Research Roundup: Covid, Antibiotic Use; Proton Pump Inhibitors; And Flu

CIDRAP: SARS-CoV-2 Reinfects 5 In Nursing Home, Causing Worse Disease, 1 Death
Five residents of a skilled nursing facility in Kentucky were likely reinfected with COVID-19, and the disease was worse the second time, with one patient dying, according to today's Morbidity and Mortality Weekly Report (MMWR).Between the two outbreaks, which were reported in July and October 2020, each resident had at least four negative reverse-transcription polymerase chain reaction (RT-PCR) tests. (2/26)

New England Journal of Medicine: Dexamethasone In Hospitalized Patients With Covid-19
In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. (The RECOVERY Collaborative Group, 2/25)

CIDRAP: Evidence Conflicts Over Efficacy Of Monoclonal Antibodies In Severe COVID
The New England Journal of Medicine yesterday published two studies on the effectiveness of the interleukin-6 receptor antagonists tocilizumab and sarilumab in severely ill adult COVID-19 patients, one finding a benefit to a combination of the two drugs and the other showing no benefit with tocilizumab alone. The first study, led by researchers at Imperial College London as part of an ongoing international platform trial, involved randomly assigning 803 patients in 113 intensive care units (ICUs) in six countries to receive tocilizumab, sarilumab, or usual care from April (tocilizumab) and June (sarilumab) through November 2020. (Van Beusekom, 2/26)

American Academy Of Pediatrics: Factors Associated With Severe SARS-CoV-2 Infection 
Initial reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in children suggested that very young age and comorbidities may increase risk of severe evolution, but these findings remained to be confirmed. We aimed to analyze the clinical spectrum of hospitalized pediatric SARS-CoV-2 infection and predictors of severe disease evolution. (Ouldali et al, 3/1)

American Academy Of Pediatrics: Suicide Ideation And Attempts In A Pediatric Emergency Department Before And During COVID-19 
Elevated rates of mental health concerns have been identified during the coronavirus disease 2019 (COVID-19) pandemic. In this study, we sought to evaluate whether youth reported a greater frequency of suicide-related behaviors during the 2020 COVID-19 pandemic as compared with 2019. We hypothesized that rates of suicide-related behaviors would be elevated between the months of March and July 2020 as compared with 2019, corresponding to the onset of the COVID-19 pandemic. (Hill et al, 3/1)

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CIDRAP: National Safety Program Linked To Reduced Hospital Antibiotic Use 
Implementation of a national safety program that helps US hospitals to establish antibiotic stewardship programs (ASPs) and clinicians to improve their antibiotic decision-making was associated with reduced antibiotic use and fewer hospital-onset Clostridioides difficile infections, according to a study today in JAMA Network Open. The study, conducted by researchers with the Johns Hopkins University School of Medicine, the University of Chicago, and the Agency for Healthcare Research and Quality (AHRQ), evaluated the impact of AHRQ's Safety Program for Antibiotic Use, which was established in 2017 to support hospitals in their efforts to establish ASPs and successfully implement stewardship principles. ASPs have been associated with reduced antibiotic use in individual hospitals across the country. (Dall, 2/26)

CIDRAP: Report Examines Social Science Insights On Antibiotic Use
The London School of Hygiene and Tropical Medicine (LSHTM) yesterday released a new report on antibiotic use in low- and middle-income countries (LMICs) that focuses on social science research and the emerging insights on novel ways to address antimicrobial resistance (AMR). The report from LHSTM's Fresh Approaches to the Study of Antimicrobials in Society project examines antibiotic use in LMICs through three different lenses: practices, structures, and networks. The idea behind the report, which combines insights gleaned from a growing body of published social science research into AMR and from a series of panel discussions held in 2020, is to formulate ideas of how these insights can be used to develop local interventions for addressing human and animal antibiotic use in a diverse range of settings. (2/25)

CIDRAP: Danish Study Finds Link Between Community C Diff, Proton Pump Inhibitors
A nationwide study in Denmark found an association between the use of proton pump inhibitors (PPIs) and increased risk of community-associated Clostridioides difficile infections (CA-CDI), Danish researcher reported today in Clinical Infectious Diseases. For the study, researchers from Denmark's Statens Serum Institute used the Danish National Microbiological Database to identify all incident episodes of CA-CDI in Danish adults from February 2010 through December 2013. They obtained data on filled prescriptions for PPIs, which neutralize or reduce the production of gastric acid, from the Danish National Prescription Registry. (2/25)

CIDRAP: WHO Experts Swap Out 2 Flu A Strains For Next Northern Hemisphere Vaccine
The World Health Organization (WHO) today announced that its influenza vaccine strain selection committee has made its recommendations for the Northern Hemisphere's 2021-22 flu season, which swaps out the two influenza A strains for both the egg-based and cell-based or recombinant vaccines. For the egg-based vaccines, they recommend replacing the current 2009 H1N1 vaccine strain (A/Guangdong-Maonan/SWL1536/2019) with A/Victoria/2570/2019 and replacing the current H3N2 component (A/Hong Kong/2671/2019) with A/Cambodia/e0926360/2020. (2/26)