April ID Update

Sanford Guide ID Update features current developments in infectious diseases, curated by the Sanford Guide Editorial Board. Links marked with an asterisk (*) provide details to Web Edition subscribers, while all other links are universal. If you received this message from a colleague, subscribe now.
 

April 2019
 

Improved Sanford Guide Organization & Features

  • Web Edition* and mobile apps for Antimicrobial Therapy and Collection:
    • Activity Spectra tables may now be accessed from the main menu level on both the web edition and mobile app.
    • The Tables & Tools menu has been reorganized to correspond with the categories and structure found on drug pages.
    • new drug-drug interaction (DDI) table can be found in Tables & Tools under Drug Interactions.

New Drug Approvals

  • Dovato (dolutegravir 50 mg + lamivudine 300 mg), a two-drug fixed-dose regimen for the treatment of HIV-1 infection in adults who are ARV treatment-naive with no known or suspected resistance mutations to DTG or 3TC. Recommended dosage: one tablet once daily, with or without food.

New or Updated Treatment Guidelines

  • Guidelines on the optimization of beta-lactam treatment in ICU patients from The French Society of Pharmacology and Therapeutics (SFPT) and the French Society of Anaesthesia and Intensive Care Medicine (SFAR) (Crit Care 23:104, 2019). The guidelines are available on the journal website.
  • Guidelines for empiric and targeted antimicrobial therapy of complicated intra-abdominal infections (cIAI) from the 2018 Lebanese Society of Infectious Diseases and Clinical Microbiology (BMC Infect Dis 19:293, 2019). The guidelines are availalbe on the journal website.
  • Updated clinical guidelines for the diagnosis and treatment of HIV/AIDS in HIV-Infected Koreans from the Committee for Clinical Guidelines for the Diagnosis and Treatment of HIV/AIDS of the Korean Society for AIDS (Infect Chemother 51:77, 2019). These guidelines update the 2015 version are are available on the journal website.
  • Clinical management guidelines for the management of acute appendicitis in adults from the Eastern Association for the Surgery of Trauma (J Trauma Acute Care Surg 2019 Mar 22 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention and management of blastomycosis, histoplasmosis and coccidioidomycosis in the pre- and post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 29 [Epub ahead of print]).
  • Updated guidelines for the management of vancomycin-resistant enterococci (VRE) infections in solid organ transplant candidates and recipients from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 26 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention and management of diarrhea in the pre- and post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 26 [Epub ahead of print]).
  • Updated clinical practice guidelines for the management of asymptomatic bacteriuria from the Infectious Diseases Society of America (Clin Infect Dis 2019 Mar 21 [Epub ahead of print]). These guidelines update the 2005 version and are available on the IDSA website.
  • Updated guidelines for the management of Clostridioides (Clostridium) difficile infection in surgical patients from the World Society of Emergency Surgery (World J Emerg Surg 14:8, 2019). These guidelines update the 2015 version and are available on the journal website.
  • Position statement on the management of hepatitis C virus infection in patients with chronic kidney disease from a joint committee of the Italian Association for the Study of the Liver (AISF), Italian Society of Internal Medicine (SIMI), Italian Society of Infectious and Tropical Disease (SIMIT), and the Italian Society of Nephrology (SIN) (Infection 47:141, 2019).
  • Updated guidelines for the management of sepsis in neutropenic cancer patients from the Infectious Diseases Working Party (AGIHO) and Intensive Care Working Party (iCHOP) of the German Society of Hematology and Medical Oncology (DGHO) (Ann Hematol 2019 Feb 22 [Epub ahead of print]). The guidelines update the 2013 version and are available on the journal website.
  • Guidelines for the treatment and management of women living with HIV in the UK during pregnancy and postpartum, and their infants, from the British HIV Association (HIV Med 20 Suppl 3:s2, 2019). The guidelines are available on the journal website.
  • Clinical practice guidelines for the provision, monitoring and support of pre-exposure prophylaxis (PrEP) for the prevention of
    HIV acquisition from the British HIV Association and the British Association for Sexual Health and HIV (HIV Med 20 Suppl 2:s2, 2019). The guidelines are available on the journal website.
  • Updated guidelines for the diagnosis, prevention and management of cryptococcosis in the pre- and post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 22 [Epub ahead of print]).
  • Updated guidelines for the epidemiology, diagnosis, and management of Aspergillus in solid organ transplant recipients from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 21 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention and management of tissue and blood protozoal infections in the pre- and post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 21 [Epub ahead of print]).
  • Updated guidelines for the diagnosis and management of pneumonia in the post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 21 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention, and management of adenovirus infection after solid organ transplantation from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 12 [Epub ahead of print]).
  • Updated guidelines on BK polyomavirus infection, replication, and disease from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 12 [Epub ahead of print]).
  • Updated guidelines for the epidemiology, diagnosis, and management of emerging fungal infections in solid organ transplant recipients from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 12 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention, and management of herpes simplex virus infection in the pre- and post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 12 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention, and management of HHV-6A, HHV-6B, HHV-7, and HHV-8 in the pre- and post-transplant period from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Mar 7 [Epub ahead of print]).
  • Updated guidelines for the screening, diagnosis, prevention, and treatment of cytomegalovirus in organ transplant recipients, from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Feb 28 [Epub ahead of print]).
  • Updated guidelines on potential drug-drug interactions between anti-infectives and immunosuppressants, from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Feb 28 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention, and management of tuberculosis in the pre- and post-transplant period, from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Feb 28 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention, and management of Nocardia infections after solid organ transplantation, from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Feb 28 [Epub ahead of print]).
  • Updated guidelines for the diagnosis, prevention, and management of RNA respiratory viral infections in the pre- and post-transplant period, from the Infectious Diseases Community of Practice of the American Society of Transplantation (Clin Transplant 2019 Feb 28 [Epub ahead of print]).

From CDC

  • Now that IV quinidine has been discontinued by the manufacturer and is no longer available, artesunate (the WHO-recommended first-line treatment) is now first-line treatment for severe malaria in the US. IV artesunate is neither FDA-approved nor commercially available in the US, but it has been available from CDC since 2007. For details on how to obtain IV artesunate and other FAQs a Malaria Notice has been posted.

Weekly Practice Pearls

  • In resource-limited countries, prolonged treatment courses of amphotericin B for infections such as cryptococcal meningitis in patients with HIV can be challenging to administer safely and effectively. In a phase 2 noninferiority trial conducted in Tanzania and Botswana, induction therapy with a single dose of liposomal amphotericin B (10 mg/kg) in combination with high-dose oral fluconazole (1200 mg daily for 2 weeks) was well tolerated and found to be noninferior to 2 weeks of once-daily liposomal amphotericin B (3 mg/kg) plus oral fluconazole for the primary outcome measure of mean rate of fungal clearance from the CSF. This short-course treatment strategy is now being studied in a phase 3 clinical endoint trial (Clin Infect Dis 68:393, 2019).

Drug Shortages (US)

  • Antimicrobial drugs or vaccines in reduced supply or unavailable (as of April 7, 2019) due to increased demand, manufacturing delays, product discontinuation by a specific manufacturer, or unspecified reasons:
    • [New on the list since March 31]: None
    • [Shortage recently resolved]: Ciprofloxacin injection
    • [Continue to be in reduced supply]:
      • Aminoglycosides: Amikacin injection, Gentamicin ophthalmic ointment (unavailable), Tobramycin injection
      • Carbapenems: Meropenem injection
      • Cephalosporins: Cefazolin injection, Cefepime injection, Cefotaxime injection (unavailable), Cefoxitin injection, Ceftazidime injection, Ceftriaxone injection, Cefuroxime injection
      • Fluoroquinolones: Ciprofloxacin 0.3% ophthalmic solution, Ciprofloxacin oral suspension, Gemifloxacin tablets
      • Glyco-, glycolipo-, lipopeptides: Daptomycin injection, Vancomycin injection
      • Macrolides/azalides: Azithromycin injection, Azithromycin ophthalmic solution 1% (unavailable), Erythromycin lactobionate injection (unavailable), Erythromycin 0.5% ophthalmic ointment
      • Penicillins: Ampicillin/sulbactam injection, Piperacillin/tazobactam injection
      • Other antibacterials: Clindamycin injection, Metronidazole injection, Mupirocin calcium 2% cream, Mupirocin calcium 2% nasal ointment (unavailable), Nitrofurantoin oral suspension
      • Antifungal drugs: Amphotericin B injection (unavailable), Clotrimazole 10 mg oral troches, Fluconazole injection, Nystatin oral suspension (unavailable)
      • Antiparasitic drugs: Pentamidine isethionate
      • Antiretroviral drugs: Nelfinavir tablets (unavailable)
      • Antiviral drugs: Cidofovir injection (unavailable), Letermovir injection (unavailable), Valganciclovir oral powder for solution
      • Vaccines: Hepatitis A virus vaccine inactivated, Hepatitis B vaccine recombinant, Zoster vaccine recombinant (Shingrix), Yellow Fever vaccine (YF-VAX is unavailable, but Stamaril can be obtained through a limited number of clinics in the US. Click here).
  • Antimicrobial drugs newly discontinued: Quinidine gluconate IV (in December 2017). Product distribution will continue until expiration of current stock (March 2019).
    • Recent discontinuations: Terbinafine granules (in May 2017), MenHibrix (in February 2017), Elvitegravir (Vitekta, in December 2016), Peginterferon alfa-2b (in February 2016; 50 mcg vials still available in limited quantities), Boceprevir (in December 2015), Permethrin 1% topical lotion (in September 2015)