HIV and ID Observations

March 25th, 2009

March (Guideline) Madness …

A couple of interesting ID guidelines out this week.  For those of you too busy with basketball, here are the relevant links: Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities. Identified in 24 states and now found “routinely” in New York and New Jersey, these carbapenem-resistant Enterobacteriaceae (“CPE” is much […]

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February 26th, 2009

Meningococcal Resistance to Ciprofloxacin

Ciprofloxacin-resistant Neisseria meningitidis has now been documented in the United States. Here’s a nice summary in Journal Watch, with two different perspectives. I suppose we shouldn’t be surprised, but it did take a while.  (At least compared to that other famous neisseria-bug, Neisseria gonorrhoeae.) Oh well. Why is this important?  As every practicing ID doc/primary care provider/public health […]

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February 13th, 2009

CROI 2009: Greatest Hits

Fresh back from lovely Montreal, where the temperature (I’m glad to report) climbed into the balmy 40’s … Here’s a rapid-fire listing of the Greatest Hits.  As I’m sure to be leaving something off this list, happy to accept other suggestions: Interleukin-2 does not work.  The ESPRIT and SILCAAT studies are over. Yes, the CD4’s increase, but […]

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January 29th, 2009

Too Many Options: What Actually Happened

We recently published a case in AIDS Clinical Care entitled “Too Many Options”, describing a patient with longstanding HIV infection, virologic failure, and resistance to NRTIs, NNRTIs, and PIs. Fortunately, resistance and tropism testing gave him several options for a new drug regimen — including darunavir, etravirine, maraviroc, enfuvirtide, and — if one believes phenotypic NRTI […]

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January 13th, 2009

Can We Have “Too Many Options?”

As part of our regular series “Antiretroviral Rounds” in AIDS Clinical Care, today we post a case of a highly treatment-experienced patient with dreaded “triple class” resistance — that is, resistance to NRTIs, NNRTIs, and PIs. The good news now, of course, is that we have more than these three drug classes. The tough part is choosing […]

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December 31st, 2008

Free Antibiotics!!!

Yes, the northeast supermarket/pharmacy chain Stop & Shop will now offer antibiotics — for free.  (And they are not the first.  Take a look at this amazing advertisement.) Says Stop & Shop’s “consumer advisor” Andrea Astrachan: Stop & Shop pharmacies are committed to improving the health and wellness in our communities during the winter season when families are susceptible to coughs, […]

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December 23rd, 2008

Flu Resistance to Oseltamivir: The Bugs Win Again

I must admit, the recent report that 49 of the 50 H1N1 flu viruses tested by the CDC are resistant to oseltamivir caught me by surprise.  For the non-math majors among the readership, that’s a 98% resistance rate.  Yikes. Actually, the rate of resistance is so high that at first I didn’t believe it when my wife […]

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October 27th, 2008

Antibiotics as Placebos?

This article in the BMJ is geting lots of news:  Out of 679 practicing physicians in the United States, about half admitted to prescribing placebos on a regular basis.  A “small but notable proportion (13%) of physicians reported using antibiotics.” My first instinct was surprise that the rate was this low, but then I remembered that public […]

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April 23rd, 2008

Antiretrovirals in the Pipeline: And Then There Were … None?

The flurry of drug approvals that began in 2005 with tipranavir – followed rapidly by darunavir, maraviroc, raltegravir, and most recently etravirine – has been nothing short of astounding. Every experienced HIV clinician now has many patients who are on successful (read: suppressive) treatment for the first time ever. The Vancouver HIV program — wonderfully called […]

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