HIV and ID Observations

April 25th, 2011

FEM-PrEP: A Set Back in HIV Prevention Research

HIV prevention has been on such a roll recently that the recent negative news from the FEM-PrEP study came as something of a surprise.  Bottom line: Following a scheduled interim review of the FEM-PrEP study data, the Independent Data Monitoring Committee (IDMC) advised that the FEM-PrEP study will be highly unlikely to be able to […]

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April 1st, 2011

Clindamycin or Cephalexin for (Mostly) MRSA?

Over on the Journal Watch Pediatrics site, there’s a summary of a study that compared clindamycin with cephalexin for purulent skin infections in kids age 6 months to 18 years.  The results? MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) were isolated from 70% and 19% of children, respectively … The primary outcome — clinical improvement at […]

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March 30th, 2011

Journal Club: Even When You Think You Should Wait, It’s Probably Time to Start

Two papers just published in AIDS with relevance to the “when to start” antiretroviral therapy question. Both apply to certain patients in whom we might consider waiting to start treatment– but both these studies suggest we do otherwise. The first applies to the patients with slooooow CD4 decline. Perhaps so slow that both you and […]

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March 26th, 2011

Zoster Vaccine for Age 50 and Up? A Resounding “Yea” Vote Here

I was getting off the elevator at the hospital the other day, and a cardiologist greeted me with the phrase every ID doctor in the world will instantly recognize: Can I ask you a quick question? It was actually a series of questions, and, as is often the case, it wasn’t so “quick”.  But I […]

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February 17th, 2011

Zinc May Work for Colds — But Don’t Pretend It’s Not a Drug

Does zinc work for colds? Apparently it does, according to this Cochrane Review.  From the “Plain Language Summary”: This review identified 15 randomized controlled trials, enrolling 1360 participants of all age groups, comparing zinc with placebo (no zinc). We found that zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the […]

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February 14th, 2011

Pspring Training Pseudomonads

A few ID/HIV issues to ponder as we welcome back the most important sport in the universe: Interesting new Guidelines on UTIs from IDSA — especially their recommendations not to use fluoroquinolones for uncomplicated cystitis and to promote nitrofurantoin for 5 days to first-line for this indication. And welcome to fosfomycin — though this could eliminate […]

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January 26th, 2011

Insurance Company Cheese Shop Redux

I had an interesting exchange with one of our nurses this week about a long-term patient of ours. The e-mails went something like this: Got a fax from —-‘s insurance that his Lipitor won’t be covered anymore.  They will cover simvastatin, lovastatin, and pravastatin.  Let me know what you want to do. Charlie He’s on […]

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January 6th, 2011

Thursday Thienamycins

Plenty going on in the ID, HIV, and (for the middle of winter) baseball worlds: Just out in CID, there’s a comprehensive review of Management of MRSA as part of the IDSA’s Practice Guidelines Series. Soft tissue infections, bacteremia, endocarditis, pneumonia, bone and joint infections, frequent relapses …  MRSA in all its painful glory. Some […]

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January 2nd, 2011

2011: A New Meaning for “Antiviral”

January 1, 2011 Dear Lake Superior State University, Clinicians are particularly concerned about this year’s “List of Words Banished from the Queen’s English for Mis-use, Over-use and General Uselessness“, as topping the list was the word, viral. One nominator said: Events, photographs, written pieces and even occasional videos that attracted a great deal of attention once […]

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December 17th, 2010

Update on Berlin Patient II: Still Cured of HIV

First, who was Berlin Patient I? Second, over in the journal Blood is the latest update on Berlin Patient II, the guy apparently cured of HIV by bone marrow transplantation: We have previously reported the case of an HIV-infected patient in whom viral replication remained absent despite discontinuation of antiretroviral therapy after transplantation with CCR5Δ32/Δ32 […]

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