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Surveillance of Healthcare-Associated Infections in Low- and Middle-Income Countries: From the Need to a Reality
Opinion StatementSurveillance of healthcare-associated infections (HAI) is a useful tool for prevention of HAI; however, in low- and middle-income countries, the implementation of HAI surveillance has many methodological and resources challenges. Some challenges are related to skilled and dedicated human resources to perform tasks; others are related to methodological issues such as HAI definition and diagnostic tests available, prioritization of infection to follow-up, data reporting methods, data quality and availability of analyzed information for decision-making. Lack of consistent and representative HAI data are hidin...
Source: Current Treatment Options in Infectious Diseases - January 24, 2018 Category: Infectious Diseases Source Type: research

Implementing Infection Prevention and Control Programs When Resources Are Limited
Opinion StatementThere have been established at least four pillars of patient safety viz., healthcare-associated infection prevention and control (IPC), surgical safety, medication safety, and patient communication. It has always been challenging to design, implement, and monitor the functioning of such pillars especially when resources are limited. The trained human resource is most precious of all followed by infrastructure, consumables, and continuous training. The establishment of “IDEAL framework” recommended elsewhere is the approach to achieve “optimal minimal” patient safety goal; however, simple steps with...
Source: Current Treatment Options in Infectious Diseases - January 22, 2018 Category: Infectious Diseases Source Type: research

Environmental Cleaning in Resource-Limited Settings
Opinion statementPurpose of reviewEnvironmental surfaces in healthcare facilities, particularly in a patient room, are a critical pathway for healthcare-associated pathogen transmission. Despite well-established guides and recommendations regarding environmental surface cleaning and disinfection, there are several challenges in resource-limited settings. This viewpoint article will discuss the practice of environmental cleaning in resource-limited settings including challenges and relationship between environment and healthcare-associated infections in this setting and outlines pre-requisites to overcome these challenges.R...
Source: Current Treatment Options in Infectious Diseases - January 18, 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 - December 8, 2017 Category: Infectious Diseases Source Type: research

Managing the HIV/HCV-Co-Infected Patient in the Direct-Acting Antiviral Era: a Review of Pertinent Drug Interactions
Opinion statementPurpose of Review With the advent of direct acting antiviral (DAAs) drugs, hepatitis c is now a curabledisease. The human immunodeficiency virus (HIV) and hepatitis c virus (HCV) have similar risk factorsfor acquisition, and thus the co-infected patient population provides its own set of unique challenges. Theclinical course, monitoring and treatment of co-infected patients will be reviewed. Important druginteractions between DAAs and antiretroviral therapies (ART) will be highlighted.Recent Findings HIV accelerates the natural history of HCV, and liver complications (including end-stageliver disease) resu...
Source: Current Treatment Options in Infectious Diseases - November 8, 2017 Category: Infectious Diseases Source Type: research

Retreatment Options Following HCV Direct-Acting Antiviral Failure
Opinion StatementDespite the excellent efficacy of direct-acting antivirals (DAA) for hepatitis C virus (HCV), treatment failures do occur. Until recently, retreatment decisions after DAA failure were influenced by the number of available agents, concerns about HCV drug resistance, and lack of data regarding retreatment. Recommended treatment approaches previously depended on limited clinical trials and expert opinion. In this article, we review the current state of the evidence for HCV retreatment after DAA failure. Based on recent clinical trial data, most patients who fail HCV treatment with DAA agents now have excellen...
Source: Current Treatment Options in Infectious Diseases - November 4, 2017 Category: Infectious Diseases Source Type: research

Treating Hepatitis C Infection in Patients With Chronic Kidney Disease: Our Options Have Improved Greatly
Opinion statementChronic hepatitis C infection (HCV) is a common problem in patients with kidney disease (Corouge M. et al. Liver Int (2016); 36:28 –33, Fabrizi F. et al. Int. J. Artif. Organs (2017); 0). In the past, treatment of hepatitis C infection was very difficult due to poor efficacy, significant side effects, and the multiple comorbidities that affect patients with advanced kidney disease (Pockros PJ et al. Gastroenterology (2016); 150:1590 –1598). Significant recent advances in oral interferon-free treatment regimens allow patients with hepatitis C to be treated effectively with minimal side effects. For pati...
Source: Current Treatment Options in Infectious Diseases - October 18, 2017 Category: Infectious Diseases Source Type: research

Treatment of Latent Tuberculosis Infection
Opinion statementThe treatment of latent tuberculosis infection (LTBI) is an essential component of tuberculosis (TB) elimination in regions that have a low incidence of TB. However, the decision to treat individuals with LTBI must consider the limitations of current diagnostic tests for LTBI, the risk of developing active TB disease, the potential adverse effects from chemoprophylactic therapy, and the importance of treatment adherence. When an individual has been diagnosed with LTBI and active TB has been ruled out, this is followed by an evaluation of the risks and benefits of LTBI treatment within the context of the re...
Source: Current Treatment Options in Infectious Diseases - September 22, 2017 Category: Infectious Diseases Source Type: research

Reactivation of Occult HBV Infection in Patients Cured of HCV With Direct-Acting Antivirals
Opinion statementThe era of hepatitis C virus (HCV) treatment with direct-acting antiviral (DAA) therapy has remarkably improved liver-related morbidity and overall mortality with patients achieving rapid and sustained clearance of HCV infection. The initial DAA clinical trials excluded patients with hepatitis B virus (HBV) co-infection, and thus potential complications were unforeseen until case reports of HBV reactivation associated with DAA therapy began to emerge. A recent United States Food and Drug Administration (FDA) drug safety communication has brought public attention to the issue of HBV reactivation in patients...
Source: Current Treatment Options in Infectious Diseases - September 20, 2017 Category: Infectious Diseases Source Type: research

Treatment of Hansen ’s Disease (Leprosy)
AbstractPurpose of reviewBecause leprosy (Hansen ’s Disease, HD) is rare, details of treatment of this infection and of its complications are not familiar to many physicians. The basic treatment ofMycobacterium leprae infection, prevention of associated disabilities, and management of its complications have therefore been reviewed.Recent findingsMulti-drug therapy (MDT) for HD is highly effective, but lengthy (12 –24 months). Drug resistance and relapse of infection are rare. New anti-mycobacterial agents are being tested to try to reduce the duration of treatment. The major challenge in HD is the management of immuno...
Source: Current Treatment Options in Infectious Diseases - August 18, 2017 Category: Infectious Diseases Source Type: research

Improving Antimicrobial Stewardship in Cancer Patients Through Implementation of Clinical Guidelines
AbstractPurpose of review Antimicrobial stewardship programs have consistently demonstrated the ability to reduce excessive antibiotic utilization, improve the management of targeted diseases, improve outcomes, and reduce costs. Implementation of institutional guidelines are effective options to promote appropriate cost-effective antimicrobial utilization and are recommended by the Infectious Diseases Society of America and the U.S. Centers for Disease Control and Prevention. Cancer patients are frequent users of antimicrobials and present unique challenges for antimicrobial stewardship programs, due to high risk for infec...
Source: Current Treatment Options in Infectious Diseases - August 15, 2017 Category: Infectious Diseases Source Type: research

Antiviral Drugs for the Treatment and Prevention of Influenza
AbstractPurpose of reviewThis paper provides an overview of the currently available treatment options for influenza infections. Currently, the options are limited to only one class of drugs known as the neuraminidase inhibitors (NAIs) (oseltamivir, zanamivir, laninamivir and peramivir) as there is widespread resistance against the adamantanes, an older class of antivirals. This review therefore discusses the mode of action, dosing, summary of clinical trial data and resistance within the context of NAIs. Newer antiviral therapies in late-phase clinical trials are also summarized in this review.Recent findingsOseltamivir is...
Source: Current Treatment Options in Infectious Diseases - August 10, 2017 Category: Infectious Diseases Source Type: research

Moving to a Dengue Preventive Treatment Through New Vaccines
Opinion statementDengue fever is a viral disease with no curative treatment. However, symptomatic treatment exists to alleviate the fever and provide analgesia to the multiple types of pain mainly headache, arthralgia, myalgia, and retro-ocular pain. Antiviral drugs to interfere with the process of viral replication are still under investigation. In the past, homeopathic treatment has been tried as well, with no success. In the case of severe dengue, hospitalization with strict monitoring of vital signs, parenteral liquids, and electrolytes replacement and, if needed, blood transfusion, are the most adequate courses of man...
Source: Current Treatment Options in Infectious Diseases - August 5, 2017 Category: Infectious Diseases Source Type: research

Discovering Drugs for the Treatment of Ebola Virus
Opinion statementPurpose of reviewEbola virus, a member of the Filoviridae family, is a causative agent of severe viral hemorrhagic fever in humans. Over the past 40 years, the virus has been linked to several high mortality outbreaks in Africa with the recent West African outbreak resulting in over 11,000 deaths. This review provides a summary of the status of the drug discovery and development process for therapeutics for Ebola virus disease, with a focus on the strategies being used and the challenges facing each stage of the process.Recent findingsDespite the wealth of in vitro efficacy data, preclinical data in animal...
Source: Current Treatment Options in Infectious Diseases - August 4, 2017 Category: Infectious Diseases Source Type: research

Treatment of Leprosy and Leprosy Reactions
Opinion statementLeprosy is classified as a tropical neglected disease by the World Health Organization (WHO). In the 1980s, the prevalence of leprosy around the world was approximately 12  million cases, while in the early 2000s, it declined to around 800,000 cases. Most cases occur in India, Brazil, and Indonesia, and are caused byMycobacterium leprae. A special clinical presentation, called diffuse lepromatous leprosy, is caused byMycobacterium lepromatosis, and most cases have been reported in Mexico. The incidence and prevalence worldwide have steadily declined in recent decades. This dramatic change is accountable t...
Source: Current Treatment Options in Infectious Diseases - August 3, 2017 Category: Infectious Diseases Source Type: research