HIV and ID Observations

June 17th, 2012

For Inpatients, HIV Medication Errors Common — Then Promptly Corrected

Several papers have shown that antiretrovirals may be incorrectly prescribed for hospitalized patients with HIV. How do they do at Johns Hopkins — the site of one of the best comprehensive HIV programs in the country (and perennial US News and World Report #1 Hospital in the Universe)? As described in a new CID paper, investigators reviewed […]

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June 15th, 2012

ID Learning Unit — The D Test

I suppose it’s not surprising that we’d follow-up the Etest with the D test, though perhaps if I were being alphabetical, the order would have been reversed. The D test is important, because it screens for a form of clindamycin resistance in MRSA that might otherwise not be detected — the “inducible” kind, which can […]

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June 12th, 2012

ID Learning Unit — The Etest

Every year I attend on the general medical service, so it gives me a chance to work directly with the medical residents — and to brush up on my non-ID-related Internal Medicine. In exchange for what they teach me, each day on rounds I try to tell them about at least one ID-related thing that […]

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June 6th, 2012

A Fun Internet Poll for ID Nerds

Over on Medscape, one of my ID heroes, John Bartlett, has a new series called, “The Medscape Awards in Infectious Diseases” and it looks like a winner. Here’s how it works: The Medscape Awards in Infectious Diseases is a new series that will honor the greatest achievements in the field of infectious diseases during 1980-2012. […]

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June 2nd, 2012

Cryptococcal Meningitis Study Stopped — Early HIV Therapy Clearly Harmful

From NIAID, an important clinical trial has been stopped early: The Phase IV study … was evaluating whether HIV-infected participants hospitalized with cryptococcal meningitis (CM) but not yet taking antiretroviral therapy (ART) would improve their chances of survival if they began ART while receiving CM treatment as inpatients compared with the standard practice of beginning […]

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May 30th, 2012

Little Fluffy Baby Chicks Spread Deadly Intestinal Infection

Sorry for the headline, but that was the first thing I thought of when reading this paper just published in the New England Journal of Medicine: In this report, we describe a prolonged and ongoing multistate outbreak of human salmonella infections primarily affecting young children and linked to contact with live young poultry from a […]

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May 25th, 2012

Generic Nevirapine Now Available — But the Big One is Next Year

As I’m sure you’ve heard from your patients — as I did — lamivudine (3TC) is now available generically. Now comes news of the release of several generic formulations of nevirapine (NVP), an effective but always somewhat overshadowed medication. Since its approval way back when in 1996, there has always been a solid reason to […]

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May 20th, 2012

News on HIV and HCV Testing, and in Praise of Accurate Screening Tests

Two recent news items reminded me how lucky we are to have some very accurate screening tests for certain infectious diseases. The news: An expert FDA panel backed approval of the first true home test for HIV, the OraQuick mouth swab test. Approval of OraQuick for home use may occur later this year. While home […]

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May 16th, 2012

Azithromycin Linked to Cardiovascular Death — Not A Placebo After All

I’ve commented before about azithromycin, that remarkable antibiotic that clinicians seem to prescribe for, gosh, you-name-it. But a paper just published in the New England Journal of Medicine links use of azithromycin to an increased risk of cardiovascular death, a reminder that “azithro” is in fact a drug — and that all drugs have side […]

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May 7th, 2012

Difficulties and Differences on C difficile

Some things in our field — diseases, treatments, generalizations, cliches, fads — have really changed since back in the early 1990s, when I started in this business. Here are a few that quickly come to mind: “Double coverage” of pseudomonas with a beta lactam plus an aminoglycoside was de rigueur MRSA was an inpatient concern […]

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