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Isavuconazole: Has It Saved Us? A Pharmacotherapy Review and Update on Clinical Experience
Opinion statementThe new triazole antifungal, isavuconazole, gained approval in 2015 for the treatment of invasive aspergillosis (IA) and mucormycosis in adult patients. Predictable pharmacokinetics, a favorable safety profile, and demonstrated clinical efficacy against a wide spectrum of yeasts and molds result in expansion of the antifungal armamentarium. The place in therapy for this medication has yet to be defined. This review aims to place isavuconazole ’s role in therapy in perspective. Three studies evaluate isavuconazole activity in the treatment of IA, mucormycosis, and candidiasis. Isavuconazole was non-inferi...
Source: Current Treatment Options in Infectious Diseases - August 3, 2017 Category: Infectious Diseases Source Type: research

Treatment of Hepatitis C Virus (HCV) Genotype 1 Disease
Opinion statementThe landscape of therapeutic options for HCV infection has dramatically changed with the approval of all-oral direct-acting antiviral (DAA) regimens. DAAs target important steps in the HCV viral life cycle, resulting in higher response rates and fewer adverse events than were afforded with interferon and ribavirin, the prior standard of care. The achievement of sustained virologic response (SVR) rates in excess of 90% with use of DAA regimens has not only been translated into HCV eradication for the hundreds of thousands treated but is also anticipated to decrease the incidence of major complications assoc...
Source: Current Treatment Options in Infectious Diseases - May 25, 2017 Category: Infectious Diseases Source Type: research

Options for Effective Treatment of Visceral Leishmaniasis
Opinion statementVisceral Leishmaniasis (VL), also known as kala-azar, is caused by several species ofLeishmania, a protozoan parasite (Leishmania donovani) transmitted to humans by the bite of infected phelobotomine argentipes sandflies. VL is a disease of poverty, affecting the poorest of the poor. It is a major cause of morbidity and mortality in some areas (localized). If the infection is left untreated, the patient dies in about 2  years. Several drugs are now available for the treatment of VL. However, some of them are very costly (miltefosine, lipid amphotericin B). Sodium stibogluconate is an effective drug and th...
Source: Current Treatment Options in Infectious Diseases - May 25, 2017 Category: Infectious Diseases Source Type: research

Surveillance and Prevention of Surgical Site Infections in Breast Oncologic Surgery with Immediate Reconstruction
Opinion statementSurgical site infection (SSI) after immediate breast reconstruction is much more common than would be expected after a clean surgical procedure. Although the SSI rates reported in individual studies are quite variable, there are no obvious explanations for the variation in infection rates between institutions. The microbiology of these SSIs is unusual, with higher proportions of infections caused by atypicalMycobacterium species and Gram-negative bacilli than would be expected for this anatomic site. In an effort to prevent SSIs, many surgeons use a variety of different practices including irrigation and s...
Source: Current Treatment Options in Infectious Diseases - May 11, 2017 Category: Infectious Diseases Source Type: research

Novel Therapeutic Targets for Human African Trypanosomiasis
Opinion statementHuman African trypanosomiasis (HAT) or sleeping sickness is one of the neglected tropic diseases caused byTrypanosoma brucei and endemic in sub-saharan Africa. HAT affects half a million people every year in Africa and is fatal, if untreated. Although the number of cases have dropped in recent years, but still there is a strong need to identify and validate new therapeutic targets for trypanosomiasis. Treatment of HAT poses several challenges due to the availability of few drugs and their associated risks like limited efficacy, toxicity, lack of selectivity, stage specificity, and drug resistance. Overcomi...
Source: Current Treatment Options in Infectious Diseases - May 11, 2017 Category: Infectious Diseases Source Type: research

Current Recommendations on the Workup and Post-exposure Prophylaxis for HIV, HBV, and HCV in Healthcare Workers
Opinion statementHepatitis B, hepatitis C, and HIV are the most commonly acquired infections related to occupational exposure in the health care setting. Measures to reduce the risk of transmission in health care workers (HCW) include primary prevention and post-exposure prophylaxis (PEP). Primary prevention essentially includes the adoption of standard precautions to avoid percutaneous or mucocutaneous injuries and hepatitis B vaccination. PEP varies according to both the source patient and HCW serologic status. So far PEP is not approved for hepatitis C. The post-exposure management for hepatitis B will depend on the vac...
Source: Current Treatment Options in Infectious Diseases - May 10, 2017 Category: Infectious Diseases Source Type: research

Human Cystic and Alveolar Echinococcosis
In conclusion, current interventions need to b e sustained and combined with effective vaccines. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - May 9, 2017 Category: Infectious Diseases Source Type: research

Antiviral Drugs and Other Therapeutic Options for Dengue Virus Infection
Opinion statementDengue is an important mosquito-borne human viral disease globally. Dynamic clinical presentations in affected subjects have been well documented. Majority of affected people are asymptomatic, and to some extent, mild dengue fever. Only small percentage of individuals progress to life-threatening dengue, dengue hemorrhagic fever, and dengue-shock syndrome, featured with increase vascular permeability and plasma leakage. Although the death rate is low, the consequence of the public burden is always underestimated. Currently, mosquito control and supportive care are the most common practice for dengue measur...
Source: Current Treatment Options in Infectious Diseases - May 8, 2017 Category: Infectious Diseases Source Type: research

Pearls in Infection Control for Clostridium difficile Infections in Healthcare Facilities
Opinion StatementPrevention ofClostridium difficile infection (CDI) is a complex task; adequate and sustained success is difficult to obtain. Focus on prevention has to start by analyzing the targeted patient population; the most important risk factors for development of CDI are previous exposure to antibiotics, hospitalization and advanced age. Thus, limiting antibiotic exposure and over exposure with an antibiotic stewardship program that employs combined strategies reducing the number of doses and spectrum is essential. Reducing hospital exposure by ambulatory care and short-stay procedures aids in this task, but, when ...
Source: Current Treatment Options in Infectious Diseases - May 6, 2017 Category: Infectious Diseases Source Type: research

Role of Human Factors Engineering in Infection Prevention: Gaps and Opportunities
Opinion statementHuman factors engineering (HFE), with its focus on studying how humans interact with systems, including their physical and organizational environment, the tools and technologies they use, and the tasks they perform, provides principles, tools, and techniques for systematically identifying important factors, for analyzing and evaluating how these factors interact to increase or decrease the risk of Healthcare-associated infections (HAI), and for identifying and implementing effective preventive measures. We reviewed the literature on HFE and infection prevention and control and identified major themes to do...
Source: Current Treatment Options in Infectious Diseases - May 6, 2017 Category: Infectious Diseases Source Type: research

Simplifying HAART: the Role of Two-Drug Therapy
Opinion StatementSince 1996, triple-drug combinations consisting of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) plus either a ritonavir-boosted protease inhibitor, a non-nucleoside reverse transcriptase inhibitor or recently, an integrase inhibitor have been considered the standard of care for treatment of HIV-infected individuals. As patients ’ life expectancy has increased, an increasing rate of comorbidities has been reported. Cumulative toxicity and cost have become an important concern motivating new research exploring alternative antiretroviral treatment strategies. In different clinical tria...
Source: Current Treatment Options in Infectious Diseases - May 6, 2017 Category: Infectious Diseases Source Type: research

Human Hookworm Disease: Alternative Strategies to Achieve the Global Health Agenda for Elimination
Opinion statementThis year marks the fifth anniversary of the World Health Organization ’s roadmap and the activities spearheaded by the coalition Uniting to Combat Neglected Tropical Diseases for the control and elimination by the year 2020 of these diseases. It also marks a decade of integrated scaled-up mass drug administration efforts supported by the US Agency for International Development. Through the 2012 London Declaration for NTDs, the soil-transmitted helminths were targeted for control through mass drug administration (MDA) or preventive chemotherapy, together with basic sanitation and clean water (WASH). Howe...
Source: Current Treatment Options in Infectious Diseases - May 4, 2017 Category: Infectious Diseases Source Type: research

Implementing Hand Hygiene Programs in Hospitals with Limited Resources
Opinion StatementHealth care-associated infections can affect up to a third of all patients in low- and middle-income countries and represent a serious financial burden. Nevertheless, their control by means of hand hygiene faces various obstacles in this context such as the lack of adequately chlorinated water supplies, poor access to alcohol-based hand rub, lack of proper regulations and guidelines, and the scarcity of data on the impact of the hand hygiene programs on health care-associated infections in this setting. Notwithstanding the foregoing, there have been numerous efforts to implement strategies to improve hand ...
Source: Current Treatment Options in Infectious Diseases - May 3, 2017 Category: Infectious Diseases Source Type: research

What ’s New in the Diagnosis and Treatment of Orthopedic Prostheses-Related Infections
Opinion statementPeriprosthetic joint infection (PJI) is one of the leading cause of failure in prosthetic joint surgery regardless the implantation site, causing an important burden to hospitals and society. Diagnosis is challenging, as there is lack of a gold standard test. When it is diagnosed within 30  days of onset or if the etiology is hematogenous with either a susceptible or non-virulent microorganism, the recommended surgical management option is debridement and irrigation, followed with antimicrobial treatment in order to preserve the device, with different reported success rates. In those cases of delayed and ...
Source: Current Treatment Options in Infectious Diseases - May 3, 2017 Category: Infectious Diseases Source Type: research

HIV-1 Integrase Inhibitors Resistance: Update of the Current Literature
Opinion statementIntegrase strand transfer inhibitors (INSTIs) have become the most important class of anti-HIV-1 drugs used as third element of the classic three-agent regimen. In addition, they have become pillars of simplified therapeutic schemes. They represent a fundamental resource which cannot be misused. In particular, the most worrisome risk is the occurrence of class resistance that could prevent physicians from employing this impressive weapon in the anti-HIV-1 armamentarium. A precise insight into mechanisms and pathway of resistance is necessary to use these drugs wisely. Pending the advent of new-generation I...
Source: Current Treatment Options in Infectious Diseases - February 26, 2017 Category: Infectious Diseases Source Type: research