Recent findingsIn LMIC, there are important challenges in antimicrobial prescription; although not all inhabitants have access to adequate antibiotic therapy, the consumption of th...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

Current Treatment of Mycetoma
AbstractPurpose of reviewThe purpose of this review is to update the status of treatment of actinomycetoma and eumycetoma. Specific information is presented to describe the best medical management for uncomplicated and complicated actinomycetic and fungal mycetomas.Recent findingsLocalized actinomycetoma that involves the skin without affecting underlying organs is treated with trimethoprim/sulfamethoxazole for 3 to 12  months. In extensive infections with bone or deep organ involvement and in those with no therapeutic response, amikacin can be added. Duration of treatment varies from 5 to 20 weeks and will depen...
Source: Current Treatment Options in Infectious Diseases - September 1, 2018 Category: Infectious Diseases Source Type: research

Current Challenges in Antibiotic Stewardship in Low- and Middle-Income Countries
AbstractPurpose of reviewASPs are key tools in the time where an increase in the rates of bacterial resistance and cases ofClostridium difficile disease is observed worldwide, forcing a more efficient use of antibiotic therapy. We review some examples of the actual state of bacterial resistance in low- and middle-income countries (LMIC), as well as some of the proposed strategies for the establishment of ASPs in resource-constrained environments.Recent findingsIn LMIC, there are important challenges in antimicrobial prescription; although not all inhabitants have access to adequate antibiotic therapy, the consumption of th...
Source: Current Treatment Options in Infectious Diseases - July 17, 2018 Category: Infectious Diseases Source Type: research

Cutaneous Botryomycosis and Staphylococcus aureus : Diagnosis, Management, and a Systemic Literature Review
We present a case and provide a review of the literature of all confirmed cases of cutaneous botryomycosis due toStaphylococcus aureus between January 1, 1990 and January 31, 2018.Recent findingsCutaneous botryomycosis occurs in diverse age groups and more frequently in men. Immunodeficiency increases risk for botryomycosis. Preceding trauma commonly occurs, and after bacterial inoculation, patients develop a variety of chronic skin lesions. Culture and biopsy of lesions aid in diagnosis. Pathology usually displays the Splendore-Hoeppli reaction. Culture confirms the identity of the bacterium and provides antimicrobial sen...
Source: Current Treatment Options in Infectious Diseases - July 16, 2018 Category: Infectious Diseases Source Type: research

An Overview of the Treatment of Mycobacterium ulcerans Infection (Buruli Ulcer)
AbstractPurpose of reviewBuruli ulcer is a major cause of morbidity in the regions where it is endemic across 33 countries. The treatment of the disease has changed drastically over the last 15  years with a move away from reliance on wide surgical excision, increased confidence in the efficacy of antibiotics and a better understanding of the pathogenesis ofMycobacterium ulcerans infections.Recent findingsAntibiotic regimens based on rifampicin for 8  weeks combined with either streptomycin, clarithromycin or a quinolone companion drug are highly effective againstM. ulcerans. Excisional surgery and thermotherapy ...
Source: Current Treatment Options in Infectious Diseases - July 3, 2018 Category: Infectious Diseases Source Type: research

Treatment of Chagas Disease in the United States
AbstractPurpose of ReviewChagas disease (CD) is endemic to much of Latin America, but also present in the United States (U.S.). Following a lengthy asymptomatic period, CD produces serious cardiac or gastrointestinal complications in 30 –40% of people. Less than 1% of the estimated six million cases in the Americas, including 326,000–347,000 in the U.S., are diagnosed. Infected persons are typically unaware and the bulk of clinicians are unfamiliar with current treatment guidelines. This review provides U.S. and other clinician s with the latest knowledge of CD treatment.Recent FindingsChagas cardiomyopathy (CC...
Source: Current Treatment Options in Infectious Diseases - June 26, 2018 Category: Infectious Diseases Source Type: research

Current Treatment Options for HIV Elite Controllers: a Review
AbstractOpinion statementInitiating antiretroviral therapy (ART) in human immunodeficiency virus (HIV) elite controllers remains controversial, because current evidence does not definitively demonstrate that the benefits of ART outweigh risk in this patient population. However, it is the opinion of the authors that in developed countries, where first-line ART regimens have minimal toxicities, treatment of elite controllers should be strongly considered. Treatment of elite controllers has the potential to minimize the size of the HIV reservoir, which benefits elite controllers who choose to pursue future cure, dampen immune...
Source: Current Treatment Options in Infectious Diseases - June 1, 2018 Category: Infectious Diseases Source Type: research

Mucosal Barrier Injury Laboratory Confirmed Bloodstream Infections
AbstractPurpose of ReviewTo increase the awareness of the new CDC survey definition of Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infection (MBI-LCBI). We included a comparison of the definition of Central Line-Associated Bloodstream Infection (CLABSI), with a high sensitivity but low specificity and Catheter-Related Bloodstream Infection (CRBSI). There are other parameters like the difference between the size of the inoculum (catheter lumen vs peripheral), that increased specificity and is useful for research and clinical decisions. Also, MBI-LCBI secondary to bacterial translocation in patients who had recei...
Source: Current Treatment Options in Infectious Diseases - June 1, 2018 Category: Infectious Diseases Source Type: research

Tele-antimicrobial Stewardship in Action
AbstractPurpose of reviewSummarize the latest literature and our own clinical experience in the emerging technique of tele-antimicrobial stewardship, and provide practical advice for those considering providing or consuming this service.Recent findingsThe need for tele-antimicrobial stewardship is high and rising. Although the benefits of antimicrobial stewardship are well documented, tele-antimicrobial stewardship is a recent advance, and there is a relative lack of peer-reviewed clinical trials substantiating the impact of telehealth techniques in antimicrobial stewardship.SummaryAntimicrobial stewardship is more importa...
Source: Current Treatment Options in Infectious Diseases - June 1, 2018 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship in the Treatment of Infections Among Patients With Cystic Fibrosis
AbstractPurpose of ReviewTo describe potential antimicrobial stewardship program strategies to enhance the optimization of antimicrobial therapy for patients with cystic fibrosis (CF).Recent FindingsCystic fibrosis is a complex medical condition known for its frequent pulmonary exacerbations attributed to microorganisms which are treated with antimicrobials administered by various routes. Due to exposure to antimicrobials from an early age, both as eradication regimens and for chronic colonization, this patient population often has drug-resistant organisms colonizing their respiratory tract. With CF patients surviving well...
Source: Current Treatment Options in Infectious Diseases - June 1, 2018 Category: Infectious Diseases Source Type: research

Role of Antimicrobial Stewardship Programs in Decreasing Hospital-Associated Clostridium difficile Infections
Opinion statementPurpose of reviewTo provide a review of literature that discusses some of the most successful antimicrobial stewardship interventions reported across institutions worldwide in response to increasedClostridium difficile infection (CDI) rates.Recent findingsAlthough many different types of antimicrobial reduction practices have been proven effective, differences in resources across varying sizes of institutions may make some interventions more attainable than other. Regardless of available resources, an initial assessment of the correlation of positive laboratory tests to clinical disease is necessary to qua...
Source: Current Treatment Options in Infectious Diseases - June 1, 2018 Category: Infectious Diseases Source Type: research

Hepatocellular Carcinoma Risk After Hepatitis C Cure
Opinion statementWith the recent introduction of direct acting antiviral agents for hepatitis C treatment, many patients are receiving these highly effective therapies. Patients with advanced fibrosis or cirrhosis prior to antiviral treatment will have decreased but persistent risk of hepatocellular carcinoma following cure of hepatitis C. This review will discuss this risk and review current surveillance recommendations. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - June 1, 2018 Category: Infectious Diseases Source Type: research