Research Roundup: COVID; Azithromycin; Flu; Fluoroquinolones; ASB; Chronic Wasting Disease

CIDRAP: No Benefit Found From Treating COVID Patients With Azithromycin
A randomized controlled trial in Brazil found that adding azithromycin to standard of care treatments did not improve clinical outcomes in patients with severe COVID-19, according to a study published late last week in The Lancet. In the open-label, randomized clinical trial, investigators at 57 Brazilian hospitals enrolled patients admitted to the hospital with COVID-19 and at least one indication of severe disease, including the use of supplemental oxygen or invasive or non-invasive mechanical ventilation. All patients in the study were randomly assigned 1:1 to treatment with the standard of care, which included the antimalaria drug hydroxychloroquine, or standard of care plus azithromycin (500 milligrams once daily for 10 days). (9/8)

CIDRAP: Kids With COVID-19, Flu Equally Prone To Severe Illness 
A single-center study of 315 pediatric COVID-19 patients and 1,402 children with seasonal flu identified no difference in rates of hospitalization, intensive care unit (ICU) admission, or mechanical ventilation between the two groups. The retrospective cohort study, published today in JAMA Network Open, compared the clinical characteristics of children diagnosed as having coronavirus from Mar 25 to May 15, 2020, with those diagnosed with flu from Oct 1, 2019, to Jun 6, 2020, at Children's National Hospital in Washington, DC. (Van Beusekom, 9/8)

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CIDRAP: Link Between Fluoroquinolones, Aorta Problems May Not Be As Strong As Thought 
Two studies published today in JAMA Internal Medicine suggest observed links between use of fluoroquinolone antibiotics and increased risk of a bulging or rupture of the largest artery in the body may not be as strong as previously reported. In one the studies, US and Canadian researchers found that patients receiving fluoroquinolones for pneumonia had an increased risk of hospitalization for aortic aneurysm or aortic dissection (AA/AD) compared with those who received azithromycin, while patients who received fluoroquinolones for urinary tract infection (UTI) were not at greater risk for AA/AD compared with those who received trimethoprim and sulfamethoxazole. The overall incidence of AA/AD in all patients studied was extremely low. (Dall, 9/8)

CIDRAP: Urinary Culture Intervention Linked To Lower Antibiotic Prescribing
An intervention to reduce antibiotic treatment for asymptomatic bacteriuria (ASB) at a Toronto hospital was safe and associated with reduced exposure to unnecessary antibiotics, Canadian researchers reported this week in Infection Control and Hospital Epidemiology. In a prospective observational study conducted at Mount Sinai Hospital in Toronto, which implemented an intervention in 2013 to stop processing midstream urine cultures (MSUs) from patients unless the laboratory was called, researchers interviewed 1,678 patients with an MSU order on days 0 and 4 to ask about urinary symptoms and any adverse events. From 2017 to 2019, day 30 follow-up was added. (9/4)

MSphere: Study Suggests Rocky Mountain Wood Ticks Not A CWD Vector
Chronic wasting disease (CWD) is an emerging and fatal contagious prion disease that affects cervids, including mule deer, white-tailed deer, black-tailed deer, red deer reindeer, elk, and moose. CWD prions are widely distributed throughout the bodies of CWD-infected animals and are found in the nervous system, lymphoid tissues, muscle, blood, urine, feces, and antler velvet. The mechanism of CWD transmission in natural settings is unknown. Potential mechanisms of transmission include horizontal, maternal, or environmental routes. (Shikiya et al, 9/1)